What's that down there, exactly?

March 18, 2011 9:37 AM

[HerpesFilter] I have been dating someone awesome for about a month now. We have known each other for a year and a half and just started dating a month ago because I asked him out (he missed my first subtle asking out, I drunkenly told him he'd turned me down and he wanted to rectify). I knew he was kind of checked out of the dating game (afaik he hasn't been on another date since I've known him). Then I found out it's because he has herpes.

Before our first date even happened, he told me that there was something I should know about him and it was that he has herpes. I said okay, that I'd still like to go out and see where it went. Where it went was AWESOME Town. We are super in love and we have had sex (with condoms). I still have questions about what I can do to protect myself and how much healthy fear I should have.

He currently takes Valtrex twice a day and we use spermicidal condoms. He hasn't had any outbreaks or pre-outbreak symptoms while we've been together but we are planning to be abstinent when that inevitably happens.

What else can we do, specifically with regards to oral sex (me on him)? I love it, he Ioves it, but I'm not keen on suckling a balloon. Risk it? He got it from oral sex from someone with cold sores, so it seems like he could have the mouth kind.

I have an appointment at Planned Parenthood today to get tested and get more information, but I also thought MeFi might have additional insight.

My questions:
1. What else can I do to protect myself here? Is there a vaccine or other therapy I can try?
2. How much should I worry? If I get it, I get it right? It seems like minor discomfort...

Thanks MeFi!

posted by anonymous to Health & Fitness (11 answers total)

planned parenthood will have all the information in handy pamphlets and details (if you are comfortable asking) (and unless their funding gets cut). that said, from folks in my world, it is absolutely manageable - and as was said in the late 80's and early 90's, safe sex is hot sex - always defer to caution, as it is your health you're talking about.
posted by anya32 at 10:00 AM on March 18, 2011

Seconding Anya32. Good for the both of you for having a major discussion about sex.
posted by Silvertree at 10:01 AM on March 18, 2011

*I meant to write mature.
posted by Silvertree at 10:02 AM on March 18, 2011

You sound like you've got everything completely under control. I know several people with herpes, and they all agree that the worst part is the awkward disclosures before sexytime. Only you can appropriately assess your risk tolerance, and it seems like you're doing what you need to do make an informed decision.

Congrats on your great new relationship!
posted by psycheslamp at 11:32 AM on March 18, 2011

I would advise against spermicides--they can irritate skin and make it easier to transmit things that travel via skin-skin contact. Unless this is some new non-irritating spermicide I don't know about. Condoms are great if his outbreak is on the part of his penis covered by the condom. It goes without saying that you should avoid contact when sores are visible or if he feels an outbreak coming on. Does he have frequent outbreaks? As for the condom-less bjs, I'd say that depends on your comfort level (apart from avoiding around the time of outbreaks). It's been a few years since I've read up on this, but studies of long term couples show that it's possible (though not 100%) to avoid passing infection as long as direct contact is avoided during tinglyness/outbreak time.

As for the worrying...hopefully with your visit to PP they'll explain to you how most adults (estimates are ~90%) have antibodies to HSV-1 (aka oral herpes, though it can be transmitted to other parts, as your bf discovered). So if you get tested, there's a pretty good chance you'll test positive, as the test looks for antibodies. This doesn't necessarily mean you have it, it just means that you were exposed and your body produced antibodies in response. It could possibly mean you do have it, but don't experience visible symptoms. The world of herpes is still a bit mysterious in that respect. But seriously, don't worry. Did I mention ~90% of adults have the antibodies?

Herpes is some weird boogievirus to people even though, as mentioned, it's super common. Back when I studied infectious diseases, the one virus people loved to ask me about after a few drinks was herpes. If you read up on it at a reputable site, like say the CDC, you may feel a bit better about things.
posted by mandymanwasregistered at 11:37 AM on March 18, 2011

It seems like minor discomfort...

