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Genital HSV 1 Questions

I was diagnosed with genital HSV 1 from receptive oral sex back in March of this year (positive via culture).  My inital outbreak in March was very severe and my doctor prescribed Valtrex 1000 mg dialy.  To my knowledge I have not had any additonal sypmtoms until last Monday, I started to have vaginal irritation and I immediately started the Valtrex again 1000 mg daily and am still taking it.  It lasted about 3 days and I did not have any sores, fever, etc. just burning and irritation so  I am not even sure it was an outbreak?  My doctor has not been helpful at all in helping me understand this disease.  How do I know if I'm having an outreak?  How long do outbreaks usually last?  My boyfriend has been away and will be coming back into town tonight.  I told him we need to obstain from sexual intercourse but he wants to have oral sex.  He is not the partner that I obtained this from and we know via blood testing that he is negative at this time.  Is it safe to have oral sex at this point?  At what point is it safe to have protected sex?  Everything I read is focused on HSV 2 so I'm just trying to get a handle on how to recognize outbreaks, how long they last, when it is safe to resume sexual activities and should I take any additional precautions than I am taking now.  Thanks so much for everything!
3 Responses
239123 tn?1267651214
MEDICAL PROFESSIONAL
First, my overriding advice is that your questions require far more time and attention than I or anybody else can properly manage in the brief time and words available on line.  There is excellent information on several websites.  I particularly recommend the American Social Health Association (www.ashastd.org) and the information provided by the Westover Heights Clinic of Portland, OR (www.westoverheights.com).  Perhaps most important, ASHA offers personal counseling by phone by really high quality experts; not toll-free, but an hour of a paid call would be well worth your time and can cover much more detail than I can.  ASHA also keeps lists of herpes-knowlegeable heatlh care providers and might be able to help you find someone near you.

To your specific questions:  Most important, there is a good chance you won't have a problem with recurrent outbreaks.  Among people with genital HSV-1, 40% have no recurrences at all and most of the others have only 1-2 recurrent outbreaks over the next 1-2 years, then nothing.  It's a very different disease than HSV-2, which typically causes 3-8 outbreaks a year for many years.  Also, asymptomatic viral shedding and sexual transmission to partners is much less common than for HSV-2.  (If you have to catch genital herpes, HSV-1 is the one you want!)

For these reasons, most experts do not recommend routine suppressive treatment for genital herpes due to HSV-1.  Even off the Valtrex, you might never have a problem.

So your recent irritation probably wasn't a herpes recurrence; recurrent outbreaks usually last at least a week and have overt blisters/sores--not as many as the initial infection, but basically the same--i.e.,not usually just itching and irritation.

Therefore, most likely there is no reason to abstain from genital sex with your boyfriend.  There certainly is no reason to avoid oral sex, since you don't describe any evidence you have oral herpes.  If you didn't have oral sores at the time of your first genital symptoms, probably you don't have oral infection at all.  And HSV doesn't travel through the body from genitals to mouth or vice versa.

Finally, your boyfriend:  for the reasons mentioned above, the risk of transmitting your infection to him may be quite low.  Don't worry about oral sex at all.  If you are careful to avoid vaginal sex when you're not having an outbreak, the chance you'll transmit the infection to him probably is quite low--again, very different than for HSV-2.  But the risk isn't zero; you probably will have some times when the virus is present without symptoms.  Still, he and you should understand that getting genital herpes, especially HSV-1, isn't the end of the world.  Herpes of either viral type, but especially HSV-1, is not a serious enough problem to allow it to get in the way of healthy sexuality and romance!

I hope this helps get you started on the information you need.  My guess is that other forum regulars (e.g., gracefromHPP) will follow-up with additional helpful comments.  In the meantime, go to the websites I mentioned above.

Good luck-- HHH, MD
Avatar universal
Wow what an incredible resource, thank you so much!!  I received more information here than I received from my doctor after multiple inquiries and boy have they charged me a lot of money!!  I sincerly appreciate your help and will visit the sites you mentioned.
Please continue this valuable asset to us all!!
Avatar universal
Sorry, just to clarify one point.  When you say don't worry about oral sex, it does not travel from one body site to another.  I understand that you mean if I perform oral sex on him.  Is it the same if he performs oral sex on me since I have genital HSV?  I am pretty sure I don't have oral HSV. Never had a symptom.
Thanks again.
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