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What you need to know about genital herpes but were maybe afraid to ask

Mar 04, 2015 - 1 comments

Genital Herpes




need to know

What you wanted to know about herpes but were afraid to ask (or couldn’t find anyone who knew the answers)

By gracefromhhp and auntiejessi

So you've just found out you have genital herpes or you think you might have genital herpes - what next??  Well, after you are done reading this - stop by the std community or the herpes community and post and we'll try to give you a hand with any questions you might have that this guide doesn't cover enough for you :)  This is only a basic guide to help point you in the right direction .

Are my symptoms herpes?

You have some strange things going on, and want to know, “Is this herpes?”  Well, that question isn’t so easy to answer, but we’ll try.  Keep in mind that no one can diagnose you over the internet, and that you need a medical provider to examine and test you for an absolute diagnosis.

As you read this part, remember that 90% of those with genital herpes type 2 (ghsv2), don’t even know they have it because their symptoms are so mild (about 70%), or because they get no symptoms at all (about 20%). Genital herpes can cause different symptoms for different people.  The most common symptoms are blisters that break, then heal.   This can be a few big blisters, or a cluster of smaller ones.  Typically, a herpes recurrence will last a week or two, but this does vary from person to person, or if you are taking antiviral medication.  (More about a primary outbreak in a minute.)

Other common symptoms are ulcers, lesions, itching, raw, red patches, and pain.  Its so important to remember that many other infections can cause these symptoms, including fungal infections, other stds, allergic reaction, etc., so don’t panic and think you have herpes just based on symptoms.

Primary outbreak vs recurrence:

A primary outbreak is when someone is newly infected with herpes simplex virus type 1 (hsv1) or herpes simplex virus type 2 (hsv2).  A true primary is when a person is newly infected, and does not have an established hsv infection of any kind.  Symptoms typically appear within 2-20 days, but this is not a hard and fast rule.  

If a person gets either type 1 or type 2, and it’s a true primary, they might have more severe symptoms than someone who already had an hsv infection in another location (as in someone who has oral hsv1 and then gets genital hsv2).   This person might have aches, a fever, tiredness, and flu-like symptoms.  This can also happen with a non-primary new infection, but is more likely with a true primary. A recurrence is an outbreak that happens after the first outbreak does.  These are almost always less severe than the first one, and typically heal faster.

Keep in mind that not everyone will get “classic” symptoms when they first get herpes, and some never get symptoms at all.  About 20% of people with ghsv2 are truly asymptomatic, meaning they never get symptoms.  Also, never make a self-diagnosis just based on your own symptoms.  If doctors don’t always get it right by a visual exam, you probably won’t either.

What type of herpes do I have?

Many folks are diagnosed by a visual exam only which is a fine thing to start treatment based on but you also need diagnostic/laboratory testing to find out if indeed you do have herpes and if you do , what type you have.  Traditionally herpes simplex type 1 ( hsv1 ) is oral but it can also be genital.  In fact in the under 30 age group in the US - it's the cause of about 60% of all newly diagnosed genital herpes infections.  In the US about 60% of folks have hsv1 orally so it's very common. In other countries the rate of hsv1 oral infection is even higher. Not many of us make it thru life without at least hsv1.  Herpes simplex type 2 ( hsv2 ) is the most common cause of genital herpes infections but it too can infect the oral area.  Statistically in the US, 1 out of every 4-5 adults has hsv2. It too is quite common but unfortunately most folks who have it aren't aware that they have it.

So finding out what type of herpes you have and where is the first step.  You also will need to know what your partner's status is too and what type(s) they have too so that the two of you can make educated decisions about what precautions to take from here on out in your sex life.

For some people finding out if they have herpes or not and what type will come very quickly and be fairly easy to find out.  Getting seen promptly by your provider as soon as you suspect that something is going on in the genital area is important. A lesion culture of active symptoms is most likely to be accurate if done within 24-48 hours of its appearance. Wait longer than that and the risk of having a false negative goes higher quickly. Discuss with your provider whether it's a good idea to get a blood test too at that time and then repeat it if need be in a few months.  If you do get a blood test - make sure it's a type specific IgG herpes blood test. Do not waste your time or money on the IgM test for herpes. Why? Well, Dr Handsfield in the std expert forum has said it best in the past already so check out his post about it (  ;).

For some people though the blood tests aren't going to be very clear cut. Visit the boards if you have any questions about your blood tests. Also check out gracefromhhp's journal entry on blood testing for herpes too (  http: ).  The website is a terrific resource too, as well as the other resources we'll list here.  Also if you get a negative lesion culture - that might not be the final answer as to if you have herpes or not.  The false negative rate can be pretty high sometimes so additional testing might be necessary.  We can help you sort things out on the boards if you have questions about your testing.

