Likelihood of HSV2 transmission from F to M

[worrywort123]

Hi Terri,

I (42F) was dx’d w/ HSV2 in 2004. One initial outbreak, 1 or 2 subseq. 2021 IGG test showed 1.15 for HSV2. You suggested WB to confirm. WB confirmed -HSV1, +HSV2.

Am on daily Valtrex 500mg and have been so for months (sometimes I forget, but usually not). Over Xmas 2021, I had what I guess was my first OB in over a decade by my best guess. Throbbing prodromal nerve pain in right groin/labia area and next morning there was 1 spot near lower left labia that felt like a blister and was tender/stinging. However, I had physician ex look, too, and neither of us could find a lesion/blister or anything suspicious there. Regardless, I assumed OB because of the way the area felt.

This was helpful in that I now associate the throbbing nerve pain with legit prodrome, whereas I can occasionally have nerve pain in the same area, but it’s intermittent and can happen after sex, etc. It doesn’t throb the same way, if that makes sense.

I have a newer partner and am worried I might have exposed him. My question is: any idea the likelihood of transmission in this scenario? Bluntly: there was about 2-3 minutes of external genital-genital contact where I was sitting on top of him (both nude), some rubbing. Then unprotected sex for under two minutes, as I got nervous about the lack of condom, pushed him off, and used my mouth & hand to finish him. This happened 2 days ago and again today. Still, when I checked myself later today, I saw 1 red spot that may or may not be a blister/lesion on the inside of r. labia minora. Slightly larger than a ballpoint tip. Not tender atm, and I don’t see other spots. Again, I am on 500 Valtrex and added 100mg Amenalief I started 3 days ago because I read the mech. of action is similar to Pritelivir and there could be a synergistic effect when combined. Is he in danger? He knows my status. He is -. I have had 5 partners since dx & have not transmitted to any I’m aware of, even after 0 meds or condoms for over 10yrs with ex-H.

Thanks!

[Terri Warren]

By now, he may or may not have had symptoms. Sorry, we’ve been camping out of reach of internet. I think the risk for him is low but if he was going to get herpes from you and be symptomatic, he would have had an outbreak by now. Good for you for taking the meds and disclosing your status.
What is his status?

Terri

[worrywort123]

Thanks for your reply! As of his last test months ago, he was negative for HSV2 and positive (well-established infection) for HSV1. He gets cold sores on his mouth several times a year and has for over a decade.

Follow up questions:
1. I am currently on swallowed Flovent (fluticasone) to help treat eosinophilic esophagitis (allergic reaction to something/condition that causes white blood cell build up there). I take is 2x a day for six weeks and it’s considered topical steroid use, as it’s coating my esophagus. Since steroids suppress the immune system, am I more at risk for outbreaks or transmitting HSV2 while on this medication? (I’m still taking my Valtrex).

2. If my partner were to start taking daily Valtrex for his HSV1 to prevent cold sore OBs, would that give him any protection against my HSV2? And if not, why is that? I’ve read that the drug is only activated in the presence of the virus, so I have a hard time understanding, if he takes this daily and is exposed to my HSV2, why Valtrex wouldn’t attack it and prevent replication the same way it does for me and for his HSV1?

I just want to keep him as safe as I possibly can. Is there anything else I can do to help protect him? My ex-H would wash his penis with soap and water very shortly after sex and, as far as we can tell (he hasn’t been tested, no symptoms), he never got it from me in 15 years. Does this help? Yes, it makes me feel slightly… dirty, but I also am not really offended. If it is helpful, I encourage it.

[Terri Warren]

Him taking Valtrex would not protect him from getting your HSV 2, no. It is likely that the dose he would take daily would be insufficient to prevent latency from happening. I don’t think there is a downside for him to do that but we just have no evidence that that would be useful.

I think soap and water after sex is fine, yes. We aren’t sure how effective that might be, but again, it can’t hurt.

You could also try doing Valtrex 500 twice a day for a bit more protection and to keep blood drug levels more even.

Terri

[worrywort123]

Thank you for your response. I’m not sure I have any questions left. If not, I’ll purchase more.

I have a question about prodrome nerve pain. I always get it in the same spot. Right side, kinda achy in my right butt cheek and down the back of my right leg. My initial OB was primarily concentrated on my right side, iirc, and that’s always been my warning signal.

Anyway, lately I am getting a lot of nerve pain after sex or masturbation, even though I am doing 500 mg Valtrex twice daily and have been for some time. I’ve not yet seen any blisters form in the wake of the nerve pain, but I can pretty much count on the nerve pain after any kind of friction, even well-lubed. Is this legit prodrome or more of a nerve irritation issue? For instance, I had sexual relations Sunday, nerve pain afterwards and into Monday. Eased up by Tuesday. Masturbated Tuesday, slight nerve pain the following day. Masturbated last night, pretty strong nerve pain today. Still no sores that I can see. This has been going on for weeks, and I’ve dealt with it before in the past. My OB suggested amytriptyline or gabapentin to see if they help, but I’m afraid to take it if the pain is legit prodrome because, since I never get anything that appears to be a lesion, I wouldn’t be able to tell I’m having an OB without the nerve pain. See the quandary?

Thanks!

[Terri Warren]

It simply isn’t possible to know if the nerve sensations that you are having are related to HSV activity or not without a swab test of the genital area to determine if there is active viral shedding going on or not. But generally, something that last for weeks isn’t herpes. I do see the quandry, but in general, if Valtrex removes all the pain, you can assume that that sensation is due to herpes and act upon that, in terms of avoiding sex when you have that symptom.

Terri

[Author]

Posts