If you end up getting genital herpes, and you want to have children down the line, you will likely have to get a C-Section because your child may end up having serious birth defects if you have a vaginal birth. The transmission rate from mother to child is small because the hospital will just make you get a C-Section if you have genital herpes, because even if you don't have any active lesions or sores, you very well likely will shed the virus during labor.

I recommend that you also look at the education pamphlet from the American College of Obstetricians and Gynecologists, and not just the CDC literature. It has more thorough information, including the troubles that arise with regard to child birth and breastfeeding.

Good for you for visiting Planned Parenthood and asking questions to qualified health professionals who are really going to the best source of advice.
posted by anniecat at 12:23 PM on March 18, 2011

Don't freak out about not being able to have a vaginal birth if you have herpes. I do, and have very rare genital outbreaks. Lots of people have very few outbreaks and it doesn't adversely effect their relationships or sex life. I had a completely normal vaginal birth. Anyone, including a doctor, who tells you that you will be required to have a C-section, regardless of whether you are having an active outbreak, or not, should be avoided. I've been married 17 years and my husband has not acquired the virus from me, nor did my son during birth or breastfeeding.
posted by gidja at 12:44 PM on March 18, 2011

Compare and contrast

If you end up getting genital herpes, and you want to have children down the line, you will likely have to get a C-Section because your child may end up having serious birth defects if you have a vaginal birth. --Random internet person

with

If you develop genital herpes for the first time during the third trimester (week 27 of the pregnancy until birth), particularly during the last six weeks of the pregnancy, the risk of passing the virus on to your baby is considerably higher. This is because you will not have time to develop any protective antibodies to pass to your baby, and the virus can be passed to your baby before or during the birth.

To prevent this happening, you may need to have a caesarean section delivery. --The NHS (emphasis mine).

(Summary of the rest of that NHS page: If you do have herpes and and are pregnant, you'll pass on antibodies to the baby, protecting it, and also you can take acyclovir, which reduces symptoms and thereby minimises risk.)
posted by Lebannen at 2:01 PM on March 18, 2011

He got it from oral sex from someone with cold sores

You know, this is possible, but unlikely. You can get oral herpes on your genitals, but usually there aren't subsequent outbreaks if that happens. (The CDC says genital outbreaks of type I are less frequent than type II.)

I bet your new friends is misinformed or making a wrong assumption about where he got it. I hope he's not being deliberately dishonest.

Having said that, herpes is very common and there's much less anxiety about it in the medical world than there used to be. You certainly don't need to get a C-section if you have it. The danger in pregnancy is if you have your primary (first) outbreak in your first trimester or if you have active lesions during birth. Unlikely.

Herpes is not possible to fully protect yourself against. Condoms will only protect you from herpes lesions that are under the condom. However, if he is taking antivirals and you guys are committed to skipping that kind of sex when he has an outbreak, you are pretty darned safe.

So have fun!
posted by serazin at 9:46 PM on March 18, 2011

I wanted to pop back in and encourage you again to ask qualified health professionals questions about all the health advice you're getting in this thread. In fact, if I were you, I would print out this thread and show it to the folks at Planned Parenthood or your gynecologist and see what they say. In fact, go to two gynecologists and ask them what they think.

I strongly urge you to only consider information you receive from Planned Parenthood, and/or your gynecologist (especially your gynecologist) when making your decisions and not people here.
posted by anniecat at 10:56 AM on March 19, 2011

In response to that little chastening above, I went back and checked uptodate's (online reference for docs and health professionals - research based) entries on genital herpes and neonatal herpes and so forth.

I was wrong about about the first trimester infections being particularly dangerous - even intrapartum HSV infection (extremely rare) tends to happen in the third trimester. I know this is not really a major part of your real question OP. I stand by the other stuff I said although of course you have to asses your own comfort level around risk.

I am not a doctor, but I'm a medical writer and nursing student and I spend all my work and school time researching, reading, writing, and doing education about medicine and health. Incidentally, you're likely to talk to a lay health educator at PP, not a doctor, as most PPs utilize young, nonprofessional counselors to do their health ed stuff. FYI.
posted by serazin at 11:44 AM on March 19, 2011