STDs: Talk STDs with Sue (cont.)
I thought there was no cure for genital herpes?
There is no cure for genital herpes, but there is suppressive
medication, which can reduce the number and severity and duration of an
What is involved in suppressive therapy?
Suppressive therapy is a prescribed medication taken daily by mouth,
which curtails a flare-up of genital herpes. It is a prescription from
your family doctor. If you have any concerns, please get it checked out
immediately, and ask about suppressive therapy.
Hopefully you can answer this question for me: How much of a risk is my
partner at even if I don't have an outbreak at the time?
That is something we really do not know. Some herpes patients are
shedders. Even if they do not have an outbreak, old dead skin cells can
slough off and in some cases contact could trigger an infection with
How do you know if you're a shedder?
At this point we have no guaranteed way to tell. So we go on the
assumption that everybody could possibly be a shedder and must be aware
Aside from the meds, what else should I be doing?
Be aware of the prodromal signs and symptoms, such as a painful bump
that tingles, itches, or burns, followed by a lesion or blister that may
be very painful. This will last up to 10 to 14 days, then will heal
without leaving a scar.
Prevention is condoms, safer sex every time, all the time. Please do
not use condoms lubricated with nonoxynol-9. Be open and honest with
your partner if you suspect an outbreak is impending. Avoid any sexual
contact at that time.
How do I get a potential lover to get tested before we do anything? Any
Talk to your partner. Tell your partner you are concerned for their
health and you are concerned for your health. So in both your interests,
why don't we go together to see the family doctor or a sexual health
clinic and be tested for the possibility of all sexually transmitted
diseases (STDs) including genital herpes.
Talk to your partner openly and honestly. Tell them you enjoy being
with them, you have great fun together, and you find this partner very
attractive and interesting, and you hope that this might develop into an
If you have a history of diagnosed genital herpes, you wait until
there is an opportune moment when you are alone, when there are no
distractions, and you can talk on a personal level. Then you say, "I
find this very embarrassing, but when I was in college, I picked up an
infection. It does not bother me and I take medication so that it is
pretty well under control."
Then go and say, "Do you know about cold sores, the ones you get on
your lip? Instead of getting them on my lip, I get them below the
At this point your partner will probably say, "What is it?" And you
can say, "It's called herpes. I don't have an outbreak too often, and I
take ongoing medication to help control it."
Then I would go on to say, "I promise you I would always tell you in
advance whenever I feel I am aware of the prodromal symptoms, because I
want to protect both of us."
You need to be honest about outbreaks not only to protect your partner,
but also to protect yourself.
Because if you have a herpes lesion and your partner is HIV positive,
you could be infected with the HIV virus through that open lesion. That
is why suppressive medication is so beneficial.
And if you can't talk to a sexual partner about these things, maybe you
shouldn't be having sex with them?
If you are too embarrassed or too ashamed to talk to your partner about
the possibility of a transmission of any of the sexually transmitted
diseases, then perhaps it would be advisable to postpone any sexual
contact until the relationship is well established and the intimacy and
trust level are at a level that you can be comfortable talking about the
possibility of sexually transmitted diseases.
Can herpes of the mouth such as a cold sore be transmitted to the
Yes. Generally, herpes of the mouth is herpes simplex virus 1 (HSV-1),
but with oral genital sex it could be transmitted to your partner's
Conversely, if your partner has genital herpes, (generally herpes
simplex 2 or HSV-2)) it could be transmitted to you by oral genital sex.
That's why it is essential that you talk to your partner well in advance
about such intimate details.
Are there any side effects from taking the medications?
For some people on suppressive medication, there may be some side
effects, such as nausea, vomiting, upset stomach, or diarrhea. Talk to
your family physician.
What do you think of the attention HPV has received lately and how
prevalent it seems to have become suddenly with new testing and such?