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primary outbreak and transmission questions

How do you know if you are having a primary outbreak or a recurrence? I've heard that in a primary outbreak, the symptoms are quite pronounced. However, being  a female and having had irritating yeast infections before, I'm wondering if what I thought was a yeast infection was actually an outbreak. However, I never had clusters of blisters before like I did just recently. Also, the subject of transmission is just so confusing. Some sources will tell you that you usually get your first outbreak within 2-14 days after transmission, others will tell you that you can get it months or years after transmission. If you have sex with somebody and have an outbreak a week later, is it safe to assume that that person transmitted the virus? Or should you also try to notify the person you had sex with three months back? This is all so confusing.
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Avatar universal
Thank you so much for your answer. It's so helpful to have this board. Whoever thought grooming could be so dangerous.
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207091 tn?1337709493
COMMUNITY LEADER
If its an outbreak, then it might last a few days to a week, give or take, and you can have sex again when the skin is back to normal.

If it isn't herpes, then it could be staph, or you nicked it when you were trimming (been there, done that lol).

Aj
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Avatar universal
Thank you so much for your prompt answer. I really appreciate it. I have upped my Valtrex dose just in case. The pimple has been there about four days. If it is a recurrence, how long should it last and how long will I be contagious? If it isn't, any ideas what it might be? I'm going to try to get seen on Thursday if it stays the same or gets worse. Thank you again for your input. Take care.
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101028 tn?1419603004
It's a 2% risk/year of him contracting hsv2 from you if you just avoid sex during obvious symptoms and you are on daily suppressive therapy. If he's ok with that risk, let him be if you are ok with ditching the condoms too at this point.  

I'd avoid sex until this lesion is healed. Up your valtrex dose to 500mg 2x/day for 3 days just in case it is herpes.  If it's still there in a few days or gets bigger, see your provider.

grace
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Avatar universal
I was wondering if anyone could help me. I recently developed what looks to be a pimple above my clitoris in the pubic hair area. Since I haven't had a recurrence since my diagnosis a year ago, I was wondering if this could be one? It's not painful or itchy and I have no other symptoms. Found it in the shower. I recently trimmed this area and was thinking it might be related. I've also been on suppressive therapy since my diagnosis. Also, I've been in a relationship for four months and wanted to make sure I was providing him with the correct info. He knows I'm on suppressive therapy and I told him that there is a 3% chance of contracting it using that alone. I informed him that used in conjunction with condoms, the risk is approx. 1%. Is this correct? He has expressed that he does not always want to use condoms and is okay with the risk. I find myself reminding him from time to time about the risks using both methods and condoms alone. Is this overkill?
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Avatar universal
Thank you so much Grace. I appreciate your help!
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101028 tn?1419603004
Just missing a day every now and then isn't an issue.

grace
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Avatar universal
Hello to all. I was so busy today that I forgot to pick up my Valtrex refill. My pharmacy is now closed.  Unfortunately, I am completely out and will not be able to take one today (I take it as supressive therapy). Does anyone know how this will affect/interfere with transmission reduction to a partner? I will pick them up tomorrow and begin taking them again. However, I will not be able to get them until around 4:30 or 5:00 p.m. Any help would be appreciated.
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101028 tn?1419603004
You will still get ob's while on suppressive therapy,  just way less which to me is always a good thing :)

grace
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Avatar universal
Thank you for your response. No, I'm certainly not complaining, but definitely hoping it stays this way. It sort of makes me afraid to ever go off of Valtrex.
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101028 tn?1419603004
valtrex is why you aren't having ob's :)

If you read their prescribing info ( available on their website ) they break it down into what % of folks don't have an ob 6 months into suppressive therapy and how many are still ob free 1 yr into suppressive therapy.  Of course none of that really matters since only time will tell how it'll be for you.

and I know you aren't complaining about not having ob's right? lol

grace
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Avatar universal
I'm not looking for trouble, but I'm wondering if it's normal to not have had a recurrence since my initial outbreak in March of '08. I have been taking daily Valtrex since that time. I'm beginning to wonder if my culture was typed incorrectly (I was told the results were positive for HSV-2). Any thoughts?
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101028 tn?1419603004
don't eat corn on the cob either on the first or 2nd dates - learned that lesson a few years ago...he he he

Yep even us old broads still have to deal with dating sometimes ;)  The older you get, the more baggage we all carry around. At least I can control my herpes with a pill or two a day - not that easy to control ex's and kids and bad habits and debt etc.  It's never as easy as boy meets girl, boy and girl fall head over heels and live happily ever after :(

grace
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Avatar universal
106?? Sounds biblical, though I can relate to the feeling. Oh the horror of eating greenery in front of a guy for the first time. There's just no good way. I guess your guy could be a keeper though as he seems to like his women au natural. Glad you got the chance to dazzle him again. Thanks for the story.