Treatment Choices

So let's say you've been to your provider and have been visually diagnosed as having genital herpes and properly tested. What next?  It's appropriate to start treatment for genital herpes immediately based on the visual diagnosis only while waiting for test results to come back. The sooner you start treatment, the more it can do for you to help speed healing and make you feel more comfortable faster!  No need to wait to find out if indeed you do have herpes and what type it is - you can be taking medication while waiting the couple of days it takes until that information comes back from the lab.

What medication is best? There are 3 different herpes antivirals that are commonly used:  acyclovir, valtrex and famvir.  Each of them have websites to read more about them and their side effects. Also there is a lot of info on them in the herpes handbook too ( see below for link ).  You and your doctor can decide which one is best for you based on your insurance as well as how likely you are to remember to take pills ( also personal preference by some providers plays a part too ). Check out grace's journal entry for more info as well on how to make the decision of what medication to use and how to use it ( ).

So what's next?  Well if you haven't already, talk to your partner if you have a regular partner ( for tips on this see auntiejess's journal entry on how to talk about herpes with a partner as well as the other resources below (  ;).  Your partner will need to find out what type of herpes they have or don't have, too.   Your partner should ask a medical provider for a type specific IgG herpes blood test. Once you know what type you have and what type your partner has - then decide if episodic therapy ( treating each outbreak ( ob ) as they occur to help speed healing ) or if suppressive therapy ( taking medication every single day whether you have an ob or not ) is the right choice for you and your lifestyle.

This will be a different choice for each person  - if you need help trying to decide which choice is best for you - visit us on the boards and ask and we'll gladly try to give you a hand with this decision. Your medical provider can also help with this too.

How do you get herpes?

So what about those of you who are just worried about possibly having herpes? Perhaps you don't have "classic" symptoms or you are wondering about certain scenarios and if they are a risk for herpes or not?  Perhaps you've already been doing some reading elsewhere and have seen that herpes presents differently in different people and can oftentimes be rather vague in its appearance so you are worried?  Here is a list of prior posts from either the std community, the herpes community or the std experts community to make it easy for you to do some reading :

herpes from lap dance

herpes from oral sex

herpes from fingering

herpes from fooling around

herpes from toilets, gym etc

herpes from a partner who is on suppressive therapy

oral herpes transmission

genital herpes transmission to children

Performing oral sex with an active cold sore present -

Last but not least - where else can you do some reading for yourself or what other resources are out there that you can use for yourself, a friend or a partner?  Here is a list of the ones we recommend : - the herpes handbook section  ; - this is a terrific video by Terri Warren - the herpes expert on medhelp

The IDEA of herpes is usually far scarier than actually living with it is.  So many of us have it but yet no one ever takes the time to teach us about it. Visit us on the boards and ask any questions you have and we'll try to help you learn more about this awfully common virus!!!

grace and jess

PMs for STD and HIV questions - please...

Nov 19, 2009 - 11 comments

Please don't send me questions that have already been answered on one of the STD or HIV forums.  I will not disagree with correct info from Vance, Grace, 2terrifed, KDaily, Teak, Lizzie, Joggen, JeanClaude, Nursegirl, etc., and most certainly not Drs. Handsfield and Hook.  If you have been given incorrect information, it will be corrected on the forums by one of the regulars who is educated in that field.

Also, if your question hasn't been answered, post it on the appropriate forum.  I don't mean to sound harsh or offend, but I've been working a lot, just moved, etc.  I don't have much time to get on here and answer questions.  You will be doing yourself a big favor by posting your questions on the appropriate forum.

A few notes, as these are the questions I get most often -

HIV is not possible from oral sex.

No one - even a doctor - can tell you if you have an STD or HIV from a description of symptoms.  If you are worried, you have to test.

Herpes alone doesn't mean someone cheated.  HPV doesn't either.  Actually, no STD or HIV means someone cheated.  A lot of things go into determining that.

We can help you assess risk, figure out timing, test results, etc.  We just can not diagnose, and no one should diagnose you online.


STDs still on the rise

Jan 15, 2009 - 1 comments





incidence rates





Check this out.  What does it mean for you?  It means to use those condoms and test regularly if you are sexually active with more than one person, or are sexually active with one person who has more than one person.

This isn't cause for panic - just be aware and use condoms and test.

