welcome to the consequences.
October 14, 2008 6:52 AM Subscribe
I'm worried that I have genital herpes. I don't have any lesions, but I know that's not conclusive, and it's going to be a long, long time until a clear antibody test is definitive. How can I stay sane until then? (You are neither my doctor nor my shrink; I have done my Google reading. )
Twelve days ago, guy comes over to stay for a long weekend. We have five days of crazy, awesome sex. It's been seven days since then.
This evening, the guy calls me and tells me that he likely has genital herpes. He was asymptomatic when we had sex; I believe him when he says that he had no idea. He's a decent guy, and more to the point, right now, during this long, painful freakout, I'm not really interested in apportioning blame. We both had lapses in judgment.
When we were having that crazy, awesome vaginal or anal sex, outside of two very brief intervals in the vagina, he used a condom. He performed oral sex on me, briefly, without a dam. I gave him extensive oral sex, though he never ejaculated or came close to ejaculating. (We were into the crazy, awesome vaginal and anal sex. It felt like love, OK? And I know, I know. As mentioned above. Major lapse of judgment. Wrap it up all the time. Believe me, I have learned my lesson.)
Since then, I definitely have not had any lesions. Four days after the last sex we had, I had some dry genital regions, followed by itching and some burning when I peed, but I wrote it off on account of the time of month/having had sex for the first time in three years. I have a bump on my lower back that I'd put down to a bizarre mosquito bite, despite the fact that I live in a mid-Atlantic city, and it's getting a bit cold. I haven't had any flu symptoms, though the glands in my neck are a little swollen. That might be because of allergy season, though. I get cold sores, though I don't have any now, so I understand thus, HSV-1 in the oral area.
From what I understand, even if I don't get lesions down there, I'm going to need clear IgG antibody tests twelve to sixteen weeks out from the last date of possible transmission in order to really know. I'm also given to understand that antibody tests starting from a month might be good indicators, but aren't nearly as conclusive as the ones twelve to sixteen weeks out.
Help me stay sane until February.
Twelve days ago, guy comes over to stay for a long weekend. We have five days of crazy, awesome sex. It's been seven days since then.
This evening, the guy calls me and tells me that he likely has genital herpes. He was asymptomatic when we had sex; I believe him when he says that he had no idea. He's a decent guy, and more to the point, right now, during this long, painful freakout, I'm not really interested in apportioning blame. We both had lapses in judgment.
When we were having that crazy, awesome vaginal or anal sex, outside of two very brief intervals in the vagina, he used a condom. He performed oral sex on me, briefly, without a dam. I gave him extensive oral sex, though he never ejaculated or came close to ejaculating. (We were into the crazy, awesome vaginal and anal sex. It felt like love, OK? And I know, I know. As mentioned above. Major lapse of judgment. Wrap it up all the time. Believe me, I have learned my lesson.)
Since then, I definitely have not had any lesions. Four days after the last sex we had, I had some dry genital regions, followed by itching and some burning when I peed, but I wrote it off on account of the time of month/having had sex for the first time in three years. I have a bump on my lower back that I'd put down to a bizarre mosquito bite, despite the fact that I live in a mid-Atlantic city, and it's getting a bit cold. I haven't had any flu symptoms, though the glands in my neck are a little swollen. That might be because of allergy season, though. I get cold sores, though I don't have any now, so I understand thus, HSV-1 in the oral area.
From what I understand, even if I don't get lesions down there, I'm going to need clear IgG antibody tests twelve to sixteen weeks out from the last date of possible transmission in order to really know. I'm also given to understand that antibody tests starting from a month might be good indicators, but aren't nearly as conclusive as the ones twelve to sixteen weeks out.
Help me stay sane until February.
A few things:
First, not to make you worry more, but herpes isn't the only thing you could have caught, and you should probably schedule another test or two over the next few months. Chances are low, etc, but better to learn early than later.
Second, herpes is staggeringly common (more so when you consider both the -1 and -2 varieties), and there are lots of resources about living with it here on MeFi and elsewhere. I, my entire family, my partner, and everyone I know has oral herpes. Several close friends have confessed to me that they have genital herpes, and I have no doubt that I have been exposed to it at some point. For all I know, I may have it and just be asymptomatic, or maybe my partner is, who knows?
My point is, don't build up your level of worry beyond what this is worth. Genital herpes is no fun (my friends were not telling me about it in the spirit of "dude, this is so awesome!", after all), but it's not a game-ender, either.
Third, don't beat up on yourself about the brief condomless episodes, either. Condoms are great for lowering your risk, but emphatically don't reduce it to zero. If you'd used the condoms perfectly, and he called you with his unhappy news last night, you'd still have the exact same worries as you do now.
