Many people do not feel comfortable talking about sexuality and sexual health issues. This pamphlet will explore ways of feeling more confident in discussing herpes in the context of a sexual relationship. Cold sores on the mouth and genital herpes are medically the same condition. The significant difference arises from the stigma that tends to accompany a herpes infection that is sexually transmitted. Most people find that their partners are both supportive and understanding. It is a common assumption to initially think that a person may base their judgement of you on the fact you have genital herpes. However, for most this is a minor skin infection.
This is because once the herpes virus is acquired, it stays permanently in the body. Most of the time it remains inactive, but every so often it may reactivate and cause another outbreak.
Each individual is different — some people never have a recurrence; others may have recurrences several times a year. However, recurrent outbreaks are usually shorter and less severe than the first herpes episode. Certain events or situations can trigger recurrences, and you may be able to help your partner avoid or reduce the trigger factors, which may include stress at work or home, fatigue, ill health, loss of sleep, friction due to sexual intercourse, and menstruation in women.
If your partner has frequent or severe episodes of genital herpes, or if the recurrent outbreaks are causing a lot of anxiety for your partner, then he or she may benefit from suppressive therapy taking oral antiviral tablets continuously , which prevents or reduces recurrences.
If you take the necessary precautions, the chances of getting the herpes virus from your partner are reduced.
Genital herpes does not mean abstinence from sex or a reduced enjoyment of sex. The continued use of condoms in a long-term relationship is a personal decision that only the couple can make.
Most find that as the importance of the HSV infection in their relationship is seen in perspective, that condom use becomes less relevant if this is the only reason condoms are being used. However, most couples choose to avoid genital skin-to-skin contact during an active episode of herpes because this is when the herpes virus is most readily transmitted. This period includes the time from when your partner first has warning signs of an outbreak, such as a tingling or burning in the genitals, until the last of the sores has healed.
Also, sexual activity prolongs the healing of the episode. Herpes transmission risk is increased if there are any breaks in the skin. For example, if you have thrush or small abrasions from sexual intercourse, often due to insufficient lubrication.
Dating genital herpes
It can be helpful to use a lubricant specifically for sexual intercourse and avoid sex if you have thrush. Sexual lubricant is helpful right at the start of sexual activity. Sores in other areas — such as the buttocks and thighs — can be just as contagious as those in the genital area, and care should be taken to avoid direct contact with such sores during sex. At other times, there is still a small risk of transmitting the herpes infection through a process known as asymptomatic shedding, even if your partner is showing no signs of genital herpes.
This risk can be reduced significantly if a person with herpes takes suppressive oral antiviral treatment. If you or your partner has a cold sore, it is advisable to avoid oral sex as this can spread the herpes virus to the genitals. You cannot catch genital herpes by sharing cups, towels or bath water, or from toilet seats. You can still cuddle, share a bed, or kiss. After you have read this booklet and discussed genital herpes with your partner, you might have specific questions or concerns about herpes.
Continue to go back to your doctor or counsellor until all your queries about genital herpes are answered. Sexual Health Clinics also provide confidential free treatment, management and information. In some areas, there are local genital herpes support groups that can be a valuable source of information and support.
The following section gives you in-depth information about the use of oral antivirals to treat herpes. Aciclovir has been used for this indication for a number of years now and found to be highly effective in controlling herpes recurrences.
Some people with genital herpes have identified factors which may influence frequency or severity of recurrences. Factors such as stress, diet and lifestyle may be worth considering when looking at ways of managing herpes in your life. Each case is individual and what works for one may not work for another.
Frequent or severe recurrences of genital herpes infection may interfere with normal work and social activities, and cause disruption to your sex life. However, there are steps which you can take to reduce outbreaks and help bring the herpes virus under control. This section explains what you can do and answers some other questions which you may have about living with genital herpes. Once you have acquired the herpes simplex virus HSV-2 it remains permanently resident in your body, living in a structure called the dorsal root ganglion, which is part of the nervous tissue located near to the base of the spinal column.
It spreads down the nerve to break out on the skin from time to time. Most of the time it is inactive, but every so often something happens to reactivate it, which causes the symptoms you recognise. Sometimes the herpes virus can reactivate and be shed without recognisable herpes symptoms asymptomatic shedding. It is not known exactly why the herpes virus becomes active again. Some people recognise certain trigger factors which contribute to an outbreak.
