What is it?
Herpes Simplex is a common viral infection. There are two different strains of the virus: HSV1 and HSV2. Usually, HSV1 manifests as sores around the mouth, and HSV2 as sores around the genitals. Both virus strains can occur in either place, though, or even other places on the body, like on thighs, face, urethra, cervix, and even the throat and eyes. While herpes is not a serious medical concern (meaning the infection will not cause major medical issues like infertility), a positive diagnosis may feel like the end of your sex life. It’s not! About 1 in 2 Americans have HSV 1, and about 1 in 6 have HSV 2.
How did I get it?
You can contract the virus by skin-to-skin contact with infected areas during oral, anal, or vaginal sex, as well as sharing drinks, lip products, utensils, etc. Sometimes, a mother will pass the virus to her child during childbirth. You can also spread it to different parts of your own body by touching a sore and then touching another part of your body without washing your hands—so be careful! The virus is most contagious when there are sores present. In some cases, a phenomenon called “shedding” can occur, where an area of the skin that has had an outbreak in the past, but looks undisturbed in the present, is still contagious. Unfortunately there is no way to know if you are “shedding” or not, so always talk to your partners about your diagnosis before foreplay or sex.
The virus can lay dormant for extended periods of time before an outbreak occurs, so do not automatically assume the last person you were sexually active with gave it to you! When someone in a committed relationship suddenly gets an outbreak, and both partners have no prior history of the virus, it does not necessarily mean that your partner was unfaithful. It is also possible for partners to transmit to each other from mouth to genital region and vice versa, no matter which strain is present, so consider use of dental dams and/or condoms.
What are the symptoms?
HSV1 and HSV2 have very similar symptoms; HSV1 sores can appear on both the mouth and genitals (although mouth sores are more common), and likewise HSV2 sores can appear in both places, but may be more commonly found on the genitals. Do not assume you have one or the other based only on where the infection started; only a test from your healthcare provider can tell you for sure. Many people never have symptoms, or the symptoms are so minor they go unnoticed. The most invasive and common symptoms are sores or ulcers that eventually scab over. Usually, herpes sores follow a certain course: first, one experiences pain and/or tingling where the sores will begin to emerge. Second, blisters form, usually reddish in color. They may appear as one sore or as a cluster of smaller sores, and are usually very painful (this intense pain may help distinguish between a herpetic outbreak and a pimple or ingrown hair). Third, the blisters fill with fluid, which will be a yellow or clear color. Fourth, the blisters burst open and are very raw. Fifth, the blisters begin to scab over and heal. They usually will not leave a scar, but can if you poke at them too much! They can take up to 2 to 3 weeks to heal, and you should abstain from sexual activity until about 7 days after the sores have cleared up. It is very common for outbreaks to reoccur, but they are almost always less severe than the initial appearance of sores. When dealing with this infection, it is especially important to maintain a healthy lifestyle, as certain things like stress, sicknesses, or sleep deprivation can trigger an outbreak. Other common symptoms include: pain and itching in the genital area, tingling around the lips, and flu-like symptoms, such as fever, headache, muscle pain, and swollen lymph nodes (these are all over your body, but the ones most likely to be affected are the ones near your groin, under your chin, the sides of your neck, and in your armpits).
What do I do when the test comes back positive?
There is currently no cure for herpes, because it is a virus; but living with it is still very manageable. There are certain antiviral medications that can help prevent outbreaks, or help shorten their duration, and also reduce the chances of spreading the virus to others during sexual activity. The main medications used are called Acyclovir (Zovirax), Famciclovir (Famvir), and Valacyclovir (Valtrex). There are two ways to use these medications: some begin taking them for a short cycle at the onset of an outbreak (you can ask your doctor for more specifics about dosage and they may even give you a prescription to keep on hand in the event of an outbreak); others take them daily if they are prone to frequent outbreaks, if the outbreaks are usually severe, or if they are in a relationship and decide not to use protective measures during sex. It’s especially important to lessen the chances of spreading to partners by abstaining from sex during outbreaks. To protect yourself and your partner in the case of “shedding” (possible presence of the virus without visible sores), use latex condoms, dental dams, other barrier protections, and correct cleaning measures before/after using sex toys. Daily suppressive therapy will greatly lessen the chance of an outbreak and transmission to partners, but will not eliminate the risk completely. Many couples still decide to forgo barrier protections when sores are not present despite the small risk of transmission.