
- With Mayo Clinic women's health nurse practitioner
Lois McGuire, R.N., M.S.N., W.H.N.P.
read biographyclose windowBiography of
Lois McGuire, R.N., M.S.N., W.H.N.P.
Lois McGuire, R.N., M.S.N., W.H.N.P.
Lois McGuire was a registered nurse in Obstetrics and Gynecology for 20 years. This experience made attending Planned Parenthood of Minnesota for the Women's Health Care Nurse Practitioner Program a natural step. Later she attended Case Western Reserve University to achieve her Master's in Nursing. She has been employed at Mayo Clinic as a nurse practitioner for 15 years. She works with women from adolescence though all the life cycles. Lois is committed to a holistic nursing approach, empowering women to take care of their health.
Latest entries
- New Pap smear guidelines explained
Jan. 21, 2010
- Generic Valtrex cuts cost of herpes treatment
Jan. 13, 2010
- Condom how-tos for better protection
Nov. 12, 2009
- No-period pills: Are they safe?
Oct. 21, 2009
- HPV vaccine side effects
Aug. 11, 2009
Mayo Clinic Health Manager
Get free personalized health guidance for you and your family.
Get StartedSafe sex blog
-
Nov. 25, 2008
Herpes prompts many questions
By Lois McGuire, R.N., M.S.N., W.H.N.P.
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
December 9, 2008 9:42 p.m.
Val: Thanks so much for your wishes. We have always had a strong marriage, I hope and pray this problem will only make us stronger. All I know is if my doctor is correct and I do not have herpes, I've certainly learned a lot in just a few days, and I'm appalled that not more is being done to educate about this problem. I'm almost afraid to hope my doctor is right. My husband and I are still going in to speak with him. Deb: My doctor feels blood test are far less accurate than the swab culture, especially since I had active symptoms when he took the culture. Unless I really had my head screwed on wrong...which is possible...I don't beleive I said my husband had facial sores. He never has had anything like that. He has had what he thought was an occasional cancre sore in his mouth, but nothing else. Sorry if I confused the facts.
- Elaine
December 9, 2008 9:16 p.m.
First of all I want to say thank you for the warmth and support that I have received from you here on this web site. I have been feeling so alone and "damaged" that I forgot that there are others that are suffering from the psychological devastation of this virus too. Elaine, I hope you and your husband can get through this in tact as a married couple. As I said before, situations change instantly. Hopefully you can both draw strength from each other and remember the reason why you got married in the first place. Deb, I just heard something recently that kind of fits what you have told me. It is: If you look at things differently-then the things you look at will be different. So I must strive to look at myself as I did before the virus and know that I need to change the way I do things, not who I am. I just hope that my friend can see that too. I'm struggling but I think I will eventually be okay. Now I have a question or two for Lois. If both partners have HSV2 and have unprotected sex could it possibly lead to a more virulent virus? Also if you both have it is it still necessary to use condoms? I guess I can understand if only one has the virus but not the other why condoms would be necessary. I do hope these questions are not redundant for other readers who may already know these answers.
- Val
December 9, 2008 9:11 p.m.
Elaine, Did your dr. suugest blood tests for you and your husband? Might be wise to have that done to be sure, especially since you mentioned your husband had facial sores from time to time. Since you've just experienced the possibility of having to live with herpes, I hope you are indeed negative.
- Deb
December 9, 2008 8:45 p.m.
Lois: I received a call from my doctor. The test (swab culture) came back negative for Herpes. Do I dare trust this? He suggested coxsackie virus.
- Elaine
December 9, 2008 12:44 p.m.
Hello! I want to respond to many of your comments. New Mom-please have your son tested! Unless you have already had a blood test that confirms he has herpes, I am not convinced that he has it. Many people,including providers, are confused, thinking sores inside the mouth with a flu or cold are herpes. Usually they are not! You may have been given some bad information. MILW-You still need to protect your partners. Even though you have not had an outbreak for many years, this virus can be activated at any time. Also, you may not have obvious outbreaks but you could still be shedding the virus without symptoms. Vanessa-we have not discussed that the virus can appear in unusual places on the body. I would suppress as you don't know if you are shedding without symptoms from your genital area. Elaine-you and your husband should have a blood test. If you both have HSV 1, he could have exposed you during sex. Jennifer and Deb-your questions about treatment are addressed on the next blog. It should be available soon.
