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Recurring Genital HSV 1
Dear Dr. HHH,
I was diagnosed with Genital HSV 1 in October through a culture swab and I reconfirmed it through a blood test in February. I got it from a guy who performed oral sex on me a few days before a cold sore developed. However i didn't develop any symptoms until a week later after rough sex. My main sore was at the entrance of the vagina with lots of others in the area. The initial outbreak was horrible and very painful. After the diagnosis my doctor put me on Valtrex 500mg daily for 3 months, I didn't have any recurrent OBs during that time. I stopped taking the Valtrex end of February and just a few days ago I developed lots of itching and seem to have only one blister right at the entrance of my vagina again. This seemed to happen just a couple days after i went in for my pap smear. My Questions are:
1) Since I seemed to have an OB so soon after going off of valtrex, does this mean that I am going to be one of the unfortunate ones who gets an OB all the time despite it being HSV 1 unless i stay on suppressive therapy?
2) Are my outbreaks triggered by anything entering my vagina in a painful way, in other words will i have an OB every time i have sex now?
3) Also, my doc told me that I am probably more susceptible to recurrences due to they fact that i have hypothyroidism and am taking accutane for acne. Is this true? Does that mean the OBs will lessen once i stop taking the accutane?
I am getting married soon to a wonderful man and although he is ok with my status, he is negative for both and I do not want to pass it on to him. I am also worried that if sex is a trigger that i will never be able to have a normal sex life again. Any help would be greatly greatly appreciated!!!
Thank you!
I was diagnosed with Genital HSV 1 in October through a culture swab and I reconfirmed it through a blood test in February. I got it from a guy who performed oral sex on me a few days before a cold sore developed. However i didn't develop any symptoms until a week later after rough sex. My main sore was at the entrance of the vagina with lots of others in the area. The initial outbreak was horrible and very painful. After the diagnosis my doctor put me on Valtrex 500mg daily for 3 months, I didn't have any recurrent OBs during that time. I stopped taking the Valtrex end of February and just a few days ago I developed lots of itching and seem to have only one blister right at the entrance of my vagina again. This seemed to happen just a couple days after i went in for my pap smear. My Questions are:
1) Since I seemed to have an OB so soon after going off of valtrex, does this mean that I am going to be one of the unfortunate ones who gets an OB all the time despite it being HSV 1 unless i stay on suppressive therapy?
2) Are my outbreaks triggered by anything entering my vagina in a painful way, in other words will i have an OB every time i have sex now?
3) Also, my doc told me that I am probably more susceptible to recurrences due to they fact that i have hypothyroidism and am taking accutane for acne. Is this true? Does that mean the OBs will lessen once i stop taking the accutane?
I am getting married soon to a wonderful man and although he is ok with my status, he is negative for both and I do not want to pass it on to him. I am also worried that if sex is a trigger that i will never be able to have a normal sex life again. Any help would be greatly greatly appreciated!!!
Thank you!
MEDICAL PROFESSIONAL
No, valacyclovir does not affect blood test results to our knowledge. You stated your swab test was positve for HSV-1. I would not worry about gential HSV-2.
Sorry, the chances of infection to your husband are unknown. Low for sure and certainly lower than the about 6% per year that occurs in couples in which one person has HSV-2 and the other does not. Could it be 1% or less, sure but that is just a guess. There are no scientifically determined data. Sorry I can't be more precise. EWH
Sorry, the chances of infection to your husband are unknown. Low for sure and certainly lower than the about 6% per year that occurs in couples in which one person has HSV-2 and the other does not. Could it be 1% or less, sure but that is just a guess. There are no scientifically determined data. Sorry I can't be more precise. EWH
MEDICAL PROFESSIONAL
Welcome to our Forum. Dr. Handsfield and I share the forum. You got me. FYI, the reason we share the forum is because we have worked together for nearly 30 years and while our verbiage styles vary, we have never disagreed on management strategies or advice to clients.
Good questions. I will try to help by providing you with the information we have gained from studies which have helped to describe what persons with genital herpes can anticipate, on average. The unfortunate part about such information is that this of course does not predict what any individual will experience. With those limitations, the information from the studies is very helpful and I hope that this will be the case for you.
In general, genital herpes caused by HSV-1 is less likely to recur and less likely to be transmitted to sexual partners than HSV-2. Similarly, asymptomatic shedding of the virus is less likely to occur when genital HSV is caused by HSV-1. When persons with GH due to HSV-1 do have recurrences, they tend to have one or two in the first year following infection and then few or no more. For both HSV-1 and HSV-1, recurrences are more likely to occur in the first year following infection. Furthermore, for persons placed on suppressive therapy when they take daily antiviral therapy, it is common to have a recurrence soon after discontinuing therapy so your recent recurrence does not mean that you will have frequent further recurrences, only time will tell.
