primary outbreak and transmission questions

[tes77]

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.

[tes77]

Thanks for the reply and the reminder about increasing my Valtrex. Those same directions are on my presciption bottle. However, since my brain has definitely not been thinking clearly lately, it didn't even occur to me. Guess I'm just surprised about the supposed ob. Do you think I should increase the Valtrex even though I'm not sure what it is? My symptoms are not horrendous and I just got my period today, but I want to take the medication correctly. I called my provider and scheduled an appt. for Friday. I wish I had remembered about increasing the Valtrex so I could have asked that question while I was on the phone with them today. I'm truly appreciative of your knowledge.

[gracefromHHP]

About half of folks have a recurrence within 2 months of the first one - pretty common.  It might not even be your herpes even.  If you still have symptoms or they get worse after your period - see your provider to get checked for yeast and bacterial infections.  When you think you have a recurrence - you increase your valtrex to 500mg 2x/day for 3 days.

The herpes handbook at www.westoverheights.com has terrific info as does the www.ashastd.org site.  Also the valtrex website itself has some wonderful information - especially if you go under the for healthcare providers section.  There are some instructional sections there that I think are really worthwhile for non-medical folks to watch and learn from.  

grace

[tes77]

Thanks for the info. Wish I had been smart enough to insist on STD testing prior to this. I was definitely in a state of temporary insanity over the last year and a half when it came to sex. I can't believe I was so careless about unprotected sex with the partner I was with. I mean, I was way more conscientious about that even with my ex-husband.

Maybe I was confused about the provider's explanation of Valtrex losing its effectiveness for reducing transmission after a year of usage, but I thought that's what I heard. Glad to hear differently. Could you recommend any websites, studies, etc. that I could get more information from?

I may become a huge fan of suppressive therapy too! Not that this is great news, but I think I am getting, or have gotten, a reocurring ob. Had some mild itchiness, irritation and discharge over the past couple days, but thought it was maybe due to my oncoming period. Checked down below today and thought I saw 2-3 tiny bumps on one side of my vaginal wall. Same place as original ob, but that was bilateral. If this is the only discomfort I'm going to get, I have to say, I'll be so relieved! I'm wondering if the difference in pain felt in my first ob compared to this one (if this in fact is an ob) is due to suppressive therapy with Valtrex or if this is just the way my obs will reocurr? Since my first ob ocurred at the beg. of Apr. and lasted until the beg. of May, isn't it unusual to have another so soon? I guess it's probably different for everybody, but you know, it would be nice to be average when it comes to this.  

Just a note: although I'm pleased about the level of discomfort felt during this supposed ob, I'm definitely not that happy about getting a reocurrence. I was still kind of hoping this was all a big mistake.

[gracefromHHP]

Valtrex when taken suppressively continues to protect your partner - not just for 1 year and then there isn't any benefits. I'm not sure where that provider got the info on that from unless they way they explained it was confusing and they only meant that they only have info on use for 1 year in discordant couples or something?

Feel free to ask any other questions about suppressive therapy you have too.  I'm not only suppressive therapy's #1 fan - I also know a thing or two about it ;)

grace

[waringblender]

Valtrex cuts transmission risk by at least 50% if taken properly. It could be even higher than that. But it's at least 50%. That is as long as you use it correctly. Once you stop using it on a daily basis, you lose the benefit of preventing transmission to a partner.

So the one provider who told you it doesn't work is wrong. If you don't mind taking medication every day to prevent outbreaks, you can keep taking it. There are no long-term issues with the suppressive drugs. The original medication from which Valtrex was designed has been on the market for a couple of decades at least, so we know it's safe.

For future dating, I would insist on full STD testing of both of you so that you both know where you stand. You know what you have, and you need to know what your partner has. I've never had a problem with a partner refusing to be tested. (Usually they are eager because it means we can get on with having sex!) Unfortunately, I'm always meeting HSV-negative guys. :( Given how much dating I've done, it surprises me I can't meet anyone who also has it - I only use medication if I have a negative partner since I don't have any symptoms.  But about 25% of people out there have it, so it's probable you may meet someone who has it already.

[tes77]

Thanks for your suggestions. I will check them out. I don't think I need a referral to a specialist on my health plan, so that could be an option. I originally got treated at a PP, and got different information from the 2 providers I saw on 2 different occasions (different opinions on medication usage, one provider said my current partner at the time should get tested and the other provider said it didn't matter, one provider stated I would never know who I acquired it from and the other said, after listening to my history, that there was a good chance it was my partner at the time). I also called one time to speak to a provider (she was busy so the person who answered the phone said she would try to answer my questions) and again, I received different information. As I was in a state of shock at the time, it was difficult to sift through all the different opinions and make the best choices. Oh yeah, nobody ever called me with my results, so I called 1 1/2 wks later and the person who answered the phone said "No news is usually good news," put me on hold, then came back and told me I was HSV-2 positive. I honestly think they are all compassionate, intelligent people, but it was difficult to figure out which information was accurate at that crucial time.
I would really like to discuss the best course of action for my medication with a provider who is knowledgable. I'm currently using Valtrex for suppressive therapy, but have heard a lot of differing opinions about it. Transmission is not a concern at this time, but hopefully, could be in the future. I really want to avoid outbreaks as much as possible since the first was excruciating and caused me to miss work. In addition, 1 of the providers at PP said that there is no conclusive research that Valtrex cuts down on transmission after the first year of using it. Has anyone heard of this? That's a major bummer to me since I can't picture myself getting into an intimate relationship any time soon. But, I was hoping I'd eventually come to terms with it and be able to use suppressive therapy as a precaution.

Thanks also for the info. on the support groups. There is one in my state (about an hr. away) that meets once a month. I went this month and plan to go next month (if I can afford the gas, ha ha).