G-HSV1 Prodome

[Westerby]

I'm a male in my 30s with genital hsv-1. I've had it for about 5 years now - after the primary outbreak I had another one about 6 months later. Since then, I've not had any visible outbreaks. In the past year I've been taking 500 MG of Valacyclovir every day because I want to take every available precaution to protect my partner, who is hsv negative. We use condoms always as well. In the last week or so I've been experiencing a tingling in my genital region and on and off mild burning/tinges. It's not consistent, but I feel it every now and again. I keep inspecting myself very closely and don't see any sores, blisters or even any redness. Nonetheless, I've read this may be what's known as prodome.
I've very panicked because, over the weekend, my girlfriend and I got drunk and stupidly had sex. It was protected for the most part, though the condom broke at one stage and i was inside her before I noticed what had happened. Anyway it was really stupid to have sex while I was having these aches and tingles, and now I'm scared that I was contagious while we had sex.
Do people with ghsv1 on Valacyclovir daily still get outbreaks or prodomes that you've seen?
Do people with ghsv1 still get prodomes even if you take suppressant medications daily?
What do you think the chances are that that's what this is?
What do you think the chances are that I've passed this on? My partners is fine so far -- but it was only this weekend.
I've noticed that Dr Hansfield on certain posts has said before that higher dosages of valtex is required for HSV1 to be effective. The Herpes handbook says if you get less than 9 obs a year, you should take 500mg of Valacyclovir a day. Is Dr Hansfield contradicting the herpes handbook? Should I be taking more?
Lastly, if ghsv1 is steadily on the rise, why aren't there studies being done on it?

[Terri Warren, RN, Adult Nurse Practitioner]

It isn't that you are infectious all the time, it is that you are potentially infectious at any time.  There is a difference.  No, Viagra or similar drugs would not trigger outbreaks.

Terri

[Westerby]

Final question: would erectile dysfunction drugs such as Viagra or cialys potentially trigger genital herpes outbreaks?

[Westerby]

Thanks for the feedback.
So assuming that I've been experiencing prodomal symptoms (does it sound like it?) would that mean that I've been contagious the whole time?

[Terri Warren, RN, Adult Nurse Practitioner]

Certainly, the medicines you are taking reduce the risk of both transmission and outbreaks.  However, the medicines are not perfect and you could get prodromal symptoms even while taking medication.  Yes, the medicine is slightly more effective for HSV 2 than HSV 1, I agree with Hunter, but the difference is not big.  

The hand book statistics deal with HSV 2, not HSV 1, for the directions on how much to take.  There are not my suggestions, these are the FDA approved guidelines for taking Valtrex.  I don't think taking more would help you, honestly.

HSV 1 genitally is really tough to study because the outbreaks are so infrequent (as you know from your own experience) and shedding is quite low.  Just far tougher to do clinical trials and see differences when people have HSV 1 genitally vs. HSV 2.

I think you are doing all that you can and you are being very conscientious.  Just keep doing what you are doing.

Terri