Let's address you specific questions:
1. See above. Your recurrence does not mean that you will have frequent recurrences. I would continue to not take the valacyclovir and see what happens.
2. There are no data to suggest that sex triggers recurrences of HSV. the chances that sex will trigger recurrences is quite unlikely. Trauma has been shown to re-active oral HSV so that sexual trauma might possibly be associated but most sex is not traumatic and even this would be unusual.
3. There are no data so suggest that hypothyroidism or use of accutane increases risk for recurrence.
Hope this is helpful to you. EWH
Good questions. I will try to help by providing you with the information we have gained from studies which have helped to describe what persons with genital herpes can anticipate, on average. The unfortunate part about such information is that this of course does not predict what any individual will experience. With those limitations, the information from the studies is very helpful and I hope that this will be the case for you.
In general, genital herpes caused by HSV-1 is less likely to recur and less likely to be transmitted to sexual partners than HSV-2. Similarly, asymptomatic shedding of the virus is less likely to occur when genital HSV is caused by HSV-1. When persons with GH due to HSV-1 do have recurrences, they tend to have one or two in the first year following infection and then few or no more. For both HSV-1 and HSV-1, recurrences are more likely to occur in the first year following infection. Furthermore, for persons placed on suppressive therapy when they take daily antiviral therapy, it is common to have a recurrence soon after discontinuing therapy so your recent recurrence does not mean that you will have frequent further recurrences, only time will tell.
Let's address you specific questions:
1. See above. Your recurrence does not mean that you will have frequent recurrences. I would continue to not take the valacyclovir and see what happens.
2. There are no data to suggest that sex triggers recurrences of HSV. the chances that sex will trigger recurrences is quite unlikely. Trauma has been shown to re-active oral HSV so that sexual trauma might possibly be associated but most sex is not traumatic and even this would be unusual.
3. There are no data so suggest that hypothyroidism or use of accutane increases risk for recurrence.
Hope this is helpful to you. EWH
MEDICAL PROFESSIONAL
Sometimes (often actually) when persons are focused on something like this, they start to notice things about themselves that they might not have noticed before. This may or may not be going on for you. I am not trying to put you off and I appreciate your efforts to be able to recognize what an outbreak might look like. To do so however, you really need to have the areas you are concnerned about looked at and, possible tested. For me to try to make a diagnosis of any sort over the internet would be improper of me and not in your best interest. Sorry. EWH
I am sorry Dr. Hook I am sure it gets frustrating hearing us worry constantly about this subject. I really am just trying to understand to the best of my ability what is and what is not an outbreak so that i may best protect my husband. I checked again today, it looks like there are a couple more bumps now outside of the vagina at the bottom, again no itching, they aren't even as tender to touch anymore, but they are bumps, not ulcers, not yet at least. Is there anything sex related (non HSV related) that can cause this? Is there a chance that if this is another outbreak that they can still stop recurring since it is only second since the initial OB or is it likely that with this pattern they will continue to recur frequently? Again I apologize if I am being a pest, just trying to get a grasp on this disease somehow and how it works to help my relationship to the fullest.
Thank you
Thank you
MEDICAL PROFESSIONAL
I doubt that there is anything that you are doing wrong. That this started to hurt when you began to have sex suggests this may be related to the sex, not to your HSV. The other characteristics which also make it different from your prior recurrence also support the idea that this is not HSV. Could it be HSV, yes. Is it likely, no. I would urge you to try to put this behind you. EWH
Thank you for your response Dr Hook, I truly appreciate it.
You are right, ever since the diagnosis every little itch has made me wonder if I am having another outbreak. In this case, the ulcer seems to be in the same spot where I always get them, I just don't understand how it started after sex, I hadn't had sex since my diagnosis, so over 5 months ago, so I related the initial pink tinged bleeding to that, but then the next day when we had sex it started to hurt, only when he first entered, and so i checked with a mirror, and i saw what looks like an ulcer, just like the ones i have had before, one on the inside of the vagina, at the bottom of the entrance. The thing is, besides being painful to touch, there are no other signs of an outbreak at all. The first recurrence I had was very itchy, so i knew i was having an outbreak, with this one, it just hurts to touch. Is it normal for the s/s to vary from each recurrence?
Again I guess I am most worried that sex is my trigger, and this happened due to sex. I am not understanding why I am having problems with HSV 1, it should be harmless from what almost every doctor tells me. Is there something that I am doing wrong?