By Elizabeth Landau

ATLANTA, Georgia (CNN) -- In spite of prevention efforts, new cases of some of the most common sexually transmitted diseases are going up, according to a new report from the Centers for Disease Control and Prevention.
Much of the burden of STDs falls on adolescents and people in their early 20s, the CDC says.

The report, "Sexually Transmitted Disease Surveillance 2007," also said that women and minorities in particular are more likely to have sexually transmitted diseases, or STDs.

That fact isn't surprising, experts say, as studies on STDs in the past have also shown that women and minorities bear the greatest burden of STDs. The age of those affected hasn't changed much either -- nearly 19 million new sexually transmitted infections occur each year, and almost half of those affect 15- to 24-year-olds.

The CDC began a national syphilis elimination program in the late 1990s, targeted at African-American heterosexuals, especially women and their babies. As a result, the condition was nearly eradicated as an ongoing health problem in the United States.

But in the last two years, the trend has reversed, said Dr. John Douglas, director of the CDC's Division of STD Prevention.

"The success we've been experiencing for a number of years in African-American heterosexual populations, particularly women, is beginning to be eroded," he said. Video Watch more on the CDC's report »

Syphilis resurfaced as a danger in 2001, and cases went up by 15.2 percent between 2006 and 2007, the CDC said.

Reported cases of chlamydia and gonorrhea together surpassed 1.4 million in 2007, the report said. Both of these conditions can cause infertility when left untreated. The CDC will address HIV rates in the United States in a later report.
Health Library

A record number of chlamydia cases were reported nationally this year, the report said. But Douglas noted that a major strategy is detecting infection before it spreads, so each case is an opportunity to prevent ongoing transmission.

Chlamydia is the most common reportable STD and infectious disease, he said.

Since the early 1980s, there has been a dramatic downturn in gonorrhea cases, but for the last 10 years, the rates have leveled off, especially in African-American populations. The CDC is looking at a number of ways to create awareness of the problem, he said.

STDs affect not only individuals' health, but also the economy, the CDC said -- the conditions cost the U.S. health care system as much as $15.3 billion annually.

The report reflects what Dr. Yolanda Wimberly, assistant professor of clinical pediatrics at the Morehouse School of Medicine and the medical director for the Center for Excellence in Sexual Health, sees in the clinics where she works. In her 14 years of practicing, she has been diagnosing more and more cases of chlamydia, syphilis and gonorrhea, she said.

Based on the report and her own observations, it's safe to say that some of the prevention efforts are not working, Wimberly said. New, innovative methods will be required to get through to this generation of young people, for whom text messaging and the Internet are integral parts of daily life.

Many people hold the misconception that STDs come along with a visible sign, such as irregular discharge or a rash or bump. But, in fact, most STDs do not present symptoms, she said.

"That's how STDs are so easily spread," she said. "It's not people who know they have gonorrhea and who go out say, 'I'm going to spread it to all these people.' It's the people who don't even know, who maybe don't get checked up regularly."

It's important to be screened at least once annually, even twice a year for younger people, Wimberly said. She offers to test everyone who comes into her office for STDs, even if they do not have any symptoms or came to see her for a different reason, if they haven't been tested in at least the last six months.

However, not all doctors are so conscientious about STD testing, Douglas said.

Particularly in nonminority populations, doctors are inclined to think, "The young woman sitting in front of me looks pretty healthy, she looks pretty respectable -- she wouldn't have a sexually transmitted disease, right?" Douglas said. "We simply miss those screening opportunities."

Other doctors simply don't want to broach the subject of sex with their adolescent female patients, he said. There's also the problem of access to health care -- some women do not have physicians for this reason.

Current prevention efforts include promoting awareness of STDs, personal protective behaviors such as limiting partners and using condoms, and screening programs, Douglas said. A key area to work on is normalizing conversations about STDs and sexual health, he said.

"If the parents assume that's the doctor's business, or the teacher's business, and don't roll up their sleeves and get in there themselves, and if our schools aren't giving comprehensive education, and if our clergy and other community leaders who are interested in youth well-being aren't including sexual health on the agenda, we're going to create missed opportunities."

Happy Holidays and Thanks!!

Dec 22, 2008 - 0 comments

I'd like to wish everyone in the STD, Chlamydia and Herpes fourms a wonderful holiday season!!

Thank you so much to the regulars who help - Vance, Dallas, Emma, Waring, Slacker, Daisy - there are more, but you know who you are.  :)  These forums wouldn't be nearly as helpful and informative without your input, and I hope you know how much you are appreciated.