Is it herpes?

[needadvice3]

Dr. HHH / EWH,

I've never had unprotected sex and I've never had any casual sex. I'm very selective about who I get into relationship with and only get intimate with that particular person. In April 2011, a day before I was leaving on a business trip, I had a sore that appeared on my penis. It was sensitive to touch. I became very anxious thinking that it might be herpes although I've never had unprotected sex. My dermatologist was unavailable that day so I saw him a week later after I came back. It was almost gone and he said that herpes usually doesn't go away that quickly. He said that 95% it's not herpes but something frictional and to see him if anything shows up again.

I had another similar sore almost on the same spot a month or few months later (don't remember exactly). At that time my dermatologist was on vacation and I couldn't see him again and my sore was gone by the time he was back. So I didn't have it properly evaluated. I still don't know for sure what it was but for some reason I'm convinced that it is herpes although I haven't had it since.

I'm getting involved in a relationship now with someone who I really care about a lot. Like me, she's also very selective and careful about who she gets intimate with and I know we'll have a conversation about these things before we get intimate. I will definitely tell her about it. I truly care about her and I really hope this will not be a showstopper in our relationship but she will have to make that decision. She's also a doctor so she will be able to make a conscious decision. I wanted to know for myself and ask you - if what I had was herpes, does that mean that she will most likely get it too if we have sex? Is it only transferred if there's an open sore / outbreak or it could be transmitted even if it's not open? What are the implications of having herpes in general? Do you think it's important that I go through some specific tests now?

Thank you very much.

[Edward W Hook, MD]

Yes the HerpeSelect is a widely available blood test that your doctor can order.

Yes, your understanding of HSV is generally correct.  EWH

[needadvice3]

Thank you for your detailed answer, Dr. EWH.

Is HerpeSelect a type of a blood test? Can it be done at a doctor's office  or it has to be done at special diagnostic centers?

Lastly, is genital herpes very different from the common cold sores that people get on the lips or it's very similar but in the genital area? From what I've read, I understand the herpes that people get on the lips is caused by HSV-1 and genital is caused by HSV-2 but it's also likely that HSV-1 may cause a sore in the genital area and the difference between HSV-1 and HSV-2 diminishes in a way because HSV-1 is very common and can be transmitted during oral sex from lips to genitals. Do I understand it correctly?

Thank you very much.

[Edward W Hook, MD]

Welcome to our Forum.  While you are at low risk and I doubt that what you describe was HSV, a recurrent genital lesion can and should raise the possibility of HSV.  This is one of the few situations where a type specific antibody such as a HerpeSelect test might be helpful.  

If you do happen to have HSV, the risk of transmitting it to your partner is rather low.  I have seen couples who have not transmitted the infection after years of sexual contact.  In the only large study of the matter, transmission occurred within couples at a rate of about 5% per year when one person has the infection, the other does not and they have intercourse about 3-4 times a week.  Condoms and antiviral suppression can reduce the risk still further but we need not go into that at this point (we'll cover the "what ifs" if you decide to test and find you have HSV).  EWH