- Lois McGuire
December 9, 2008 8:49 a.m.
Val, You are still the same person you were before. Your boyfriend is scared and so are you and you both need time to understand herpes. Your dr. can give you information and it is possible to have a fulfilling sex life safely. If your boyfriend does decide to leave, then maybe he wouldn't have been with you for other tough situations. It's easy to be in love and together without challenges to overcome. Just know that a lot of us have been in your situation and have come through "the other side" okay and are living good lives and also having a sexual life. And, we are good people--we did nothing wrong by contracting this virus!!
- Deb
December 9, 2008 7:57 a.m.
Val: We = me and my husband...not me and our friends!!! We're close, but not that close!!! :)
- Elaine
December 9, 2008 7:52 a.m.
Val, if it helps, we are very apprehensive about intimacy too. We just know we have to be open and honest about our feelings and talk. I personally don't know when I'll be ready to be intimate again. I don't expect things to be just like they were before the diagnosis, because frankly they aren't. We will have to make some adjustments in that area of our lives. I think we want things to be what we think is "normal". Now we have to redefine "normal". Take care.
- Elaine
December 9, 2008 7:44 a.m.
Hi Val: Being recently diagnosed myself, my mind is not in a place to help you get over a lot of the feelings you are having as I have also felt the same and still am. I think for me the confusion is the worst as I have no idea how I got this. One would think when one has been in a monogomous relationship for several years that one would be safe. Plus my husband and I have no experience living with H and just aren't quite sure how to adjust. We are facing the same concerns with sharing this info with our best friends. We have been friends with the same couple for 18 years, get together friday nights to play cards, go on vacation together etc. etc. Because we are so close and there are some things we are going to have to change like having a taste of the others glass of wine/beer to see if we want to order the same - we feel we need to share this with them. I will be refraining from all alcohol now just to keep my immune system in the best possible shape. We've laughed and cried a lot together over different things throughout our friendship, and we are just going to have to trust they will be supportive. If they choose not to, then it will be a great loss, but we don't want to be in situations that would put them at risk or would create more stress for me trying to sidestep why some aspects of our relationship has changed. You did the right and responsible thing telling your new friend. I'm sorry if he can't accept it. I know it hurts. God Bless.
- Elaine
December 9, 2008 12:39 a.m.
I am a middle aged woman and I was married for 22 years. We divorced 2 1/2 yrs ago. Just two weeks ago an outbreak on my upper buttocks prompted a visit to the doctor. I was diagnosed with HSV2. Of course, to make matters worse, I've been dating a man for the last 6 months (the only man since my ex) and have had unprotected sex with him unknowing of the virus. As soon as I was diagnosed I told him right away and believe me it was the hardest thing I've ever had to do. He has been tested and is negative for the virus (thank God). I'm unsure if he will want to continue our relationship as it has changed virtually overnight. I can feel that he is very apprehensive about intimacy. It saddens me to think I could lose my new friend over this. This has been life altering. I am embarrassed, distressed,and confused. I just want some suggestion on how to get back to being me?
- Val
December 8, 2008 8:33 p.m.
Thanks again Deb. We have an appt. scheduled for next Wednesday so that should help. I'll check out these sites. I agree there are things worse. I was talking to a co-worker todays whos son has 2 years to live (cancer). He's only 37 and has an 11 y.o. son. That will certainly help to put things in perspective. TXS again!
- Elaine
December 8, 2008 7:03 p.m.
Elaine, You also might want to go to herpes.org
- Deb
December 8, 2008 6:45 p.m.
