[Question #1160] Type 1 spreading

69 months ago
A few years ago I had a blood test taken that was positive for type 1 herpes but negative for type 2 herpes.  I have been afraid to have intercourse with the fact that type 1 can be genital as well, my question is what are the chances of spreading type 1 if on daily acyclovir and have had no symptoms and every pap has come back normal?
Terri Warren, RN, Nurse Practitioner
69 months ago
Have you ever in your lifetime had a cold sore on your lip or in your nose?  That would indicate that your HSV 1 infection is oral - the majority of HSV 1 is still oral, not genital.  If you happen to have this genitally, HSV 1 is infrequently recurring or shed from the genital area, resulting in lower levels of transmission than HSV 2, by quite a bit.  And daily medicine reduces this even more!  About 56% of the US population has HSV 1 infection, so you are in the majority - being infected with HSV 1.  If you were my patient, I would certainly not make the assumption that your infection is genital without symptoms.  Is there a particular reason that you think this is a genital rather than an oral infection?

Terri
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69 months ago
I have never had a sore on my mouth or nose, the reason I may think it is genital Is that over the last six years I have had constants muscle spasms in my pelvic floor muscles that affect my vagina, no doctor has had an explanation, I have had surgery to cut the nerve but did not work, and now receive nerve blocks once a week, not sure if herpes can cause muscle spasms in the genital area, but no sores that I am aware of down there in the last six years, I thought maybe I had one many years ago but it was not painful. I continue to take acyclovir with the positive type 1 but am still worried about intercourse even with condoms
Terri Warren, RN, Nurse Practitioner
69 months ago
I have never heard of herpes creating muscle spasms in the pelvic floor.  It sounds like you've really been having a hard time with this issue, though! 
Honestly I think you are over-worrying about having intercourse with HSV 1.  You are on suppression, it doesn't shed often it if it there, and most people you would have sex with already have HSV 1 because of the high prevalence of HSV 1 in our society.  You have a choice  here - live more fully, disclose to partners if you wish (the debate rages on about that)  and enjoy your sexuality.  I would hate to see you live the rest of your life with this concern stopping you from living fully.

Terri
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