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    Lois McGuire, R.N., M.S.N., W.H.N.P.

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  • Nov. 25, 2008

    Herpes prompts many questions

    By Lois McGuire, R.N., M.S.N., W.H.N.P.

168 comments posted

You have had many questions regarding herpes (HSV). This is a big topic, and so we'll look at different aspects of it over the next few weeks.

Genital herpes is common, affecting both men and women. According to the Centers for Disease Control and Prevention, the herpes simplex virus is present in as many as one in six teens and adults in the United States.

Here are some of the areas that we'll cover:

  • Types of herpes
  • Categories
  • Symptoms
  • Frequency
  • Diagnosis
  • How it is spread
  • Treatment
  • Suppressive treatment

Types

Herpes is a virus. There are eight human herpes viruses. They are:
  • Herpes 1 (HSV-1): traditionally thought of as cold sores or fever blisters
  • Herpes 2 (HSV-2): traditionally thought of as genital sores
  • Chicken pox and shingles
  • Epstein-Barr: a common cause of mononucleosis
  • Cytomegalovirus: serious when contracted during pregnancy
  • Human herpes virus 6 or roseola: a type of measles
  • Human herpes virus 7: causes a rash
  • Human herpes virus 8: causes Kaposi's sarcoma, an infection seen mostly in AIDS patients

I only tell you the above mentioned types to round out the discussion on herpes. The rest of this blog will address HSV-1 and HSV-2. If you have questions about the other types of herpes, please contact your provider.

Categories

  • Primary refers to an outbreak that occurs in a person who has never had HSV-1 or HSV-2.
  • Non-primary occurs when a person already has HSV-1 and now has been infected with HSV-2. The existing antibodies to HSV-1 may keep the outbreak from HSV-2 unnoticeable, meaning the newly infected HSV-2 person doesn't have symptoms. Up to 80 percent to 90 percent of first time genital outbreaks have no symptoms. This explains the statistics above.
  • Recurrent is just that, recurrent. People with HSV-2 have an average of 4-6 outbreaks per year. This can vary greatly from person to person. Some people can have more than one per month and others may only have one every few years.

Next week, I will begin with symptoms of HSV-1 and HSV-2. Let me know what questions and observations you have.

168 comments posted

blog index
  • October 29, 2009 9:32 a.m.

    Dear Hailey, You are right not to trust the culture test. A culture is only accurate for a couple days while you have a sore. It won't even test positive the whole time you have a sore. You need a blood test. The blood test will also tell you if it was HSV 1 or 2. If it is truly herpes, it could be that you got the sore by kissing him on the mouth and it had nothing to do with oral sex. If you do test positive, read my other blogs on this topic to learn more and how to reduce your risk of transferring this to someone else. Try to have the courage to go to another provider and ask for testing. Let me know what you find out.

    - Lois McGuire

  • October 29, 2009 9:15 a.m.

    Dear Kiki, This is a tough time for you to figure out what happened. I can not give you the answer but I can give you some information. First of all, 75% of people that have herpes find out because they gave it to someone else and didn't know they had it until they were asked to get tested. Ask to see his test results so you know exactly what tests were done. He should have had a blood test and not a culture swab. Also, if he is unwilling to share his results, you may need to question his character. By looking at his tests, both of you can decide if he should be tested for any other STIs. The test you had to estimate when you contracted herpes is not recommended as it is often inaccurate.

    - Lois McGuire

  • October 29, 2009 9:02 a.m.

    Dear Mark S, You will never be able to predict when you are shedding the virus or contagious. To protect your partner in the best possible way, I would encourage you to suppress the virus with an anti-viral medication and to use a condom. The anti-viral pills are prescribed by your provider. I have written a blog on herpes treatment that is quite inclusive. Please refer to that.

    - Lois McGuire

  • October 29, 2009 8:42 a.m.

    Dear Mya, The most accurate way to find out if you have herpes is through a blood test. This blood test measures if you have antibodies to herpes. Because it takes time to develop antibodies, this blood test should be done 3-4 months after you think you contracted herpes.

    - Lois McGuire

  • October 26, 2009 2:11 a.m.

