Chances are, unless you are a virgin, you’ve at least been exposed to herpes. Eeek, right?! Well, chances are you’ve probably never been tested for it, either. Many people are familiar with oral herpes, aka HSV-I, which usually manifests around the mouth area. But most people are ill-informed about genital herpes, aka HSV-II, which usually causes outbreaks around the genital and groin area. These closely related viruses are both very easy to catch and spread. And here’s a not-so-fun tidbit: you can get both forms on both areas of the body, HSV-I just tends to make its way to the top of your spine, and HSV-II tends to stay at the bottom of your spine, where it lives quietly and sometimes make its way back out to your skin, causing an outbreak.
Most statistics purport that 1 out of 4 Americans have genital herpes, but this estimate is low because so many people do not know they have it, and so few people actually get tested for it. If you’ve ever gone into the doctor’s office and said “test me for everything,” and they say “OK,” you think you’re getting tested for everything, right? Not really. Usually you’re just getting tested for gonorrhea, chlamydia, HIV, and maybe syphilis (if you’re a gay or bisexual man, or have had sexual contact with a gay or bisexual man). Most likely you will not get tested for other STDs or STIs unless you claim you have been exposed to someone who had something, have specific symptoms, or had an abnormal pap smear (if you’re a woman). STDs are not routinely checked for during pelvic exams. This article explains why herpes is not routinely tested for – too many false positives. Yet, as you’ll read below, even people that are asymptomatic can still spread the virus.
There are two ways to get tested for HSV-II, the only sure-fire way is a blood test, the other is a swab test (which requires you to have a fresh sore, so a practitioner can dab the sore with a cotton swab). If you are having some kind of outbreak and are unsure, you should request both tests, because it is possible you have more than one STD, or what you think is herpes could actually be something else. (Side note: whether it is on the mouth or the genitals, HSV-I can be trickier to diagnose, read one person’s story of possible misdiagnosis, a positive visual diagnosis and negative blood test, here.)
The good: The good news is neither form of herpes will kill you. Some possibly good news is that the first outbreak is often the worst, and in some cases herpes goes dormant and doesn’t cause an outbreak for years, if ever again. Occasionally outbreaks become less and less frequent until the herpes seems to have “gone away.” Women that have herpes can still get pregnant and have normal delivery, but they will have to take an anti-viral pill (such as Valtrex or the generic, acyclovir) the last month or so before birth to eliminate the risk of spreading herpes to her child. Because of the risk of spreading herpes during birth, any woman who is pregnant or thinking about getting pregnant should get tested right away. When managed properly, herpes has little effect on sex life and enjoyment of sex.
The bad: The bad news is there is no cure for herpes. Stress and a compromised immune system can trigger outbreaks. And if you contract herpes, you may have to take an anti-viral pill for the rest of your life, which is not only a pain in the butt, but it can be very expensive, too. There may be complications if you have other STDs, like HIV. Something everyone should know is that CONDOMS DO NOT PROTECT YOU FROM HERPES. All it takes is skin to skin contact, and many people’s outbreaks occur in areas not covered or protected by condoms. Plus, even people who are asymptomatic can still spread herpes. Click here for a surprisingly readable academic article discussing asymptomatic herpes and subclinical shedding. It is worth noting, however, that many people can tell when they are about to have an outbreak, so can communicate that to their partner to lower their partner’s chances of exposure.
The freaky: When you look images of herpes online, you’ll see many grotesque images of red blistery rashes covering various parts of people’s bodies. For most people, herpes does not look like these photos. Though some people can experience horrendous outbreaks and painful lesions, the majority of herpes outbreaks are mild, often so mild a person might not even notice they are having an outbreak! Some women get outbreaks on the inside of their vaginal walls and are completely unaware that is happening.
Also, if you are freaked out after reading all this, get tested, and the results come back positive, do not assume you know who the herpes came from! Another annoying thing about herpes is that although most people will get their first outbreak about 3 weeks after exposure, other people never show outward signs of herpes, and still others will not have an outbreak until years, or even decades after exposure. Some people have had their first outbreak years into a relationship, and they assume their partner has cheated on them, but this may not be the case at all. It is possible that the herpes came from a previous partner that is long gone. My gynecologist told me about one of her patients, in her 70s, who was not sexually active and whose husband was not even alive anymore, who had just had her first herpes outbreak. The woman swore she must have gotten it from a dirty toilet seat at the pool, and even though her gynecologist assured her that was impossible, the woman refused to believe it.
The bottom line is, get tested for herpes. Tell your partners to go get tested for herpes. Read more about both kinds of herpes on our Herpes page (includes link to photos), Planned Parenthood, the Herpes Resource Center, and download the Herpes Handbook – which includes the latest facts and research about genital and oral herpes – from Westover Heights Clinic here. If you get tested and your results come back negative, congratulations. And if you have herpes, it’s not the end of the world. That’s probably the last thing you want to hear but go back up to the “the good” paragraph and re-read. Having herpes doesn’t mean you’re a bad or dirty person. And it is manageable. Read about the experiences (and more experiences) other people have had, and talk to a trusted friend.