[Question #1160] Type 1 spreading

48 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
Terri Warren, RN, Nurse Practitioner
48 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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48 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
Terri Warren, RN, Nurse Practitioner
48 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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