You are right, ever since the diagnosis every little itch has made me wonder if I am having another outbreak. In this case, the ulcer seems to be in the same spot where I always get them, I just don't understand how it started after sex, I hadn't had sex since my diagnosis, so over 5 months ago, so I related the initial pink tinged bleeding to that, but then the next day when we had sex it started to hurt, only when he first entered, and so i checked with a mirror, and i saw what looks like an ulcer, just like the ones i have had before, one on the inside of the vagina, at the bottom of the entrance. The thing is, besides being painful to touch, there are no other signs of an outbreak at all. The first recurrence I had was very itchy, so i knew i was having an outbreak, with this one, it just hurts to touch. Is it normal for the s/s to vary from each recurrence?
Again I guess I am most worried that sex is my trigger, and this happened due to sex. I am not understanding why I am having problems with HSV 1, it should be harmless from what almost every doctor tells me. Is there something that I am doing wrong?
MEDICAL PROFESSIONAL
I'll try to help but to be sure, your would need a culture or PCR test for verification of whether or not this is an OB. You noticed this lesion following sex - could this be related to that? It is a bit unusual for recurrent HSV lesions to bleed. The "extra skin" does not sound like HSV.
Two other comments that may be helpful. First, realize that now, following your diagnosis, you are more likely than ever to be looking closely and you may be noticing things that you might have overlooked, ignored or dicounted before. I'm not saying you did, but this is something for you to think about.
Secondly, recurrences tend to etablish a pattern. I would still stay of regualr use of antivirla therapy for now and see if you have another OB.
Hope this is some help. EWH
Two other comments that may be helpful. First, realize that now, following your diagnosis, you are more likely than ever to be looking closely and you may be noticing things that you might have overlooked, ignored or dicounted before. I'm not saying you did, but this is something for you to think about.
Secondly, recurrences tend to etablish a pattern. I would still stay of regualr use of antivirla therapy for now and see if you have another OB.
Hope this is some help. EWH
I also noticed during my period that i had what looked like an extra lump of skin hanging from the bottom of my vagina that was sore to touch but seems to be gone now. Any chance this could be related to that?
HI Dr.
If i need to go back and repost with a new payment please let me know. I am now having what i think is another recurrence. This would make it my second recurrence the first being just 2 months back. I didn't have any prodome symptoms, i had sex with my fiancee and right after noticed slight pink tinged bleeding on the tissue after wiping. The next day I felt sore to touch at the bottom of my vaginal entrance. I looked with a mirror and saw what looked like an ulcer. Do ulcers actively bleed? I still have pink tinged blood when wiping. Does this sound like a recurrence? If so, why am i having another outbreak so quickly? Having HSV 1 i didn't expect this at all. Anything i can do to stop these outbreaks?
Thank you again for your help.
If i need to go back and repost with a new payment please let me know. I am now having what i think is another recurrence. This would make it my second recurrence the first being just 2 months back. I didn't have any prodome symptoms, i had sex with my fiancee and right after noticed slight pink tinged bleeding on the tissue after wiping. The next day I felt sore to touch at the bottom of my vaginal entrance. I looked with a mirror and saw what looked like an ulcer. Do ulcers actively bleed? I still have pink tinged blood when wiping. Does this sound like a recurrence? If so, why am i having another outbreak so quickly? Having HSV 1 i didn't expect this at all. Anything i can do to stop these outbreaks?
Thank you again for your help.
MEDICAL PROFESSIONAL
Glad to help. EWH
Okay thanks for the information! You have been of great help to me!
Thank you, I really appreciate your help. This forum has helped me a lot in coping with this. Just to clarify, does taking Valtrex affect blood test results? Is it possible that I came up negative for HSV 2 because I had the blood test done while taking Valtrex? I know the culture showed I only had HSV1 but I am just paranoid and want to be sure it is not HSV 2.
Also, what are the chances of me transmitting this to my husband (again he is negative for both 1 and 2) if we don't use protection? He really does not want to use protection since we will be in a long term committed relationship. I know they say that suppressive therapy is not necessary for genital HSV 1, so if we don't use condoms, and are not on suppressive therapy, and just avoid sex during outbreaks, what are the chances he will get it?
Again i really appreciate all your help.
Thank you!
Also, what are the chances of me transmitting this to my husband (again he is negative for both 1 and 2) if we don't use protection? He really does not want to use protection since we will be in a long term committed relationship. I know they say that suppressive therapy is not necessary for genital HSV 1, so if we don't use condoms, and are not on suppressive therapy, and just avoid sex during outbreaks, what are the chances he will get it?
Again i really appreciate all your help.
Thank you!
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