note to self: if and when there's a 2nd date, stay away from cruciferous vegetables.
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101028 tn?1419603004
Well I'm 106 and dating still isn't easy - and not for anything that has to do with my herpes!!!  I've been dating someone new for about 6 weeks now - our first date - I really was just meeting him to get it over with ( we had met online on a dating site ) and so I show up with my hair still damp for starters and I"m half asleep because I had only slept 3 hours after work that day and then I ordered a salad and broccoli. I'm sitting there with lettuce stuck in my teeth at one point and then I get freakin broccoli stuck in my teeth later on in the meal. I'm sitting there trying to keep my lips closed and suck all the produce out of my teeth without looking like a goof....lol.  I guess he didn't mind the green in my teeth - we are still going out :)  Of course up until the first face to face date I thought he had 2 kids, found out it's actually 4.  I might not be right in the head myself...he he he  Needless to say the 2nd date - I gussied myself up a bit better...he he he  

Glad your date went well :)

grace
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Avatar universal
Thanks for the reply. It was good to be reminded that I still need to be worried about a guys STD status and not just worry about how mine might affect him. Does this dating thing ever get less complicated?
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Avatar universal
:o)  

I don't recall ever telling a guy on the first date. I just want the first date to be ... well, first datey. :)

He doesn't need to know about it until the two of you are ready to have sex. But you should also ask him if he's had anything and has he ever been tested.
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Avatar universal
You are sooo right. I'm kinda jumping the gun here. Thanks for bringing me down to earth. Anyway, just got in and had a good time. Herpes was not a topic of conversation. Ha ha. I appreciate the reality check.
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101028 tn?1419603004
It's the first date - why not just worry about what you are wearing and whether you'll be a klutz and end up wearing half your dinner ?  :)

grace

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Avatar universal
I can't believe it, but I'm actually going on a date tonight. First one post herpes diagnosis, which was in April. At that point, I thought I was destined for celibacy. This situation just kind of fell into my lap. I've been getting to know him for almost a month due to work and it's progressed to this. However, I am honestly so scared about having the "talk." I know I don't have to jump right in and tell him my status and that I may not even want to sleep with him after getting to know him better. But, how have others dealt with their nerves when telling someone for the first time? I'm thinking I'll just feel so exposed.
Helpful - 0
101028 tn?1419603004
The statements on the website are known as cya statements.  In order to say anything different they would have to do more studies and go for additional FDA approval to say anything else. Not going to happen is the gist of that one.  

Terrific article by dr stephen tyring called valacyclovir, 20 years of acyclovir safety ( or something close to that ).  Your provider needs to read it.

The 8 months part is that the valtrex and reduction in transmission study was only conducted for 8 months.  They have not done long term discordant couple studies due to poor compliance in keeping people enrolled that long as well as cost.

The first year of infection we shed the virus about 3x more than we do after the first year or so on average. So yes during the first year the risk of transmission is highest.  Info from studies done has shown that couples are most likely to transmit the virus during the first 2 years of being infected but it also shows that you leave that relationship and move on to another later on - the risk is high again during the first 2 years of that relationship. Your providers reasoning is a little flawed but I certainly see where it's coming from.  

It's totally your choice what you wan tto do. I know I trust the herpes antivirals compleletely. I've been on suppressive therapy more than I haven't. I was on it for 12 years non-stop at one point - only stopped to participate in a research study.  I went right back on it when I was done.  I don't have time for ob's and I don't need to worry about my partner either.

grace
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Avatar universal
Hello. Just wanted to try to clear some things up for myself. I went to my provider on Fri. and she could not find any evidence of a reoccurence, yeast, or anything. Stated that my symptoms could be hormonal due to my period. Thought I saw something a few days before, but she said it could just be the normal bumps present in the gential area. Hope I'm not going to become a freak about this. Anyways, I brought up the subject of Valtrex and it's ability to reduce transmission after a year of usage and she said that she usually weans patients off of Valtrex after a year because there have not been any studies done that prove its effectiveness with transmission after a year. She said that the risk of transmission a year after being diagnosed goes down anyways and outbreaks tend to decrease. I was just reading the Valtrex website and read the "For Healthcare Professionals" section. Under "Reducing Transmission Risk" at the bottom of the page, it stated "No data are available on the efficacy of treatment of more than 1 year's duration (for suppression)....." It also stated that the "safety and efficacy for Valtrex for reduction in the transmission of genital herpes have only been evaluated for 8 months." So, I'm confused. Am I misinterpreting the data and what the provider said to me? I certainly hope so. Any thoughts?
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Avatar universal
Thanks so much. I'll TRY to keep that in mind. Have a nice evening.
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101028 tn?1419603004
If it's been more than 3 days - don't bother increasing your valtrex - the ob is almost over anyways then.  Just something to keep in mind for the future. I'm a fan of erring on the side of caution and increasing the meds anytime you think it might be an ob - sure beats waiting until you have a full blown ob that drives you nuts while you are waiting for it to heal.  

grace
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