    I was diagnosed 2 weeks ago with HSV-2 after after my first outbreak. I'm still in shock and I don't know how to feel about this that seems to change my life. I'm 26, and I'm dating someone a lot older than me. I been ONLY with him for the past 7 months! And after some follow up test, my doctor said that i just got it recently "less than 6 months ago". Once I told him I had it; he reacted as he never hear the word "Herpes" before (i don't believe that). Then he said he went to his doctor, and told him everything I said; he said he was tested for every STD. He claims all the results were negative, and he has no symptoms. I'm so confused and upset. Is that possible that his test turned Negative, when I'm sure I got it from him???

    - kiki

  • October 23, 2009 3:23 p.m.

    I know its able to spread when theres not a sign, but say the blister has poped and is gone for days now but the skin is still alittle red will I pass it on then or has it passed its high stage of passabilty, being its blisster pop stage

    - mark s

  • October 21, 2009 8:37 p.m.

    Hi lois...i performed oral sex on my first boyfriend when i was 15 years old. The NEXT day my upper lip on the right side had 3 white bumps, all in row very close to each other... very surfaced and very visible to the eye. They also were very hard to the touch, and extremely difficult to pick away without feeling pain. I was convinced i had herpes, i was so sure that i cut him off the very day i saw this on my lip(which was stupid cause he probably went off giving this to everyone else). Well being 15 years old, i was extremely scared to tell my mother or anyone else, so i kept this to myself for...years. When i was 17 about to turn 18, i couldn't take it anymore, i HAD to know, so i went to my local std clinic one day (aurora, il...not sure what its called, but its located on lincoln av.) i asked to be tested for herpes yet at the time there was no "outbreak" so i just explained to the doctor my incident, she swabbed my mouth and sent it to the lab. I was negative, but i do not believe this. I have these so called "outbreaks" at times frequent, so I'm convinced I have type 1! maybe type 2, i just assume type 1 based on the fact that there aren't any warts growing on my lips (if thats what type 2 even is). anyways, i guess my questions are (and based off the information i've given you) do you think it is possible my test came back negative because i waited too long to be checked? Am i not taking a sufficient enough test/test that could read type 1 better?

    - Hailey

  • October 21, 2009 8:12 p.m.

    Hello Ms. Lois, What is the best/most accurate test to determine if I have herpes type 1?

    - mya

  • October 19, 2009 12:59 p.m.

    Lois...thank you for answering our questions. I contacted HSV I ( on the lip ) as a teen; no one in my family had it and I was not dating any one with outward signs of it. I have been married for 40 years and have not spread it to my husband or children. My outbreaks have only occurred a couple times a year. Since I have been on a healthy diet and been under less stress I have not had lip breakouts. I have only had sex with my husband and now I am experincing outbreaks on my middle lower back right near the spinal chord; red bumps on the rim of my vagina, red bumps on the labia and white pustules around my anus. All this happened in from October 1, 2009 until October 19, 2009. Uncomfortable is the word. My husband and I are in our sixties and have a very close marriage; we use to have sex several times a week. Since all of this started I am being very careful with sheets, towels hoping to keep my husband from getting this miserable affliction. My husband has canker sores in his mouth but has no sores anywhere else on his body. We travel alot and I use to use hotel washclothes after sex...in the future I plan on bringing my own. Both of us enjoy good health by exercising and eating out of our organic garden. We are not on any medication. Should I go see a dermatologist, gynecologist or a STD specialist? We really appreciate your feedback. -Joy

    - Joy

  • October 12, 2009 7:58 p.m.

    Lois,I have experienced fever blisters maybe once or twice a year over my lifetime. I am 49 yrs. old. Since this past May "2009" the shedding and cold sores are driving me crazy. I have been to the Dr. and she prescribed Valtrex. Wow! The side effects are scarey. I have been married for 25 yrs. and faithful as well. Is it due to my hormone change? The blogs are scarey as well. Should my husband and I be using a condom and not kissing at all? The long period is, to say the least concerning as well as taking a prescription for Herpes.

    - Marie

  • October 4, 2009 8:31 p.m.

    I also have been married faithfully for 22 years and found out last year I had herpes. Is there some link between roseola and herpes? I saw there was but a different type of herpes.....My husband totally freaked out and didnt trust me for a long time....It freaked me out because I have never strayed.......

    - Barbie

  • October 2, 2009 6:02 p.m.

    I just found out that I have herpes. I was upset with my ex-husband because he is the only person that I have been within the last 22 years. We have been divorced for approximately 10 years. He does not believe that he has it because he is checked yearly. He will be seeing his doctor shortly, he also told me that he has been having headaches lately, is this a sign of the virus? Is it possible for me to have this for that many years and just now having a breakout?

