Diagnosed with genetal HSV1 :-(

[Sarah651]

I have been reading these posts with much anxiety, as I had been awaiting test results of my own.

A few hours ago, my doctor called and told me that I have tested positive for HSV1 in both the culture, and the blood test.  :-(  It is completely hard to take, and I am have a very hard time dealing with it.  He said that I tested negative for HSV2, and only have HSV1.  But he said there was no difference in the two.

I am a 38 year old woman, and have been in a monog relationship for the past 10 mos.  (In fact, on October 20th, my boyfriend proposed to me)  From childhood, I have gotten cold sores on my lip occaisionally.  For the past yr, I have only had 1.  

1.  How does the virus get from the mouth to now being in my genitals?  I have read in your posts that usually having the oral version provides extra immunity to the genital version.

3.  Is it possible my fiance has it, with no symptoms?

4.  If I caught it before my current relationship, why would I not have had symptoms before now?

5.  In another post you wrote:  "Most likely your boyfriend is immune, since more than half the population has HSV-1.  He can have a blood test to know. If he is already positive, you don't need to worry about it.  And as I said, asymptomatic shedding of HSV-1 is uncommon.  So if there is any risk at all (between your outreaks), it is very low.  -  If this is the case, how could I have caught it genitally, when I already have it orally?

6.  Also, if we have sex without a condom with no symptoms present, how much of a chance of me transmitting it to him (if he does not already have it)?

7.  If my fiance tests positive, will we be able to tell if I gave it to him, or if he had it previously?

I do not want to feel less worthy.  My fiance is very supportive, and says he still wants to spend the rest of his life with me.. but I feel so tainted now..

I am very much in need of help to get my head around this.. :-(

Thanks Doctor

[Edward W Hook, MD]

Your question did not tell me why you had the test. Did you have a lesion that was tested?  Where? Had you ever had it before?  Answers to these questions would help to sort this out.  Withthat said, let me provide some information.

1.  Increasingly HSV-1 is causing genital herpes.  Transmission most often is the result of oral sex.  While having cold sores due to HSV-1 appears to reduce the risk of acquiring infection, it does not prevent it.

3.  Yes, he could have it without symptoms.  He should be tested with one of the good herpes blood tests such as the Focus HerpesSelect test.

4.  Only 10-15% of Americans who have genital herpes are aware that they have the infection.  You could have had this infection for some time. Now that you are aware that you may have infection you may notice mild symptoms at some point in the future which may be a manifestation of your infection.

5.  Yes you could have caught it genitally when you already have oral infection.

6.  If he is not infected, you could infect him even though you are asymptomatic.  As mentioned above, the next step for him is to get a blood test.

7.  If you both have the infection you will not be able to tell who gave what to whom or for how long either of you have had the infection.

It sounds as though you have a strong relationship.  Working through this together could make it still stronger.  I hope that is the case.
EWH

[Sarah651]

You are right about not relaxing... the whole time I could not help thinking about whether he was thinking about it... is that crazy or what!  He and I have very much enjoyed that part of my life.. so I need to figure out how to get those thoughts out of my head  :-(

[gracefromHHP]

Being nervous about transmitting the virus to a partner can cause you to not relax enough and can also cause you not to make enough lubrication during sex. You might want to use some extra lube for awhile to help make it more comfortable for you.

grace

[Sarah651]

Doctor,

Is it normal to have a lot of soreness after resuming sexual activity...  I had been without symptoms for a good 4 days before having sex.  But now I am sore again.. ANd feeling paranoid that it is more than just soreness caused from lack of sexual activity for the past almost 3 weeks.  Should I be worried?  Or am I being paranoid?  Previous to all of this, my fiance and I have enjoyed a very active sex life.  WIll this change?

