tingling

[shoofly]

Hi Terri–thanks for providing the most rational and human material on the internet on this topic.

I started sleeping with a man with HSV2 about 2 months ago. He has had it for 25 years, hasn’t had an outbreak for 10 years, and claims to have never given it to anyone (though we both know he can’t be 100% about that, he’s friends with several past lovers). We’ve used condoms almost 100% reliably–okay, maybe 80%. I’ve done a ton of reading and research about the risk to me, and figure that life is risky. This is one I can live with. Due to other factors, I don’t know what the future of this relationship will be–it’s unlikely to last forever but he’s a great guy and we have a wonderful connection. I do have another lover as well, and have had to have some interesting conversations all the way around.

About a week ago I got a full STI screening, including HSV2, and all results were negative. I have gotten cold sores forever, and so didn’t get tested for HSV1. I know it’s too early for the HSV2 blood test to be conclusive, especially since we’re still having sex.

So here’s the thing–I’ve been having a notable, intermittent, mild to moderate tingling in my outer labia, pretty much since we started sleeping together. I was convinced for a minute that it was prodromal symptoms, until I read that prodromal symptoms don’t happen with an initial outbreak (is that true?), then I figured I was just paranoid and focused excessively on my nether parts, but now it’s been a while, and possibly increasing. It’s definitely more when I’m sitting down in tight jeans, but not exclusively. And I’m also having a hard-to-pin-down sensation in my legs, a little nervey, almost like I pinched a nerve in my hip.

I’m concerned this could be HSV2, but it’s not really matching with anything I’ve read. I’ve had no blisters (checking daily) or other outbreak symptoms. I’m especially concerned about the other lover–I’d hate to pass anything on to him. And then, if it’s NOT herpes, what the heck?? Any ideas what else could be causing this?

And another question–what’s your opinion on “lambskin” condoms? I’ve read that they are completely ineffective at preventing the spread of herpes, but I also think I’ve seen you write otherwise. They are so much more fun than latex.

Any other words of wisdom most welcome. I’m a little worried, and questioning why I’m engaging with this risk, but trying to keep it all in perspective and not let it ruin the connection.

Thanks for your work!

[Terri Warren]

It sounds like you are thinking quite rationally about the whole issue of herpes with this man.
Yes, people can have prodrome before a first outbreak and in fact most people do. but it doesn’t last a long time – how long has yours lasted? The whole two months you’ve been together?
I do think it is very common for people who are not infected having sex with someone who is to notice many genital sensations that they might not have otherwise noticed. I’ve been in your position and at the beginning of my relationship with someone who had herpes, my sensation antenna were way up. That does fade over time for sure. However, there could be other things going on here including but limited to a reaction to latex. There are also bacteria and fungi that people can pass between each other that aren’t often thought about.

I think lambskin condoms are a fine alternative to latex. No, they probably aren’t quite as effective but they are certainly better than no barrier. Also, even though he isn’t currently having outbreaks, I think the option of him taking daily antiviral therapy would still help reduce the risk of infecting you. Whether he wants to do that is an open question but I think daily therapy is a simple, cheap (if the prescription is written correctly) and low side effect risk to decrease the risk of transmission by almost 50% over not taking therapy. It is true that people who have herpes for a longer time shed virus less often, in general, which is a good thing in your situation.

You may want to retest at some point but for you, it will always be a moving target, reflecting your HSV 2 status a few months back.

Terri

[shoofly]

Yep, intermittent tingling for almost 2 months. I’ve never experienced a reaction to latex before, so I doubt it’s that. I was really trying to chalk it up to being paranoid and hypersensitive, but I’m starting to wonder if blowing it off is the right approach. But from what I’ve read, if this WAS herpes, it would most certainly have resulted in blisters by now. Is that true? How confident should I feel?

We’ve talked about the antiviral therapy and he felt that because he hasn’t had an outbreak for so long, it isn’t necessary. Maybe we should revisit that.

Are there any stats about the rates of shedding for someone in his situation, or the risk of infection for me, considering the length of time he’s been infected and hasn’t had outbreaks?

[Terri Warren]

If it isn’t latex sensitivity, then I’m not sure what it could be honestly. First of all, herpes prodrome doesn’t last for two months straight – a couple of days is usual, I think even a week is outside the norm.
We don’t have good statistics about the rate of transmission specifically for people that have been infected for a long time and who have infrequent recurrences. We believe those people still shed virus but for most, it is less frequent for sure.

So the antiviral therapy would be for your benefit, not for his, which I think you already know. It would only be a benefit for him in the sense that his concern about infecting you would be decreased but I’m not getting the sense from what you have said that he is very concerned about that, given his belief that he has not infected anyone and the long time since infection and since last outbreak. Those things are all good but not necessarily indicative of the actual situation. For example, no one he was with might have experienced an outbreak but 80% of those infected with HSV 2 don’t know it, so history usefulness is limited. And just because someone is not having outbreaks does not mean they are not shedding virus. So yes, his news is good but it doesn’t mean you are home free, which I think you also know!

Overall, without taking into consideration his time since first infection and frequency of recurrences, the rate of transmission from an infected male to an uninfected female per year, having sex twice per week on average, about 10 women out of 100 will get infected in a year. With antiviral therapy, that drops to 5 and with condoms, between 2-3 women will get infected, just statistically.

You’ve got one more question in your subscription – please feel free to ask me anything.

Terri

[shoofly]

Hi Terri,

Okay, some questions about prodrome. I’m familiar with that pre-cold-sore sensation–a very specific tingle, in a specific spot, that results in a sore in a day or two. Is it like that with genital herpes, too–specific tingle at the precise spot that a sore will erupt? Or can it be more diffuse? And, is tingling down the legs ever a thing??

Still trying to pinpoint this. I definitely notice it more when I’m sitting down for extended periods, and much less when I’m up and about and active. Maybe just because I’m distracted.

I’m tempted to make an appointment at your clinic–would you recommend that I get checked out, or maybe let some more time pass for a re-testing? The folks at planned parenthood had no insight on this one.

Thanks!

[Terri Warren]

Yes, it is exactly like that. Same thing. Some people get nerve pain in the leg for a day or two, yes.
Your issue sounds more disc-like than herpes-like.

You can sure get tested again but if you keep having sex with him this becomes very much a moving target. I’m not clear that seeing us would help you, honestly. If you do have brand new herpes (which is seriously, seriously doubt), you would be shedding lots of virus and frequently. You could do some PCR swabbing and see how that goes. if you are interested in that option, you could call the clinic and set up a phone consult with me and I could kind of tell you how all that works?

For now, you have used up your subscription questions. I you have more you can always renew your subscription.

Terri

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