These may include friction due to sexual intercourse, ill health, stress, fatigue, depression, loss of sleep, direct sunlight and menstruation. Many people find that as the years go by the number and severity of their herpes recurrences naturally diminish. Education and counselling will often help an individual cope with recurrences.
People who make contact with a support group for people with genital herpes often describe this as being a turning point in their coping with genital herpes in their life. Suppressive therapy involves taking an oral antiviral drug every day for prolonged periods. When recurrences do occur, they are usually less severe and shorter lasting. If you find the frequency of your outbreaks unacceptable, or if you are finding it difficult to cope emotionally with having recurrences of genital herpes, tell your doctor and discuss the use of suppressive therapy.
For example, a very large study found that people who had an average of over 12 herpes occurrences a year, could reduce the frequency of their herpes outbreaks to less than two a year after one year of continuous suppressive therapy. The study also showed that if recurrences do occur during suppressive therapy, they are usually less severe and shorter lasting. Your doctor may agree that suppressive antiviral therapy is suitable for you if one of the following applies to you: There are two oral antivirals available for suppressive treatment in New Zealand: Many people who use suppressive therapy say that they get so used to taking the tablets or capsules they are happy to continue with the treatment.
If you choose suppressive therapy, you do not have to stay on it permanently. If you prefer, you can take it until you feel in control of the herpes infection, but this is usually a period of months initially.
Your doctor may suggest you stop the suppressive therapy for several months after you have taken suppressive therapy for some time, in order to assess how active your genital herpes remains. If you are still having problems with herpes recurrences, you and your doctor may then decide that you should start suppressive therapy again. Aciclovir has been reported to cause no serious side-effects, even after years of use.
A few people taking suppressive therapy do experience minor side-effects such as headache, nausea and diarrhoea. If you have a problem, discuss this with your doctor. Research to date shows that people with normal immune systems who are on oral antivirals for a long period do not develop virus resistance or clinical breakthrough. Also, there is little interaction with other drugs, e. Suppressive herpes therapy may give marked improvement to your emotional well-being.
Many people find the fact that they can control the infection gives a boost to their sense of well-being and self-confidence. Even if only taken for a few months, suppressive therapy can help you to come to terms with emotions caused by recurrent genital herpes, including depression and anxiety. However, suppressive therapy is only part of it. There are benefits gained from expert counselling from your doctor or nurse, or by speaking to a counsellor on the tollfree Herpes Helpline 11 12 Make sure that you continue to talk to a health professional you are comfortable with, at least until you feel completely at ease with having genital herpes and in command of the infection.
The antiviral drug Aciclovir was the first therapy which had been shown conclusively to be effective in treating genital herpes. New antiviral drugs have become available which work in a similar way to Aciclovir, are more effective and require less frequent dosing to treat or suppress the recurrence. These are not available in New Zealand. However, these are still in the developmental research stage and will not be available commercially for some years.
Many people find that having a healthy diet, eating regularly and getting enough sleep are helpful in preventing recurrences. Having genital herpes does not affect your ability to have a baby.
Overall, the incidence of neonatal herpes babies up to 28 days old infected by herpes is very rare. However, when it does occur it is potentially very harmful to the baby.
It is therefore important to tell your doctor or midwife if you or your partner have had a history of genital herpes. They will then be able to provide information, reassurance and optimal management. Recurrent episodes of genital herpes during pregnancy are not harmful to the foetus.
If you have genital herpes at the time when your baby is due, there is a small risk that the baby could become infected at delivery as it passes down the birth canal. This risk is most substantial for mothers who are having their first ever episode of genital herpes near to or during delivery. As with any drug therapies, oral antiviral tablets are not routinely recommended for use during pregnancy.
Aciclovir has been used for treating genital herpes for over 15 years and as with any drug, a register has been kept to report any adverse side effects for women who have taken it during pregnancy. To date there have been no adverse side effects reported for either the baby or the mother. Due to the potential seriousness of a primary episode of genital herpes for the baby and the relative safety of Aciclovir, it is now recommended that Aciclovir is used for treating a first episode of genital herpes or severe recurrent herpes in the last trimester of pregnancy.
