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STDs (Expert Forum)
Can one with HSV2 really give/receive unprotected oral sex?
Answered by
University of Washington
Seattle - WA
Welcome to the STD Forum, which is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.
Can one with HSV2 really give/receive unprotected oral sex?
by northshore07, Mar 05, 2007 12:00AM
Dear Dr. HHH:
This forum is a breath of fresh air. Thank you in advance.
One night twenty years ago, I lost my virginity and acquired herpes in the same night. I met an incredible man who accepted me having herpes and we have been married 16 years and have two beautiful boys which I delivered vaginally. I have had minimal outbreaks, probably a total of 7-10 in 20 years. I have read, endlessly, on this site that transmitting herpes from genital to oral is very low or none at all. I have turned down my husband endlessly on performing oral sex on me and outside of an experimental time with dental dams, that was it. I was too worried that he would get oral herpes and then pass on to the children.
I am a registered nurse and wouldn’t mind if you give a medical explanation on how the virus doesn’t move from genital to oral (does it really favor specific sites in the body?). Also, I’m considering starting Valtrex 500 mg as suppressive therapy- more for peace of mind to myself than anything else. My outbreaks have been so minimal, but I don't know when they are coming on, only know when my urine hits the spot and it burns, then I know I have an outbreak. Other than when trying to get pregnant, we have used condoms. And, again, no oral sex my way. Have I really cheated myself all these years by not allowing myself to be sexually free? I look forward to your reply and thanks again.
This forum is a breath of fresh air. Thank you in advance.
One night twenty years ago, I lost my virginity and acquired herpes in the same night. I met an incredible man who accepted me having herpes and we have been married 16 years and have two beautiful boys which I delivered vaginally. I have had minimal outbreaks, probably a total of 7-10 in 20 years. I have read, endlessly, on this site that transmitting herpes from genital to oral is very low or none at all. I have turned down my husband endlessly on performing oral sex on me and outside of an experimental time with dental dams, that was it. I was too worried that he would get oral herpes and then pass on to the children.
I am a registered nurse and wouldn’t mind if you give a medical explanation on how the virus doesn’t move from genital to oral (does it really favor specific sites in the body?). Also, I’m considering starting Valtrex 500 mg as suppressive therapy- more for peace of mind to myself than anything else. My outbreaks have been so minimal, but I don't know when they are coming on, only know when my urine hits the spot and it burns, then I know I have an outbreak. Other than when trying to get pregnant, we have used condoms. And, again, no oral sex my way. Have I really cheated myself all these years by not allowing myself to be sexually free? I look forward to your reply and thanks again.
Doctor's Answer
by H. Hunter Handsfield, M.D., Mar 05, 2007 12:00AM
, Mar 05, 2007 12:00AM
Boy, there is a lot here, by your overt questions and by implication. It does seem you have let herpes rule your life far more than you should have.
Certainly genital to oral transmission of HSV-2 can occur. But as you have read, it is much less common than genital-genital transmission, and yes, the virus really does 'favor' specific body sites. I'm sorry you spent so many of your sexually active years apparently foregoing a potentially satisfying sexual outlet. In my opinion, herpes simply isn't important enough to allow it to have such an impact on sexual satisfaction. Condoms always? No oral sex? Herpes isn't that big a deal! What would have been the problem if your husband had acquired HSV, either oral or genital? Like you, he might have had a minimally symptomatic infection with few or no recurrences; and if he developed a significantly symptomatic infection, he could have been effectively and safely treated to control it.
Avoiding infecting the kids should not have been an issue either. No child gets HSV-2 except by sexual abuse; and most kids are going to get oral HSV-1 regardless of what precautions you take at home.
Perhaps most important, you don't say 1) what type of HSV is the cause of your genital infection and 2) whether or not your husband ever was tested. The odds are strong he is infected with your strain--in which case he is immune to catching it again. The infrequency of your recurrent outbreaks suggests a good possiblity your infection is due to HSV-1, not -2.
So if not yet done, both you and your husband need to have blood tests for HSV-1 and HSV-2. Those results will tell whether or not he is susceptible and to which type, which in turn will help tell which sexual practices carry the greatest risk of transmission. Also, you need to find a provider (and perhaps counselor) who understands herpes; your questions imply some deep misunderstandings about the infection that I cannot resolve online. You might consider contacting the American Social Health Association (www.ashastd.org) for direct advice by phone (not toll free, but well worth a few long distance calls), or for their help in finding a herpes expert near you.
Good luck-- HHH, MD
Certainly genital to oral transmission of HSV-2 can occur. But as you have read, it is much less common than genital-genital transmission, and yes, the virus really does 'favor' specific body sites. I'm sorry you spent so many of your sexually active years apparently foregoing a potentially satisfying sexual outlet. In my opinion, herpes simply isn't important enough to allow it to have such an impact on sexual satisfaction. Condoms always? No oral sex? Herpes isn't that big a deal! What would have been the problem if your husband had acquired HSV, either oral or genital? Like you, he might have had a minimally symptomatic infection with few or no recurrences; and if he developed a significantly symptomatic infection, he could have been effectively and safely treated to control it.
Avoiding infecting the kids should not have been an issue either. No child gets HSV-2 except by sexual abuse; and most kids are going to get oral HSV-1 regardless of what precautions you take at home.
Perhaps most important, you don't say 1) what type of HSV is the cause of your genital infection and 2) whether or not your husband ever was tested. The odds are strong he is infected with your strain--in which case he is immune to catching it again. The infrequency of your recurrent outbreaks suggests a good possiblity your infection is due to HSV-1, not -2.
So if not yet done, both you and your husband need to have blood tests for HSV-1 and HSV-2. Those results will tell whether or not he is susceptible and to which type, which in turn will help tell which sexual practices carry the greatest risk of transmission. Also, you need to find a provider (and perhaps counselor) who understands herpes; your questions imply some deep misunderstandings about the infection that I cannot resolve online. You might consider contacting the American Social Health Association (www.ashastd.org) for direct advice by phone (not toll free, but well worth a few long distance calls), or for their help in finding a herpes expert near you.
Good luck-- HHH, MD
Member Comments (2)
by northshore07, Mar 05, 2007 12:00AM
To: Dr. HHH
Dr. HHH- No reply necessary, just wanted to share the following: I was diagnosed with HSV-2 and my husband was tested about 10 years ago and it showed that he didn't have it (then). I did think I had a pretty good understanding of herpes, but now I know I don't. Just the idea that I could give my husband oral HSV-2 did bother me more than it should. Yes, I have definately not allowed myself to enjoy all that I can sexually. I guess I'm finally ready to do that. Your comment on "Certainly gential to oral transmission can occur" does make me nervous, but I know it's low. Herpes has definately ruled my life, but doctors like you are amazing and help those of us with herpes tremendously. I suppose I wanted to hear "Go ahead and enjoy receiving oral sex, even with HSV-2," but you basically said that anyway. Again, thanks.
