Condoms triggering ob?

[Simon1970]

Dear Doctor,
I have an herpes since 2008. Except the first ob, I had one in 2010 after my surgery to remove fibroids, then I had twice sexual relations with condoms that triggered me an herpes only after three days. The second time I immediately took Valtrex so after one day I was perfectly fine. So in five years only three ob. When I have an ob after sex with condom the entry of my vagina closes itself and won't allow penetration. It seems that my only trigger for ob will be sex, or will be the condom. I don't know but so far I always wanted to protect my partner. Also, after my first ob, I was still having sex with my current boyfriend at the time and without condoms (as he transmitted me his herpes!) and no ob....but we broke up a few weeks after that event. I have now started suppressive therapy with valtrex sinc one into...but no actual relations. Is that really the condoms that are triggering the herpes? Do I have to change an uses non latex? Is the herpes virus in my body (even dormant) near my vagina?

[Simon1970]

Thank you Doctor. I started taking valtrex just recently so I don't know about my reaction with condom....And as it is not the allergy to latex..hopefully valtrex will stop any ob during sexual activity with condom.

[Edward W Hook, MD]

Thanks for the follow-up.  There are several steps to determining what is going on here.  As the most likely candidate, the first thing to do was to evaluate whether or not this was a latex allergy.  Now that you know that it was not, the next step is to find out if these episodes are, in fact, recurrences of HSV. As I said above, for recurrences to occur in persons taking suppressive therapy is quite unusual.

If you have another outbreak it will be important to quickly seek testing when it occurs to determine if it is herpes by either PCR testing or culture.  If it is herpes, it may have been that he trauma related to your sexual activity (you mentioned that sometimes your "partner was a bit too rough") may have triggered your recurrence.  This would be consistent with your report that your other outbreak prior to these was related to gynecological surgery.  We do know that sometimes trauma can lead to recurrences of oral HSV.
EWH

[Simon1970]

Dear Doctor,
I followed your advice and did a latex allergy test on the arm for four days and that came back negative. You mentioned that you never encountered a case that was triggered by condoms...so how can I explain that?

[Edward W Hook, MD]

Dr. Handsfield will not be answering your question- you get one of us or the other.  The reason for this is thaqt we have not disagreed in our assessments or aqdvice to patients in decades.

Allergies can be induced with time. Repeated use can induce allergies.  I made this as a suggestion and told you how to assess it further.  

Suppressive valacyclovir therapy reduces the risk of getting HSV by over 50%.  This is a substantial reduction in risk. EWH

[Simon1970]

Do you have the same view as the above answer? What it so weird is if it's an allergy to latex the symptoms are the same as an ob....and the last time I had sex with a condom...it kind of hurt since the first time...and I had a tiny bit of blood...but my partner was a bit too rough that first night....then decided right after to take valtrex....second night was ok...third day the entry of my vagina closed itself....and fourth day was ok...for me the valtrex went into effect....but we didnt have sex anymore...I still don't know what to think.
Second question: with Valtrex suppressive therapy.....the chance that my partner is getting a herpes as as low as being on a birth control pill...assuming that I never forget a day of pill on valtrex?

[Simon1970]

Thank you.  However before getting my herpes I used condoms many times and never had an allergy... How can we explain that?

[Edward W Hook, MD]

Welcome to the Forum.  I'll try to help.  Different people have different triggers for outbreaks of genital herpes but I have never encountered a patient in whom use of condoms causes outbreaks. This is not to say that this could not occur but it would be unusual.  In considering your description of what happens, I find myself wondering if rather than HSV recurrences what might be occurring could be an allergy to latex in the condoms.  Latex allergies are becoming increasingly common and in some studies occur in up to 9% of exposed persons.  Going forward you may be able to sort this out in several ways.

First, if you are taking suppressive valacyclovir therapy, this should prevent recurrences.  If you experience the symptoms you describe following condom-protected sex while taking valacyclovir, this makes latex allergy somewhat more likely.

Secondly, you could try using non-latex (i.e. polyethylene) condoms and see if this changes the situation.

I hope these comments are helpful EWH