Doctor won't give valtrex for HSV-2

[JKansas]

About 2 weeks ago, I had some blisters pop up. I had done enough research to know it was herpes before the test came back positive. I had completely prepared myself for those positive results. Until they came, everything that I thought I was ready to hear. I wasn't, it's a harder reality then I actually thought.
But what makes it worse is the doctor refused to prescribe me valtrex. He gave me 5days worth of acyclovir and said to call anytime I have systomps and they would call me in a refill.
I don't want to sit around and wait for a outbreak. I want to protect myself as much as possible. I realize valtrex does not prevent outbreaks. But it does shorten them and make them less serve.
Herpes is painful and I don't want to sit around just waiting for a outbreak.
Anyways, I'm wondering if anyone else has had a doctor want to do it this way. Or maybe im missing somethjng and this is the better way. I'm just completely lost in what to do.

[JKansas]

Thank you for your help

[HowardH]

All this makes it even more likely you have been infected for a long time. Have the blood test. Your partner should also have a blood test. If positive, that will reduce the need for you to consider suppressive treatment, since there would be no need to protect him against transmission. But if he doesn't have HSV2, you definitely should consider ongoing suppressive treatment to help prevent transmission to him.

[JKansas]

As far as the source I really don't know. I've had the same partner for over 8months and even though he says he has been with no one else. We are not in a committed relationship.

[JKansas]

Yes, it was very mild. I think I felt more nerve pain then anything in my thighs and lower back.
Can I just ask for a blood test?

[HowardH]

It would still be helpful to know about severity, and recent exposures that could have been the source.  That "it only showed up in one spot and did not spread" suggests it was mild, and therefore might have been your first recognized outbreak, but actually had been present for a long time. This is quite typical. You could sort this out by having a blood test ASAP. If you have a new infection, it should be negative, turning positive in several weeks. If it was actually an older infection now just showing up, the blood test will be positive now.

And if this indeed is a longstanding and not new infection, it may be wise to sit tight and wait to see what recurrence pattern you have before you start on longstanding suppressive treatment.

I'm not defending your doctor. It may be he doesn't understand herpes well. But it's also possible he is a wise and understanding doc with a lot of experience in herpes. (Although no matter what, I agree he has a responsibility to explain exactly what his recommendations are and why. You shouldn't have to guess at all this!)

[JKansas]

A swab culture was done and it was confirmed that I did have HSV2.
It was my first outbreak and it only showed up in one spot and did not spread.
I guess I just hate to wait to see if it's going to get worse.

[HowardH]

I'll try to help, but some things aren't clear. Presumably your doctor agreed with the diagnosis, or s/he would not have prescribed acyclovir. But was the diagnosis confirmed by lab testing? Do you know which virus type you have? Was this your first outbreak? How severe was it?

Contrary to your statement, suppressive treatment with valacyclovir (Valtrex®) does help prevent recurrent outbreaks. But so does acyclovir. However, not all genital herpes should be treated with ongoing suppressive treatment. For example, if your infection is HSV1, recurrent outbreaks usually are very infrequent and ongoing treatment isn't necessary. And even with HSV2, it is often best to wait a few months to observe the outbreak pattern (frequency, severity, etc) before starting long term suppressive treatment.

If you'll fill in some of the details, I'll be happy to try to help a bit more.