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Herpes Confuses Me....
Hi Doc...
I've read many of your posts, and I thank you for taking the time to answer all of these questions..
I have a question or two that I wouldn't mind if you answer, as I'm a constant information seeker.
Here goes:
Okay, so I know there are 2 strains of herpes (HSV-1 & HSV-2) .. From what I understand HSV-1 is the 'cold sore' someone would get on their lips, and HSV-2 is better known as 'Genital Herpes'.
I read a post of yours that said HSV-1 is the only one that generally transmits to a man via oral sex (man receiving a *******), which I get, but it kinda confuses me...
Let's say a girl gives a guy a *******, and this guy has HSV-2, can the girl not get HSV-2?
if so,
Then wouldn't it stand to reason that the next guy (so to say) she gives a ******* too would get HSV-2 and not HSV-1?
Or,
Are the two transmission routes completely different? i.e. HSV-2 is truly only passed from contact with the genitals, and HSV-1 is only contracted through contact with the general mouth area?
I ask because based on some of your other answers, it obvious that a male receiving a ******* can get HSV-1 in his genitalia area, but wouldn't that then be genital herpes? Are you saying that a woman cannot get HSV-2 in her mouth from an infected male... Hopefully you see my confusion.
I hear that more time than not, there are no symptoms with many STD's, including herpes. Well if there are no symptoms, and the main cause for alarm is with the painful outbreaks, then what's the big deal.. Or, do men usually show symptoms, and if so, what is the general time frame after an 'incident' should one keep an eye out for such symptoms?
One more quick one... HPV.. Is there no test for males? How do we know if we caught a strain of HPV?
Thank you very much for your time, as these questions are just on my mind, and hopefully they may help others out there with similar questions / thoughts / concerns.
Thanks again!
I've read many of your posts, and I thank you for taking the time to answer all of these questions..
I have a question or two that I wouldn't mind if you answer, as I'm a constant information seeker.
Here goes:
Okay, so I know there are 2 strains of herpes (HSV-1 & HSV-2) .. From what I understand HSV-1 is the 'cold sore' someone would get on their lips, and HSV-2 is better known as 'Genital Herpes'.
I read a post of yours that said HSV-1 is the only one that generally transmits to a man via oral sex (man receiving a *******), which I get, but it kinda confuses me...
Let's say a girl gives a guy a *******, and this guy has HSV-2, can the girl not get HSV-2?
if so,
Then wouldn't it stand to reason that the next guy (so to say) she gives a ******* too would get HSV-2 and not HSV-1?
Or,
Are the two transmission routes completely different? i.e. HSV-2 is truly only passed from contact with the genitals, and HSV-1 is only contracted through contact with the general mouth area?
I ask because based on some of your other answers, it obvious that a male receiving a ******* can get HSV-1 in his genitalia area, but wouldn't that then be genital herpes? Are you saying that a woman cannot get HSV-2 in her mouth from an infected male... Hopefully you see my confusion.
I hear that more time than not, there are no symptoms with many STD's, including herpes. Well if there are no symptoms, and the main cause for alarm is with the painful outbreaks, then what's the big deal.. Or, do men usually show symptoms, and if so, what is the general time frame after an 'incident' should one keep an eye out for such symptoms?
One more quick one... HPV.. Is there no test for males? How do we know if we caught a strain of HPV?
Thank you very much for your time, as these questions are just on my mind, and hopefully they may help others out there with similar questions / thoughts / concerns.
Thanks again!
MEDICAL PROFESSIONAL
Welcome to the forum. Thanks for reviewing other threads. These are excellent questions and I'm taking the opportunity to write a blog-like response that can be saved for similar questions in the future. The differences between HSV-1 and HSV-2 have been discussed many times, but it helps to repeat some important points all in one place.
You correctly understand many aspects of the differences and similarities between HSV-1 and HSV-2. Either virus can initially infect either the oral area, genital area, or both. However the viruses are not identical in all respects. HSV-2 doesn't "like" oral tissues -- it is less likely to infect the mouth, even if directly exposed, than the genital or anal area. Likewise, HSV-1 doesn't take hold in the genital area as easily as it does in the mouth. In addition, when either virus infects the "wrong" area -- HSV-1 genital, HSV-2 oral -- recurrent outbreaks and subclinical viral shedding are less frequent.
In the US and most industrialized countries, about half of all new genital herpes infections are due to HSV-1, acquired primarily by oral-genital transmission. However, genital HSV-1 infections cause far fewer recurrent outbreaks (typically 0-1 outbreaks each year for a couple of years, then no more) than genital HSV-2 (average 4-5 outbreaks per year for several years). Therefore, even though INITIAL genital herpes is half HSV-1, among all people with RECURRENT genital herpes, 90% or more are HSV-2. It also works out that HSV-2 is almost always acquired by genital-genital transmission, whereas genital-genital HSV-1 transmission appears to be uncommon.
When someone performs oral sex on someone with genital HSV-2, transmission to the mouth is uncommon. When it happens, usually it is asymptomatic; and even when there are symptoms, recurrent oral outbreaks are rare. Finally, asymptomatic shedding of the virus also is uncommon. For these reasons, the vast majority of people with recurrent oral herpes have HSV-1, not HSV-2. And oral HSV-2 infection is rarely transmitted, either by kissing or by oral sex.
To some of your specific questions: Yes, a woman can get oral HSV-2 by performing oral sex on a man with genital HSV-2, but it doesn't happen often; and when it does, she might never know it and probably wouldn't transmit it further. Likewise, those who catch genital HSV-1 may never have another outbreak, or often just 1-2 outbreaks over a 1-2 year, then no more; and they don't transmit the infection to future partners nearly as often as do people with genital HSV-2.
