HSV1 Inside Mouth and In Urethra

[Tadlington]

I have HSV1 in my mouth – two confirmed sores on the left side of my tongue but it feels like there were many more and that it may in my throat. I also have it inside my urethra. Since HSV1 prefers dryer areas I am wondering if this will affect the frequency of outbreak, how infectious it will be, shedding etc. Basically, wondering if there’s anything you know about differences in the way it will show up in these areas.

[Terri Warren]

Is your HSV 1 acquisition recent? How do you know that you have it in the urethra as well? I’m not at all clear that HSV 1 prefers dryer areas – not sure what you mean by that either. HSV 1 prefers the oral area over the genital area that is definitely true. We don’t really know what characteristics of the trigeminal nerve it likes better, but it sheds more from the oral area than the genital area by quite a bit = probably double or more, and also recurs more orally as well.

Terri

[Tadlington]

Huh. I didn’t realize the affinity for HSV1 to the mouth was nerve related vs. dryness. I’d heard that somewhere.

I believe it to be recent but i can’t know for sure. I do not know 100% that it is in my urethra but here’s what I do know.

On August 9th, I had unprotected sex with a woman who has had very few partners in her life (I’ve had many more than her). A few days later we were both experiencing painful urination. It felt like I was peeing razor blades. Urine was tested and it wasn’t gonorhea or chlamydia. No appreciable bacterial content or blood at all. I had no sores on my genitals. She did get sores on her genitals which were diagnosed as HSV1. A week later I began to get sores on my mouth. I felt utterly run down and could barely eat for a week. They swabbed a sore in my mouth and it came back as HSV1. So I know I have it in my mouth. The woman who likely got it from me – I never went down on her, though she did on me. She hasn’t reported any oral cold sores. So, it seems likely she got it from me genitally. A doctor I spoke with said the only reason cold sores would cause painful urination was if it was in the urethra itself. Also – once the burning peeing stopped, it felt incredibly itchy inside there. So all signs seem to point to it being there. I think I got it from my previous partner to her with whom I’d last slept with two nights before.

A friend of mine got HSV1 genitally and had one outbreak there and never again. It’s interesting to hear that it recurrs more orally and is more contagious orally. That’s good clarity to have.

A follow up question I have to this is: on p,33 of your amazing book The Good News About The Bad News (thank you for writing it) you state how “If both parties are already infected with the same type of genital herpes transmission is no longer of any concern. If the infection has been around for a few months, you needn’t be too concerned about passing the virus to a new part of the body (like the mouth) through sexual activities” – so I want to make sure I understand this…

Assuming I have HSV1 genitally and orally and I meet a woman whose had oral cold sores for years and we have unprotected sex while I’m shedding… are you saying it’s unlikely in the extreme that she would get herpes genitally from me? And that, if we made out, she would be unlikely to get ‘more cold sores’ in her mouth from me (e.g. my sores are on the tongue and maybe hers are on her lips).

Thank you again for being so available. What a gift.

[Terri Warren]

OK so now I am thoroughly confused. She was the giver of oral sex to you and she got genital sores and there was a swab test done on her genitals that was positive for HSV 1? And you had a lab test swab that was positive for HSV 1 from your mouth? And you were not the giver of oral sex to her? But she was to you and she did not get oral sores?

Terri

[Tadlington]

Oh dear. To clarify: she and I had intercourse. She gave me oral sex. I did not give her oral sex.

After this, we both had genital symptoms. She was swabbed and tested positive for HSV1 genitally. She has had no oral symptoms.

I had genital symptoms in the same time period. I was swabbed during that time to test for chlamydia and gonohrea but nothing positive for herpes showed up in that (if they could have even seen it I don’t know). But I’ve had enough symptoms to assume I have it there: burning urination, itchiness, white flecks on my stomach as evidence of discharge.

The week after I got sores in my mouth and had a swab. These tested positive for HSV1.

My theory is that I contracted both genital and oral from a previous partner and the oral simply took longer to settle in than the genital. I’m a bit confused by it all too. But that’s what happened.

[Terri Warren]

This is a very odd circumstance, I must say. You two just aren’t having outbreaks in places I would expect! Seriously, it does sound like you got oral infection from a previous partner and probably have genital infection as well since she got genital symptoms. The other possibility is that she has had this before and she gave you HSV 1 from her mouth on your mouth and on your genitals. Without antibody tests for both of you, it is not possible to know. How long ago was this? Oral HSV 1 is more likely to be symptomatic yes, have you ever had genital sores? The other odd thing about this is that it is unusual to have HSV 1 just present in the urethra and not with skin lesions.

If you really want to know and this was very recent, you could both have IgG antibody tests to try to sort it out. The one with new infection won’t have antibody yet.

Normally, HSV 1 does not cause a discharge with recurrences.

Terri

[Tadlington]

thank you terri. it feels good to have the oddness of this all affirmed 🙂

it occurred to me that she might have had this but she’d never had any symptoms before and my previous partner to her was told by a partner from years before, days after we’d spent a number of nights together, that he had herpes and that she might have it. we used protection but the condom did break once and i did perform oral on her.

My encounters with the first partner in question were from July 27 – August 12th. My encounter with the second woman who likely got it from me was August 14th. We both began to get genital symptoms Aug 16/17th. It was painful urinating for me and ejaculating was also very painful. The symptoms in my mouth began around August 24/25th and lasted almost two weeks.

And yes – I’ve never seen any lesions on the surface of my genitals at all (and man have I searched and been searched at the clinic). As far as I know I’ve never had herpes before this summer. But it’s possible I did? I’ve never done the antibodies test.

So I suppose my question remains: Assuming I have HSV1 genitally and orally and, in the future, I meet a woman whose had oral cold sores for years and we have unprotected sex while I’m shedding… are you saying it’s unlikely in the extreme that she would get HSV1 genitally from me? Or that if she has HSV1 genitally and not orally and we made out that she wouldn’t get it orally?

Thank you so much for taking the time on this unusual situation.

[Terri Warren]

Too much time has probably passed to get an accurate antibody test unless she has been taking antiviral therapy this whole time.

Yes, that is exactly what I am saying about transmission to possible new partners.

Terri

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