Finally, he needs real credit for manning up and doing the right thing by making that (awful, difficult, embarrassing) phone call to you with the bad news. Many, probably most, people wouldn't have done it. They'd have said, well, she probably didn't catch it, and anyway I want to get a second opinion, and maybe I'll get to it next week, and oh, I'm going over to visit her again soon and if I tell her she won't want to see me so maybe I'll tell her after. I don't know if you need to go so far as to buy him flowers, but he's probably having a pretty tough time right now, and chose the honorable path, and deserves to be appreciated for it.
posted by Forktine at 7:35 AM on October 14, 2008
First, not to make you worry more, but herpes isn't the only thing you could have caught, and you should probably schedule another test or two over the next few months. Chances are low, etc, but better to learn early than later.
Second, herpes is staggeringly common (more so when you consider both the -1 and -2 varieties), and there are lots of resources about living with it here on MeFi and elsewhere. I, my entire family, my partner, and everyone I know has oral herpes. Several close friends have confessed to me that they have genital herpes, and I have no doubt that I have been exposed to it at some point. For all I know, I may have it and just be asymptomatic, or maybe my partner is, who knows?
My point is, don't build up your level of worry beyond what this is worth. Genital herpes is no fun (my friends were not telling me about it in the spirit of "dude, this is so awesome!", after all), but it's not a game-ender, either.
Third, don't beat up on yourself about the brief condomless episodes, either. Condoms are great for lowering your risk, but emphatically don't reduce it to zero. If you'd used the condoms perfectly, and he called you with his unhappy news last night, you'd still have the exact same worries as you do now.
Finally, he needs real credit for manning up and doing the right thing by making that (awful, difficult, embarrassing) phone call to you with the bad news. Many, probably most, people wouldn't have done it. They'd have said, well, she probably didn't catch it, and anyway I want to get a second opinion, and maybe I'll get to it next week, and oh, I'm going over to visit her again soon and if I tell her she won't want to see me so maybe I'll tell her after. I don't know if you need to go so far as to buy him flowers, but he's probably having a pretty tough time right now, and chose the honorable path, and deserves to be appreciated for it.
posted by Forktine at 7:35 AM on October 14, 2008
Clarification -- on a second read I was worried the previous post came off blaming people whose herpes has been life-altering for somehow not dealing well, and I in no way meant to do that. I was trying to say that for many, though not all, people the medical implications are manageable, and you have to try to manage the psychological side to keep the two in proportion.
In a bit of unrelated, un-asked-for advice, I find mindfullness meditation to be really good for this sort of anxiety.
posted by mercredi at 7:38 AM on October 14, 2008
In a bit of unrelated, un-asked-for advice, I find mindfullness meditation to be really good for this sort of anxiety.
posted by mercredi at 7:38 AM on October 14, 2008
Get the blood test in February. Thereafter, make it part of your annual exam. That will give you as much peace of mind as possible, and it'll get better the more negative results that come in. I think it's important to go ahead and do the blood test for the sake of your future partners. Good luck, it's going to be ok, as people have noted already.
posted by rainbaby at 7:51 AM on October 14, 2008
posted by rainbaby at 7:51 AM on October 14, 2008
Response by poster: I don't know if you encountered this, but though HSV-1 used to be "oral" herpes and HSV-2 "genital" herpes, it has been found that those associations generally exist it is possible to get HSV-1 in the genital region and HSV-2 in the oral region. Contributing even further to the spread of herpes.
What I'm saying is, you already have herpes, and it's quite possible you performing oral sex on him gave him genital herpes.
posted by Anonymous at 8:20 AM on October 14, 2008
What I'm saying is, you already have herpes, and it's quite possible you performing oral sex on him gave him genital herpes.
posted by Anonymous at 8:20 AM on October 14, 2008
Response by poster: Er, that should say "it has been found while those associations generally exist".
posted by Anonymous at 8:24 AM on October 14, 2008
posted by Anonymous at 8:24 AM on October 14, 2008
From what I understand, even if I don't get lesions down there, I'm going to need clear IgG antibody tests twelve to sixteen weeks out from the last date of possible transmission in order to really know. I'm also given to understand that antibody tests starting from a month might be good indicators, but aren't nearly as conclusive as the ones twelve to sixteen weeks out.
Maybe this will be a relief, maybe it won't, but if you're completely asymptomatic, you're in the realm of false positives and false negatives, my friend. Not to get all biostatistics on you, but very few medical tests say that someone has a disease or does not have a disease, they only increase or decrease the probability that someone has a disease. Why is this relevant? If you don't have any symptoms (ulcers), the odds that you have herpes is low. So any test that comes back positive may increase your likelihood of having herpes, but not by much. (It depends on the test's characteristics, the sensitivity, specificity, etc, and I have no idea which particular antibody test your doctor uses.) Similarly, like you said above, a negative test result DOESN'T mean that you DON'T have herpes, either.
Welcome to medicine. This is why we try to weigh everything as risk/benefit.