"Well if there are no symptoms, and the main cause for alarm is with the painful outbreaks, then what's the big deal?" Exactly right: it may be no big deal at all. But symptoms are not the main concern of people with herpes and those who fear getting it. The main concern is the fear of transmission to new partners -- which might disrupt a marriage or other committed relationship, and requires informing future partners before having sex -- which can be a serious barrier to dating, romance, and ultimate commitment. For the reasons just discussed, HSV-2 is much more of a problem in this regard than genital HSV-1.
No test exists for HPV in men. But it doesn't really matter; there is nothing to be done for asymptomatic HPV infection. Even the test in women is intended solely to help interpret the other results on a pap smear. A negative result does not mean a woman is necessarily free of HPV, only that it can't be found in her cervix. She could still be infected say on the labia and would not know it.
I hope this helps. Best wishes-- HHH, MD
You correctly understand many aspects of the differences and similarities between HSV-1 and HSV-2. Either virus can initially infect either the oral area, genital area, or both. However the viruses are not identical in all respects. HSV-2 doesn't "like" oral tissues -- it is less likely to infect the mouth, even if directly exposed, than the genital or anal area. Likewise, HSV-1 doesn't take hold in the genital area as easily as it does in the mouth. In addition, when either virus infects the "wrong" area -- HSV-1 genital, HSV-2 oral -- recurrent outbreaks and subclinical viral shedding are less frequent.
In the US and most industrialized countries, about half of all new genital herpes infections are due to HSV-1, acquired primarily by oral-genital transmission. However, genital HSV-1 infections cause far fewer recurrent outbreaks (typically 0-1 outbreaks each year for a couple of years, then no more) than genital HSV-2 (average 4-5 outbreaks per year for several years). Therefore, even though INITIAL genital herpes is half HSV-1, among all people with RECURRENT genital herpes, 90% or more are HSV-2. It also works out that HSV-2 is almost always acquired by genital-genital transmission, whereas genital-genital HSV-1 transmission appears to be uncommon.
When someone performs oral sex on someone with genital HSV-2, transmission to the mouth is uncommon. When it happens, usually it is asymptomatic; and even when there are symptoms, recurrent oral outbreaks are rare. Finally, asymptomatic shedding of the virus also is uncommon. For these reasons, the vast majority of people with recurrent oral herpes have HSV-1, not HSV-2. And oral HSV-2 infection is rarely transmitted, either by kissing or by oral sex.
To some of your specific questions: Yes, a woman can get oral HSV-2 by performing oral sex on a man with genital HSV-2, but it doesn't happen often; and when it does, she might never know it and probably wouldn't transmit it further. Likewise, those who catch genital HSV-1 may never have another outbreak, or often just 1-2 outbreaks over a 1-2 year, then no more; and they don't transmit the infection to future partners nearly as often as do people with genital HSV-2.
"Well if there are no symptoms, and the main cause for alarm is with the painful outbreaks, then what's the big deal?" Exactly right: it may be no big deal at all. But symptoms are not the main concern of people with herpes and those who fear getting it. The main concern is the fear of transmission to new partners -- which might disrupt a marriage or other committed relationship, and requires informing future partners before having sex -- which can be a serious barrier to dating, romance, and ultimate commitment. For the reasons just discussed, HSV-2 is much more of a problem in this regard than genital HSV-1.
No test exists for HPV in men. But it doesn't really matter; there is nothing to be done for asymptomatic HPV infection. Even the test in women is intended solely to help interpret the other results on a pap smear. A negative result does not mean a woman is necessarily free of HPV, only that it can't be found in her cervix. She could still be infected say on the labia and would not know it.
I hope this helps. Best wishes-- HHH, MD
A related discussion, Infection Rate was started.
MEDICAL PROFESSIONAL
I answered most of that in the next to last paragraph of my reply. I guess the rest of the answer is that many "asymptomatic" cases truly have no symptoms, and other have mild symptoms that the infected person doesn't notice or ignores.
What "most people" think is correct. Testing for HSV is not recommended by most exerpts for most people. The main reasons for HSV testing are to diagnose infection in people with symptoms that suggest herpes and in the sex partners of infected persons. This is somewhat controversial, and some STD experts would employ more widespread testing. But most of us do not.
What "most people" think is correct. Testing for HSV is not recommended by most exerpts for most people. The main reasons for HSV testing are to diagnose infection in people with symptoms that suggest herpes and in the sex partners of infected persons. This is somewhat controversial, and some STD experts would employ more widespread testing. But most of us do not.
Great answers!
I truly hope others refer to this thread for future reference, and hopefully it will help put some peoples mind at ease a little.
The only part you seem to have missed the last paragraph,
"I hear that more time than not, there are no symptoms with many STD's, including herpes. Well if there are no symptoms, and the main cause for alarm is with the painful outbreaks, then what's the big deal.. Or, do men usually show symptoms, and if so, what is the general time frame after an 'incident' should one keep an eye out for such symptoms?"
Could you please provide a little insight to this question because I believe that most people think unless they have some sort of outbreak, testing is not necessary for HSV-1 or HSV-2.
Is this the case?
Thanks Doc!
I truly hope others refer to this thread for future reference, and hopefully it will help put some peoples mind at ease a little.
The only part you seem to have missed the last paragraph,
"I hear that more time than not, there are no symptoms with many STD's, including herpes. Well if there are no symptoms, and the main cause for alarm is with the painful outbreaks, then what's the big deal.. Or, do men usually show symptoms, and if so, what is the general time frame after an 'incident' should one keep an eye out for such symptoms?"
Could you please provide a little insight to this question because I believe that most people think unless they have some sort of outbreak, testing is not necessary for HSV-1 or HSV-2.
Is this the case?
Thanks Doc!
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
