Freaking out about HSV-1 Scare

[MikeTepper650]

I have tested negative for hsv-1 in the past. I was dating a woman that unknown to me had hsv-1. We had a relationship for several months and I have received oral sex from her on several occasions. My last encounter with her was about 4 weeks ago and that's when I found out about her HSV-1 infection. She told me she infrequently gets hsv-1 blister(s) on the side of her nose. She said she had an outbreak about 3-4 weeks before we saw each other the last time. I've never developed symptoms of HSV-1 on my genitals or mouth since our last encounter. About a week after my last oral encounter with her I developed what has been diagnosed as prostatitis. I have pressure in my perineum and rectal area, testicular pain, burning and pressure around my penis head. I was put on Bactrim for ten days which seemed to help slightly with the symptoms, but I've a slight resurgence in symptoms since going off the Bactrim about 5-6 days ago. Should I be concerned this is a genital hsv-1 infection?

[H. Hunter Handsfield, M.D.]

Welcome to the forum. This is a revised reply.  As you correclty noted, I misread part of your question -- so I'm starting over!  Sorry for any confusion.

Up to half of all adults in the US have HSV-1, mostly oral, and mostly they are undiagnosed and unaware.  And they have regular sex with their partners, including oral sex.  Once in a while the virus is sexually transmitted to those partners, but it's really quite uncommon; even after years of repeated unprotected sex, most partners don't catch it.

So the odds are low you would have been infected in this circumstance.  I cannot say it didn't happen, but there is no particular reasoon to suppose it did. Certainly your symptoms do not suggest it.  Those symptoms are much more typical of a prostate problem or, even more likely, genitally focused anxiety due to your concern about herpes and this relationship.

If you want still more reassurance, you could have an HSV-1 blood test in a few weeks. But really, I see no need -- and I certainly wouldn't do that if somehow I were in your shoes.

I hope this has been helpful. Sorry for the initial confusion.  Best wishes--  HHH, MD

[IsabelleNicole]

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[arip8]

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[MikeTepper650]

This happened during an extramarital affair. So I have two questions:

1. I've read online that even if I don't show any symptoms or have an initial outbreak, I can have an outbreak down the road. And at the same time be infectious to my wife. How true is this?

2. Should I use protection with my wife?

[MikeTepper650]

Thank you Doc H.H.H.