Herpes

[kdh]

I've been researching herpes and still have a couple of questions.

1) I've been told by both my doctor and Planned Parenthood that a herpes blood test would be ineffective b/c it would only tell me that I have been exposed to herpes and not if I actually had the virus.  My partner has just been diagnosed with herpes so I'm assuming for now that I have it as well.  My doctor actually refused to give me the blood test and said she would only test me if I developed symptoms!  I have an appointment today with Planned Parenthood (again) and will get the blood test despite their insistence that the blood test will tell me nothing.  My question is:  Are the doctors just ignorant or are there tests that just produce the results they are talking about?  I plan on asking for the tests you have recommended in others' questions.

2) Assuming that I also have herpes, can my partner and I cause outbreaks in each other?  For example, if I'm shedding, will having sex with my partner (who does have herpes) cause him to have an outbreak?

I was tested for all STD's a few weeks before meeting my current partner except for herpes b/c the people at Planned Parenthood said that it wasn't necessary if I didn't have sores.  I wish I had researched herpes more b/c I didn't realize that the symptoms could be as minor as those experienced during a yeast infection.  I fear my lack of education in this area may have caused me to infect my current partner.

Thanks for all your help and encouragement!

[H. Hunter Handsfield, M.D.]

On many occasions, I have said I avoid "competing" with health care providers who have actually examined a patient.  But that applies to a specific diagnosis, not to clear misinformation.  Your doctor and the person you spoke with an Planned Parenthood don't know what they are talking about.  A positive blood test for HSV-2 means the person is infected with the virus, not merely "exposed".  On top of that, it is by no means certain you are infected (see below), and a negative test result would show that.

Any doctor who "refuses" to draw a requested test had better have an awfully good reason--and even then should still do the test if the patient insists.  Your doctor's response is not only scientifically wrong, but incredibly paternalistic.  I hope you'll have the confidence to tell him so.  Feel free to show him this message--and if he disagrees, have him contact MedHelp to get in touch with me personally.  I will authorize the web administrator to provide him my contact information.

Whew--sorry to be so exercused!  Now that I've got that off my chest, on to your questions about the disease.

1) You may or may not be infected.  If your boyfriend is pretty sure he caught genital herpes from you, then it is highly likely he is right.  But if you have had no symptoms, you might have been luck so far--you might not yet be infected.  You are right, by the way, that some cases of herpes are misdiagnosed as yeast infections.

Herpes prevention may not be all that important to you (despite all the hype, it's usually so mild people don't know they have it).  But if that IS important, you definitely need a HSV-2 blood test (HerpesSelect or Biokit HSV-2).  If the result is negative, you and your boyfriend can take steps to help protect you from getting infected.

2) Two people who are both infected with genital herpes do not "ping-pong" the infection back and forth.  Couples in which both persons have herpes do not need to take any precautions whatsoever in their sex lives.  Most people will choose not to have sex when overt sores are present, just for comfort and the esthetics (who wants someone's sores next to their body?).  But transmission back and forth isn't a risk.

Thanks for the thanks.  Best wishes--

HHH, MD

[monkeyflower]

You know, I think it's kind of weird just how much misinformation there is about such a common STD, and I have no idea why. However, I think doctors have to read and remember an enormous amount of information about an enormous number of conditions. I just figure there are bound to be some things that slip through the cracks, lol. So, good for you for educating yourself :-)

If it were me, I'd consider this a golden opportunity to help educate my doctor. I'd put together some info on herpes from different reliable sites (www.cdc.gov/std, www.ashastd.org), and print it out, including actual links. Then, when you see your doctor, you can say you've been doing some research because you're concerned about your health and your partner's health, and give him/her a copy of what you've found. If you're sensitive, kind and considerate of his/her feelings (i.e. not rude, condescending, or arrogant), s/he'll no doubt be grateful for the info. In the long run, this can benefit everyone, including all of his/her future patients :-)

You won't cause outbreaks in each other - once you both have herpes, you have it. As long as you're comfortable having sex, that's fine. As for feeling guilty, *don't*. You seem awfully sure you infected him, when really it's just as likely he entered the relationship with it. You don't even know if you have it yet! Besides, blaming yourself or your partner is pointless and counterproductive at best. Herpes isn't some kind of catastrophe - it's a potentially annoying skin disease, and that's all. You can still lead a deeply fulfilling, satisfying sex life :-)