Elaine, You might want to go to health.nih.gov/topic/HerpesSimplex This is the National Institute of Health site and should help you start to understand herpes. There are a lot of other sites, but a lot of them want to sell products. Your doctor will have info for you and once you get calmed down and start to think rationally instead of emotionally I think you will be fine. My boyfriend and I have been dealing with this for a year and he is still herpes free. Of course, we aren't in our 20's and having real frequent sex, but at least we are still sexual beings--lol. Whenever I start to obsess about having HSV I then stop and consider how lucky that it's not HIV. Herpes won't kill you and with time the outbreaks should decrease and be less severe. Of course that is why it is spread so easily because often times there are no overt symptoms. Keep a positive attitude. Stress does seem to cause more frequent outbreaks. Good luck to you.
- Deb
December 8, 2008 9:33 a.m.
Sorry, I forgot to put my name on my last posting.
- Elaine
December 8, 2008 9:31 a.m.
Thanks for your kind response Deb. My doctor tried to give me some info the other day, but I just couldn't wrap my head around it. After the lab test return, My husband and I are going in together to talk with the doctor. In the meantime, I'm compiling a list of questions. I've always been the type of person that if I know they "whys" I cope better, it appears this may not be possible with this. I know at some point I have to quit trying to figure it out and just deal with it, but I 'm not there yet. Can anyone suggest the best on-line sites besides this one to get info.
- No name given
December 8, 2008 7:54 a.m.
Elaine, Talk to your doctor and get your husband tested too. I know you feel devastated right now, but read and educate yourself. I believe you and your husband will be able to continue a satisfying relationship. Your husband may have HSV I and you could have gotten it from him. I don't think it matters how you were infected; but it does matter on how you handle it. At least there is medication available and now this Mayo's site for information and support. And yes, sometimes you can have herpes for a long time and not even know. Maybe the stress of the holidays brought on this first noticeable outbreak.
- Deb
December 7, 2008 4:45 p.m.
I am a 56 y.o. christian/professional woman.(No one is immune!) I have been in what I truly believe has been a monogomous marriage for 25 years. I've never had any reason to doubt my husband's fidelity and I know I've never fooled around. The week of Thanksgiving we went to my in-laws and shared a common bath with several others. One relative who lived a high risk lifestyle in the past took very long baths each night. I took only 2 baths the rest were showers. We returned on Saturday after Thanksgiving and on Monday I noticed genital pain. When it didn't improve I went to the doctor and he believes I have herpes(still waiting for lab results). I felt like he had hit me in the stomach! I'm dumbfounded and confused! I have so many questions. Could this have been dormant in my husband or me for 25 years? My husband has had on occasion what he thought was a cancre sore usually only 1 or 2 at a time could it have been herpes and can he be tested so we know? Should I be more concerned about his fidelity? Is there even a remote chance I could have gotten it from the tub? This disease seems so unpredictable with respect to transmission...it seems my husband and I will always need to use condoms from now on...it this accurate? I've never felt so confused about the direction my life will take.
- Elaine
December 7, 2008 10:14 a.m.
I was widowed at the age of 42. Several years later, thinking I was ready to date and have a relationship, I foolishly had unprotected sex. Now, 4 years after that, I recently had a first outbreak of herpes virus. I am in a committed relationship and my boyfriend is very understanding (I told him about it). The main problem I am having is that it is very painful to have intercourse now. It's been a few months, and it is barely improving at all (I have been taking Valtrex since I was diagnosed). Does this happen to others?
- Danielle
December 6, 2008 11:18 a.m.
LawSchool Student, Thanks for your kind comments. Yes, it was difficult for me. I was married for 23 years and contracted herpes from my husband. Being older and a widow it is tough to meet people and then having to be open about herpes makes it that much more difficult. My boyfriend has been very understanding and we are planning on a long term relationship and maybe marriage. But I never want him to get herpes and I'm learning a lot from this blog site and I'm a retired registered nurse. We all have a responsibility to stop the spread of this virus if at all possible. I knew it was very important to tell my boyfriend about the herpes before we had a sexual relationship. Sorry your girlfriend was unable to tell you earlier--I do know how difficult it is and I remember thinking that my boyfriend would probably want to end it. Would you have stayed with her if she had been honest from the beginning??
