Wow. You just met Mr. Wonderful and he informs me that you has genital herpes.  What should you do?

This is quite a common question in sexual health clinics.  Let’s start with checking your herpes status.  Remember, 45 million Americans have genital herpes and its estimated that only 10 – 20% of those folks know it so there is a chance that you are among them.  Our current blood test for genital herpes is very good at identifying type 1 (which more commonly causes cold sores) and type 2 herpes, unlike the old tests that were available prior to 1999.  So, let’s get you tested and take it from there.

You’re positive for type 2 herpes also?  OK, it’s a drag to find out that you’re positive for herpes, but on the upside you don’t have to worry about catching a NEW herpes infection from Mr. Wonderful.  I do recommend that you should BOTH be tested for all STDs because if you’ve got one STD, you could have another.  Once we establish that you are both negative for everything else and positive only for type 2 herpes, we should still talk about safe sex.  I recommend using condoms each and every time you have sex as a general principle to stay safe.  Also, although its entirely possible to get pregnant and have a healthy baby even with a diagnosis of herpes, there are special considerations that should be discussed with your OB/GYNE, so keep that in mind if and when the time comes that you and Mr. Wonderful settle in for some serious nesting.

What if your test was negative for type 2 herpes?  Well, congrats on that one.  Remember, you should both be tested for everything to establish your baselines and make sure there are no surprises.  Should it be a deal breaker that your partner has herpes?  Most people would say no, but of course that’s a very personal decision.

There are several things you can do to lower your risk of catching genital herpes.  With discordant couples (meaning one partner has herpes and one doesn’t), safe sex is imperative!  Use a condom every time you have sex. What if Mr. Wonderful is so darn great that you want him to be your baby’s daddy someday? No problem, you can have unprotected sex in certain situations and your OB/GYNE can give you some advice on the way to minimize your risk while trying to get pregnant.  But I digress… back to he’s positive for herpes and you’re negative.

After using condoms, the next thing to consider is what we call suppressive therapy.  He can take an antiviral medication daily to reduce the risk of transmission (the risk of spreading herpes to you).  These medications are safe and often available in generic formulations.  Why not do everything you can to reduce the risk?  Lastly, you should abstain from sex if your partner is having an active outbreak or is having a prodrome, which is a tingling feeling that sometimes occurs before an active herpes outbreak.  Keep in mind that the virus can be spread at other times, but during the prodrome or an outbreak he will be most infectious.

There’s one more thing for both men and women to understand about herpes and pregnancy.  It is somewhat risky for a baby if a women develops a new herpes infection in the last portion of her pregnancy, so if you are pregnant and part of a discordant couple, talk to your obstetrician about the best way to protect your baby.  Most physicians recommend discordant couples abstain from sex (potentially including oral sex if your partner has cold sores) during the last trimester of pregnancy.

Lastly, don’t let herpes ruin a perfectly good relationship. As long as you can talk openly and honestly about STDs,  STD testing and safe sex you’re off to a good start!

If you’re concerned about herpes, getting tested is the best option to make sure you don’t pass the disease to a partner. It’s also a great way to get complete peace of mind in regards to your sexual health.