    - tiffani

  • September 23, 2009 12:06 p.m.

    i recently went to the dr's and he diagnosed me with type 1 herpes. i asked about not using a condom while having sex and he said that my b/f is not going to get until i am gettin an outbreak. i was really happy until i thought about how i got it and i really dont think the person i got it from had an form of an outbreak. so is this true? can he not get it if we dont use a condom? i was also wondering if type 1 was less contagious than type 2. or other diffrences between the 2. i would really apprectiate any information you give me! (mostly the stuff that you cant find on the internet because i have looked at so many websites but still have not found all the questions i am looking for)

    - No name given

  • September 22, 2009 11:30 p.m.

    He has oral herpes, gives it to me genitally via oral sex, he had unprotected intercourse with me( because we were foolish, in love & were going to get married someday). We know he can pass the virus oral to genital but can he pass on the virus genitally via unprotected intercourse to another partner when he has never shown any signs or sx of genital herpes? I was married 11 years, I was divorced 1.5 years before I finally went out on one date, on this date I felt I met my true sole mate. I had an ob 2-3 weeks after receiving oral, unfortunately I was uneducated about the possibility of contracting herpes this way. This was 2 yr ago the initial outbreak was severe, fortunately have not had an outbreak since & do not take daily supressive therapy. Three months ago we broke up - I'm still trying to cope with our breakup. I know I will have to share this intimate information with any prospective partner however will my ex have to tell his future partners? Since we broke up the initial feelings of humiliation, isolation... have flodded back. I feel like I will be alone forever. I know I will get through this, broken hearts do heal with time and there are understanding partners out there. I feel like I'm branded and don't want this to happen to someone else. I want us both to have the correct facts.

    - Anna

  • September 16, 2009 9:26 p.m.

    Kaye-They have blood tests now that will show if he has it or not. But if he is the only man you've slept with he has it you don't need a blood test to prove it you already have the proof. Please seek counseling for yourself.

    - no name

  • September 16, 2009 10:39 a.m.

    I was a virgin when I got married and had sex only with my husband. I had a very painful outbreak and was diagnosed with genital herpes. Now I realized my husband noticed one bump in his penis about a month ago. He said he had urinalysis and came out negative with STD. He said a dr took a look at his penis and said it was nothing. Could that be herpes? I am so devastated. I've had the sores for a week now and they're very painful. I'm also having flu like symptoms and has pain on the bones of my buttocks. Is this pain coming from the virus? How come my husband doesn't have any symptom aside from that one bump in his penis. Although I noticed he's scratching his genitals a lot. I'm so confused and lonely and thinking of separating from him. He doesn't think he has herpes. I know he uses prostitutes. He said they are free of diseases. Pls let me know what kind of test he should have to show he has herpes since he doesn't have any symptoms. Thank you.

    - Kaye

  • September 15, 2009 8:39 p.m.

    Mel-Contracting Herpes is a traumatic experience in itself. I can't imagine contracting it the way you did. I am so sorry. It seems as if you have dealt with it well though. I hope the guy who raped you is behind bars permanently. Even that isn't punishment enough. You don't seem bitter and that's remarkable and good. We have to forgive people like him and not let those bitter feelings poison us. I was 19 and pregnant when I got it. I carried my baby to six months, he was delivered and I was given 12 hours with him. His dad didn't want the baby so he infected me hoping the baby would die. It took a long time to forgive him but I have. I'm a Christian now and God has helped me through. Like you I don't believe they will find a cure in our lifetime but I hope they do find one. I also agree it does get easier as we get older. But those stupid commercials and how they insist that it can be spread when there are no signs of an outbreak through me a little and make me very angry. As I said before my husband does not have it and that's because I'm very careful and aware of when I'm having an outbreak. I truly feel that the worst thing about having herpes is the way other people react to it and as you said how uneducated they are. When I contracted herpes I had an extremely high fever and headache then I broke out so bad I couldn't walk. So it's pretty hard for me to believe that people have it and don't know it or are spreading it without knowing it.

    - no name

  • September 3, 2009 8:44 a.m.