It is believed that the benefit of using Aciclovir, by reducing the risk of transmission of herpes to the baby, outweighs the risk of not using it. Episodic treatment is taking a short course of Aciclovir at the onset of a recurrence.
Those who have less frequent recurrences may find episodic herpes treatment useful. If taken soon enough, it may stop ulcers developing known as aborting the lesion.
It helps to have aciclovir available beforehand. If you want to use episodic treatment, ask your doctor to prescribe a supply for you. This approach will not have any effect on asymptomatic viral shedding and hence its effect on reducing herpes transmission is unclear and not likely to be very significant.
4 Questions You Probably Have About Dating With Herpes
This approach is useful, however, for persons who have infrequent attacks or for when persons are stopping continuous suppressive therapy.
General practitioners are able to prescribe oral antivirals for suppressing herpes. Prescriptions can be filled at retail pharmacies. Alternatively you can download our guide as one pdf. Myths vs Fact in pdf form. Click here if you would like to get a copy of the information booklet "The Facts: Click here if you would like to get a print copy of the information booklet "The Facts: Herpes and Relationships Discussing Genital Herpes with your Partner Many people do not feel comfortable talking about sexuality and sexual health issues.
The absence of symptoms does not mean a person has not got genital herpes. Herpes simplex virus HSV most often shows up as small blisters or sores on either the mouth cold sore or fever blisters or the genitals. HSV can be passed on when one person has the herpes virus present on the skin and another person makes direct skin-to-skin contact with live herpes virus. The herpes virus is likely to be present on the skin from the first sign of prodrome tingling or itching where the outbreak usually occurs until the sores have completely healed and new skin is present.
There are likely to be certain days when active herpes virus might be on the skin even though there are no obvious signs or symptoms. Since they have not been diagnosed, they are unaware that they may be contagious from time to time.
There is effective oral antiviral treatment for people with problematic genital herpes. Have you ever had a cold sore?
The reason I ask is that cold sores are caused by a type of virus.
I have the virus. Only instead of getting a cold sore on my mouth, I get one in my genital area. Can we talk now? Last year, I found out that I had contracted genital herpes. Consider giving them reading material or referring them to a Sexual Health Centre, the Herpes Helpline 11 12 13 or the herpes website www.
What it means for Partners Your partner has genital herpes. What is Genital Herpes? How has my Partner caught Genital Herpes? What are the symptoms of Genital Herpes? How do I know if I have Genital Herpes? Do the symptoms of Genital Herpes return? What can we do to reduce my chances of getting the Herpes infection?
Where can I get more information and advice? Controlling recurrent Genital Herpes: How effective is suppressive therapy? I now take aciclovir mg twice a day and have not had any outbreaks since. If your outbreaks are frequent, I really recommend it. You are having frequent herpes recurrences. You have less frequent but particularly severe or long lasting herpes outbreaks.
You find recurrences of genital herpes are making you depressed, anxious or withdrawn, or the emotional upset caused to you by genital herpes is disrupting your social activities or sex life.
Such feelings can themselves bring on a recurrence and so you can easily get into a vicious cycle. Taking suppressive therapy, perhaps only for a short time, can help you break the cycle and give you a sense of control over the infection.
You experience severe pain neuralgia due to recurrent herpes episodes. You have only a few herpes recurrences but they always occur during specific situations, for example, when you have exams or go on holiday.Potential Partners: What You Need To Know When Considering Dating a Herpes Positive
You may wish to start suppressive therapy before you go on holiday and continue on it until you return, thereby reducing the chance of a recurrence. You don't want that to be you. The hardest part may be deciding how to broach the subject. You never know—your partner may divulge he or she also has herpes. You could start the conversation by mentioning cold sores , then move into the subject of genital herpes. You could also start by saying you want to be honest in the relationship, or that you want to discuss safe sex.
It also helps to know a little about how HSV works when you talk to a partner about the infection. Getting the details from your doctor first may be helpful, says Dr.
For starters, there are two types of the virus: HSV-1 typically causes oral herpes, known for those trademark cold sores, while HSV-2 is usually to blame for genital herpes sores. Genital herpes that come from HSV-1 are typically passed through oral sex—a good reason to divulge that you have oral herpes, if you do. Both types of herpes can be passed on when there are active sores and, less frequently, even when there are no symptoms.