I Have Herpes

Dr. Lissa Rankin answers a reader's question on how to talk to her new partner about their future sex life.

OB/GYN On-Call

I Have Herpes

Dear Lissa: I have herpes. I nearly lost my mind when I was diagnosed, but a wonderful man has come into my life and I need to know how to explain what our sex life would be or could look like including oral sex. Please help.

–Afraid of Future

Dear Afraid of Future: First off, don’t fret. Herpes is a bummer, but it’s not the end of the world. It doesn’t mean you’re sex life is over, that your health is in jeopardy, or that you’re a slut. All it means is that you had sex with one person who had sex with one person who happened to draw the unlucky herpes card. So start by blessing your body for being the temple that it is. Trust that this lovely man will also bless, appreciate and respect your body, even if it means jumping through a few hurdles and assuming a bit of risk. Then breathe, feel the peace, and read on.

It’s Just Herpes, Not HIV
Unlike diseases like HIV, syphilis, and hepatitis B and C, herpes does not put your whole body or life in jeopardy. Aside from during pregnancy, when it can potentially cause issues for the baby, it’s more of a nuisance than anything else. But because it is a virus that cannot be cured with a simple antibiotic, the way gonorrhea and chlamydia can, herpes gets a bad rap.

Intercourse poses a higher risk of causing genital ulcers than oral sex does. Giving oral sex is riskier than receiving it, since most STDs are carried in the genitals, not the mouth. If your guy goes down on you, he is at risk of getting oral ulcers, although HSV-2 (genital herpes) tends to prefer the genitals, while HSV-1 (oral herpes) prefers the mouth. Although HSV-1 and 2 prefer their zones, there can be crossover, so he could get HSV-2 ulcers in the mouth.

Your partner may want to get tested for HSV-1 and HSV-2 antibodies. Many people have already been exposed and don’t even know it. He may have never had ulcers in his mouth or genitals but may already have antibodies showing that he has been exposed.

While herpes is infectious, and your partner will be at risk of contracting herpes if he engages in a sexual relationship with you, many couples in which one partner has herpes have satisfying sexual relationships.

A Happy-Ending Herpes Story From One of My Patients
One of my long-time patients came to see me, complaining of pain on her labia. She felt like she might have cut herself shaving, so she looked in the mirror and noticed a bunch of little sores. She put antibiotic cream on them, but when she woke up the next morning, they hurt even more. I worried that she might have herpes, so I asked her whether she had any new sexual partners, and she no. In fact, her boyfriend had just proposed, and they were planning their wedding.

When I examined her, the exam was consistent with herpes, with grouped vesicles of inflamed ulcers, each oozing fluid, all over her labia and perineum, the skin between the vagina and rectum. A culture confirmed the diagnosis, and my patient was devastated.

She cried, “My boyfriend will never marry me now! He’s going to think I cheated, but I would never do that. I love him, and he’s a great guy, but he’s going to think I’m a dirty whore.”

I invited her to bring her boyfriend into my office, so the three of us could have a heart to heart. When the awkward moment arrived, with both of them seated in my office, I told her boyfriend the news, and he got out of his chair and hugged his girlfriend, long and hard.

“Thank God,” he said, tearing up. “I was afraid you were going to tell me you had cancer.”

I recommended that my patient take a daily dose of medication to suppress her shedding of the virus and reduce her partner’s risk of contracting it. Additionally, I warned them to avoid intercourse if she had an active herpes lesion.

He asked, “Do we have to use condoms forever?”

I answered, as I usually do, that most couples choose not to use condoms indefinitely. Most just decide to take the risk and if they both get herpes, they both get herpes. But ultimately, that was something they would have to decide together. He leaned in close to her and said, “I’m sure we’ll get through harder things than this.” They were married a year later.

Tips for Protecting Your Partner When You Have Herpes
There’s no surefire way to prevent transmitting genital herpes, but there are things you can do to reduce your risk.

1) Take a daily antiviral such as Valtrex, which has been proven to reduce the risk of transmission by reducing the amount of virus that is shed from your genitals.

2) Avoid genital/genital or genital/oral contact when you have an active herpes outbreak.

3) Wear condoms. Although condoms don’t completely prevent transmission of herpes because they don’t cover all the genital skin, they do reduce the risk of transmission.

4) Reconsider anal sex, which may have a higher rate of herpes transmission because the fragile anus can be easily damaged. If you do choose to have anal sex, use condoms.

5) If your partner wants to protect himself while performing oral sex on you, he can use a dental dam (latex squares commonly used by dentists during dental procedures).

6) Offer your partner a visit to the gynecologist. Creating a safe environment so your partner can ask questions can help educate him and ease anxiety.

7) Understand that you may transmit herpes to your partner, even if you do everything right. Remember that it’s not the end of the world if your partner does get herpes. If your partner can’t handle the risk, maybe he’s not the one for you. I’ve had many patients navigate the awkward herpes issue and live happily ever after.

Remember, it’s just herpes. Yes, it’s best to avoid it, it’s a nuisance when you have it, and nobody willingly signs up to get infected with an STD. But put it into perspective. If you love someone, and your partner loves you, you can overcome anything.


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2 thoughts on “I Have Herpes

  1. Gregory says:

    This is great advice Dr Lissa Rankin pushing home the point that contracting herpes is truly not the end of the world. I love the story of the couple you were seeing, open communication with a lot of understanding is truely the way. I'd like to add a great way with coping with the virus through your diet. Eat foods like: vegetables, legumes, cheese, all fish, chicken, turkey and eggs. These are great during outbreaks.

  2. Isabelle says:

    This is great advice Dr Lissa Rankin pushing home the point that contracting herpes is truly not the end of the world. I love the story of the couple you were seeing, open communication with a lot of understanding is truely the way. I'd like to add a great way with coping with the virus through your diet. Eat foods like: vegetables, legumes, cheese, all fish, chicken, turkey and eggs. These are great during outbreaks.

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