[gracefromHHP]

Hopefully your hsv1 genital recurrences will be few and far between ( for most folks with hsv1 genitally recurrences are few  - there is a difference in recurrence rates and rates of shedding even though your doctor implied otherwise ). There's no way to tell if this is a newly acquired hsv1 genital infection or if it's just your first obvious recurrence from a prior infection.  Try not to fall into the mindset of everything that goes on in the genital area must be your herpes. Should you continue to experience frequent genital symptoms - follow up with your doctor to make sure that you don't also have anything else going on like vaginitis - either yeast or bacterial.  Both can trigger more frequent recurrences of herpes and can also mimick recurrences.  If with all the stress of planning your wedding and such ( congratulations on your recent engagement by the way!!! ) if you just need some peace of mind - talk to your doctor about daily suppressive therapy for a few months so that you'll worry a little less about your genital area.  We don't have a lot of info on if it's helpful for hsv1 genitally and reduction in transmission to a partner but we do know that it should help at least a little in reducing recurrences - both orally and genitally ( because who wants a cold sore on their wedding day/honeymoon either ). Just something to keep in mind.

If you haven't had the time yet to read the herpes handbook or to watch the patient counseling video on the same site - check out www.westoverheights.com. Both are terrific resources for you and your partner to better understand genital herpes and treatments.  

I'm glad you sound like you are starting to realize that the IDEA of having herpes genitally is usually more traumatic than actually living with it.  You are not  genital herpes - you have genital herpes. The vast majority of folks you know and love have some form of herpes - either orally or genitally - whether they know it or not. It really is an incredibly common virus that few of us get thru life either having orally or genitally or both.

Hang in there - it's a lot to deal with we know!  Try not to think about it - think instead about the new life you are going to be starting as Mrs Sarah651 soon :)

grace

[Sarah651]

It is exactly that point that has helped me to come to terms with this thing... After the initial shock, I said to myself.. wait a minute.. I am the same as I was yesterday.. I still have the same virus.. it just has somehow changed it's position... And, I realized it was the perception that I was most upset about...  because, honestly, I wonder the same thing.. why the difference in perception based solely on the location???

[monkeyflower]

I'm struck by the fact that you're so intensely upset about having HSV1 genitally but fine with having it orally. What difference does it make, except that one was transmitted by sexual activity? I realize that in our sex-negative, sex-phobic society there is a bizarre stigma attached to anything sexually transmitted, but still. You didn't feel 'tainted' or 'less worthy' when you had the *exact same virus* orally...

If you stop to question your internalized ideas and beliefs about sexuality, you might feel differently. I'd suggest reading some good, sex positive books, websites, and articles. Some authors: Betty Dodson, Marty Klein, Michael Castleman, Paul Joannides, Jack Morin, Tristan Taormino...

[Sarah651]

I do have another question.  This morning I took the last Acyclovir...  All of my symptoms have been gone for some time... hOwever, I noticed a couple days ago what seems like an ingrown hair, that became light a whitehead, and felt painful...  Should I now be paranoid that every little thing is because of this?  Honestly, I have never had any symptoms before.. not even ingrown hairs :-P

[Sarah651]

The weekend of 10/13 my fiance and I had a lot more sex than usual, and for once for a very  prolonged period of time.  AFter this, I was sore inside, which is usual in that circumstance.  However, the soreness was more than I had ever experienced before, and it had not gone away by the following Friday.  On the following Friday, I noticed feelings inside that felt like tiny papercuts inside of me... although, when I looked with a mirror, I did not see anything unusual.

So I got in to see my doctor on the 23rd.. the soreness was much less by that point, but the papercut feelings were still there.  He did the culture then.

I am in a very strong relationship.. and frankly, I feel better today than I have for the past nightmareish week.. just knowing.  My fiance said that it did not change a thing about the way that he feels about me, and that he is looking forward to spending the rest of his life with me, and that this will be just a little inconvenience to deal with every so often.

I just really wish that my having this type already in my body, and having to deal with cold sores all my life would have given me that immunity you were talking about :-(