Also food for thought: oral sex can transmit herpes to either partner, and some people have HSV1 (known as "oral herpes") orally, and some people have HSV2 (known as "genital herpes") orally.
Also, the fatalist perspective: absolutely nothing you can do about it now, and stress isn't going to help. You could also theoretically argue that stress weakens the immune system, and if you were exposed to herpes, potentially your body is trying to fight it off right now, so quit stressing, as this could make you worse!
posted by gramcracker at 8:26 AM on October 14, 2008
Maybe this will be a relief, maybe it won't, but if you're completely asymptomatic, you're in the realm of false positives and false negatives, my friend. Not to get all biostatistics on you, but very few medical tests say that someone has a disease or does not have a disease, they only increase or decrease the probability that someone has a disease. Why is this relevant? If you don't have any symptoms (ulcers), the odds that you have herpes is low. So any test that comes back positive may increase your likelihood of having herpes, but not by much. (It depends on the test's characteristics, the sensitivity, specificity, etc, and I have no idea which particular antibody test your doctor uses.) Similarly, like you said above, a negative test result DOESN'T mean that you DON'T have herpes, either.
Welcome to medicine. This is why we try to weigh everything as risk/benefit.
Also food for thought: oral sex can transmit herpes to either partner, and some people have HSV1 (known as "oral herpes") orally, and some people have HSV2 (known as "genital herpes") orally.
Also, the fatalist perspective: absolutely nothing you can do about it now, and stress isn't going to help. You could also theoretically argue that stress weakens the immune system, and if you were exposed to herpes, potentially your body is trying to fight it off right now, so quit stressing, as this could make you worse!
posted by gramcracker at 8:26 AM on October 14, 2008
In situations like this, I tend to imagine the worst possible outcome: you have herpes. Now what? Your life isn't over, though this will certainly affect you. How? What will you do differently? Let yourself work through the possibility that you might have herpes. I've found that if I try to work through the worst of it (though I put myself through undue stress at the time), it's easier to let it go for the time being because you have a plan for handling it if and when it comes up. And then recognize that you may or may not, but there's absolutely nothing you can do about it right now.
posted by curie at 10:56 AM on October 14, 2008
posted by curie at 10:56 AM on October 14, 2008
The only way to know for certain you have genital herpes is if you develop an outbreak and have the lesions swabbed and they come back positive. A blood test will tell you if you are positive or negative for HSV1 and/or HSV2, but if positive, it will not tell you where you have it. You can have HSV1 on your genitals and HSV2 on your mouth, and a positive blood test for HSV1 is really meaningless since about 90% of the population has that result.
In fact, there's a lot a debate in the medical community about whether patients without symptoms should even take the IgG test. There's a large school of thought that if you have symptoms, go to the doctor and if you don't, let it be.
The USPSTF recommends against routine serological screening for HSV in asymptomatic adolescents and adults.
Rating: "D" recommendation.
Rationale: The USPSTF found no evidence that screening asymptomatic adolescents and adults with serological tests for HSV antibody improves health outcomes or symptoms or reduces transmission of disease.
posted by Violet Hour at 1:13 PM on October 14, 2008
In fact, there's a lot a debate in the medical community about whether patients without symptoms should even take the IgG test. There's a large school of thought that if you have symptoms, go to the doctor and if you don't, let it be.
The USPSTF recommends against routine serological screening for HSV in asymptomatic adolescents and adults.
Rating: "D" recommendation.
Rationale: The USPSTF found no evidence that screening asymptomatic adolescents and adults with serological tests for HSV antibody improves health outcomes or symptoms or reduces transmission of disease.
posted by Violet Hour at 1:13 PM on October 14, 2008
This thread is closed to new comments.
In fact, there's a lot a debate in the medical community about whether patients without symptoms should even take the IgG test. There's a large school of thought that if you have symptoms, go to the doctor and if you don't, let it be.
That's certainly easier said than done (and there are people who will make an epidemiological argument against that approach) but it's important to keep in mind that outside of getting a first outbreak while in your third trimester, medically HSV-2 is more of an annoyance than life altering unless you let it.
Finally, I've always had the "this will make me unlovable/I'll have to wear a shirt with a red H" sorta worries. And that's where I think you have to give yourself the benefit of the doubt. Rates of transmission using a condom are lower than those without, as are rates when the partner with herpes is on suppressive therapy (though as mentioned above, it's unclear whether you'll even rate suppressive therapy if you've never had an outbreak if you HSV-2 seropositive). You can decide to tell people before you have sex, I think, and still have a fulfilling sex/romantic life. I think you have to let go of a little of the anxiety and embrace the reality that millions of people already have herpes will little consequence on their lives and that you will not be shunned by the general population if you decide to be tested and do come pack positive.
good luck. remember, this too shall pass.
posted by mercredi at 7:27 AM on October 14, 2008