- Deb
December 5, 2008 9:50 p.m.
I sometimes get an outbreak if I wear pants, not tight fitting, but snug fitting for a couple of days in a row. Is there any way I can avoid this and still be able to wear my jeans?
- Linda
December 5, 2008 5:57 p.m.
I dated a woman for nearly two years and she had genital herpes; thankfully,I didn't contract them. Glancing at the comments, I was drawn to "Deb's" comment. I would like to salute you, Deb, for being up-front with your boyfriend and telling him, early on. I have no doubt that in addition to the difficulties of having herpes, telling a partner must be a nightmare, or, at the very least, difficult. I was particularly drawn to Debi's comment because of the aforementioned, two-year relationship with a woman afflicted with genital herpes. Much to my chagrin, this woman that I loved very much, waited almost a year to tell me she had herpes. During that time period, we had intercourse often, and after she went on birth control, a number of the times we had intercourse without condoms. Complicating matters, my former girlfriend hinted about something she wanted to tell me, something about her that also affected me, but she was scared to tell me for fear of it being a "deal-breaker." Finally, one night she told me that what she'd been keeping from me was herpes. Looking back, I am utterly stunned and quite angry at the fact that she so selfishly kept such a "secret" from me. While I try and put myself in her shoes and respect the difficulty of telling someone that you have herpes, I still can't get past the fact that I deserved to know, early on. Thus, I wanted to send some praise Deb's way; you did the right even though doing so was, I'm s
- LawSchoolStudent
December 4, 2008 1:52 p.m.
My husband and I both have HSV-2. Should we always wear condoms? Even when we are not having any symptoms? Because we both have the virus, if we have unprotected sex will we have more outbreaks? Can we perform oral sex on each other?
- annonimous
December 3, 2008 8:51 p.m.
ANother question--when should one take suppresants?I have prescriptions for both acyclovir and valtrex. My doctor told me to take them as soon as possible if I have another herpes infection in my outer ear. Bt here I've read of people using suppressants on a regular basis, as prevention. How do you know how to use these drugs? If I were to take acyclovir or valtrerx for prevention, would I need to take the whole bottle, and then keep taking it on a regular basis? Or can you take it in spurts? My prescription was written to take them in case of an outbreak--not as prevention. Thanks again.
- Vanessa
December 3, 2008 8:42 p.m.
I have had a recurrent infection of the outer ear for at least 2 years. Looking back, the first infection I'm aware of was just before I got Bell's Palsy, which can be triggered by herpes. I've had maybe 4 infections including the first. I read up on ear infections, and learned about a possible link to herpes (Ramsey Hunt Syndrome. THat is caused by the herpes zoster virus, or HSV 1, as I recall. I asked my doctor to do a culture for herpes the last time I had an outbreak. THey couldn't grow a culture. Then I asked another doctor if I could have a blood test. Results from the titred test show that I have antibodies to HSV 2, or genital herpes. So the question is, if I've had breakouts of genital herpes in my ear, how can I know whether I have dormant genital herpes in my genitals? I've never had a genital outbreak. I realize it's always good practice to use a condom, but if I've had no genital outbreak ever, is it still necessary for my partner to use a condom to avoid infection from me? What about oral sex? Is it possible that I also have a dormant infection in my mouth, even though I've never had an outbreak? It is very confusing, complicated and frustrating to try to get accurate information. Thank you for this blog!
- Vanessa
December 3, 2008 9:58 a.m.
I tested posted for HSV Type 2 about 2 years ago. To my knowledge I have never had a outbreak. Some times I freak myself out thinking maybe this time I am having an outbreak if I see a bump. I've seen all the picture and did a lot research on this but am so confused why I wouldn't have an outbreak even though the test came back positive. My husband and I separated after he found out I tested positive. Now, I'm wondering if I could ever trust someone to tell them if we decide not to stay together.
- Mel B.
168 comments posted