    I've had HSV 2 for 25 years. I agree with keeping your stress level down to curve outbreaks. I only have vaginal outbreaks about 1 time every 2 years. My outbreaks are on the back of my buttock/hip area close to my spine. This tends to happen about 3-4 times a year and that is when the change of the weather approches. I do have an extra outbreak during a death or very stressful/eventful event. I was raped when I was 17, I was a virgin. I do not know what it is like to have a sexual encounter without it. I goes through my mind still every time I have sex. I have been very lucky and my husband has not contracted this from me. It's more of an inconvience to me more than anything else and we just work around it. Diet has not had anything to do with my outbreaks. It does get easier as you get older. But, it's doesn't get any easier seeing how many uneducated people there are out there and want to act so stupid about it! We are not to be shunned but need to help others that don't understand or have no knowledge. I wished they would come up with a cure :( but won't happen in my lifetime. Right now I am dealing with a Shingles outbreak on my arm and out of work due to the fact that I work in healthcare and I want patients protected.

    - Mel

  • August 23, 2009 5:35 p.m.

    I've had this disease for 23 years that is longer than most drs have been studying it. I know what brings it out and how to make it go away. I do not like the valtrex commercials on tv because this is an emotionally upsetting disease and no one but those who have it need to know the medication taken for it. I don't care what any dr says it can be controlled by diet and by keeping our stress levels down. Telling people it can be spread when there are no signs of an outbreak is inducing panic. It makes people who have the disease feel as if we are the disease. To those drs reading this let me tell you I am not a disease and will not be treated as if I am. I have been married to a man who does not have the disease for 11 years. So no it is not spread by bodily fluids! It is spread by skin to skin contact. Some drs say you can not control it with your diet and that is wrong too. Some things to stay away from are citrus foods, caffeine, chocolate, and fried foods. Also, watch your stress levels. Go to the book store and get a book on herbs there is a lot of good information your dr may not tell you about. I have gone nearly 2 years without an outbreak. I also have a grown child who does not have this so to the concerned parents please relax and just take every precaution. Also, keep a log of what triggers your outbreaks and avoid those things.

    - no name

  • August 20, 2009 9:54 a.m.

    Dear 37 SHOCKED, I can't tell you how long you have had herpes. It sounds like you have had it since you were 20 years old. Please see my response to Melanie for statistics. It could be that you only have herpes I and that it has spread to the genital area. You may want to get a blood test to see if you have I and II or just I. Either way, you need to protect any partners in the future. It is always difficult in the beginning to learn you have herpes. Please be gentle with yourself. Read my blogs about reducing the risk of spreading it to your children. They will always need you to hug and kiss them.

    - Lois McGuire

  • August 20, 2009 9:26 a.m.

    Dear Melanie, First of all genital warts are not related to herpes. These are two separate viruses. Secondly, 90% of people who have herpes are unaware that they have herpes. Also, one in five adults has herpes. The only way for you to know if you have herpes is to have a blood test. If your daughter contracted herpes on her mouth, it could have been from any well meaning peron who didn't know they were shedding a virus or didn't understand that it could be spread so easily. Please, gently, help your daughter understand about herpes when she is old enough.

    - Lois McGuire

  • August 16, 2009 7:12 p.m.

    I contracted genital warts and they flared up while I was pregnant with my first child. That daughter was recently diagnosed with herpes. She gets a cold sore yearly or so, in the lip area as long as I can remember. Does this mean that I also have hepres and didn't know it?

    - Melanie

  • August 16, 2009 8:03 a.m.

    Hello, I am a single mother of 3 kids and I found out yesterday that I hve Hsv 1 and hsv 2. I am so sad and not sure how long I have had it. I haven't had sex in 5 years and in may had sex with a person that I thought I was in love with. We are no longer together and now I have this. How can you tell when you contracted the disease. I alway hug and kiss my kids and I hope that I haven't given them anything. I had a core sore once in my life when I was 20. This is very disturbing to me, because I haven't had that many sex partners and don't sleep around. I don't know if I should tell my sister. she is germ OCD person. Help I feel like I should just go in a hold and die.

    - 37-SHOCKED

  • August 9, 2009 4:03 a.m.

    I just found out Igot herpes s few mths ago. I've been married for 16 yrs. I was horrified when I got the news because all these while I don't hv other sex pertner beside my husband & I already have 3 kids. I trust my husband didn't has any affair outside. But I just wonder how both of us can contrated herpes? Both of us had gone for blood test. We do have oral sex often. Is the herpes virus in born? Will my children get herpes virus too since both of us having it?

    - malaydale

  • July 22, 2009 12:14 a.m.

    Im sorry those questions were for Lois ha not deb i just read debs last response to devastated. Very sorry!

    - learning to deal

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