[Question #1203] Worried wife

48 months ago
Hello doctors, i have had oral hsv 1 breakouts for almost 8 years and up untill recently i was not aware i could pass it on when i had no signes or symptoms.  My mother told me she had one or two cold sores when she was a child but none since and i did have a few friends who got them as well so its hard to pin point exactly how long i have had the virus. My husband and i have been together almost 9 years and married for almost 6 and we have never used any protection as far for oral sex, my husband knew there was risk if him getting getting it genitally and never said anything to me, hes away alot for work and i suggested that we start using protection when he comes home or course he wasnt happy about that, he has never had an OB orally nor on his genitals. I have been worring my self sick the last few weeks with this, i have never kissed or preformed oral on him with an active cold sore nor while its healing.  My question is would it be going to over bored to start using protection or just continue as we were and if he were to get it orally or genital can he pass it back to me genitally. My gyno said as long as i dont have an OB my husband will be ok but there is just so much information out there im not sure what all is true . Also my gyno gave me an rx for valtrex and said to just take it when i feel like im getting an OB does that help with hsv 1 viral shedding or is it mostly for hsv 2? 

Thank you for any information you can provide for me 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
48 months ago
I do not think for a moment that you need to use protection for oral sex or intercourse.  You've been having sex with him for 9 years and if you haven't passed it to your husband already, it is unlikely that you will in the future.

First of all, do you have any idea if your husband has HSV 1 already?  Has he been tested to know?  Have you talked to him about his wishes here?  Would he rather use condoms for oral sex and/or intercourse to avoid getting HSV 1 or not?  remember that HSV 1 genitally recurs infrequently and sheds infrequently and many times, people who get genital HSV 1 never have a recurrences once they get it.   If he gets it genitally it is extremely unlikely that you would get it genitally.  I would disagree with your gyno that if your don't have an outbreak your husband is fine however.  People who have HSV 1 and 2 shed virus  in between outbreaks as well as during outbreaks.  Valtrex taken daily can reduce the amount of virus that you shed and the chances that you will infect him.  But before you go down that road, how about if you get him tested using IgG type specific testing and also discuss HIS preferences in this arena. 

Terri
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48 months ago
Hi Terri, thank you so very much for the fast response.  I honestly do not know if he does or not he does not want to get tested and doesnt think it is anything to worry about and stated he knows there is always a risk. He definitely is not a fan of wanting to use condoms if i perform oral sex but had agreed to since it was causing me so much worry and anxiety over the last few weeks since i had read the majority of new genital hsv 1 cases were from oral sex, i felt awful because i had been so misinformed on it. I think im most worried if he does get it genitally he will have bad OBs i know every person is different but i know how embarrassed and grose i feel when i get a cold sore. If he agreed to get tested do we need ask specifically for that test or is that the standard test? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
48 months ago
You need to specifically ask for that test, a type specific IgG HSV 1 antibody test.  You can order it yourself online without a clinician order through a variety of services.  
I will ask you to step back away from the stigma of the word herpes and pay attention to the disease of HSV 1 genitally. Yes, he could get sores on his penis with a first infection and possibly recurrences, but they would be rare or most people, for sure.  I think you are reacting to the stigma of cold sores for yourself, but this is honestly your husband's decision too, right?  it's going to be difficult to let him make that decision but I think you should!  Do you trade off recurrences perhaps every other year for about 5 days for continuous use of condoms for oral sex?  If it was me, I would not make that tradeoff, knowing what I do about HSV 1 genital infection!  Try to think about the reality of a possible HSV 1 genital infection rather than all the hype associated with the word herpes.  Mild, infrequently recurring, possibly never recurring.  I would describe HSV 1 genitally as a minor inconvenience.  Let your head take the lead instead of your heart on this one if you possibly can and listen to your husband's preferences where you possibly can, please.  I know you are worried but think it through carefully before reacting

Terri
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48 months ago
Thank you so much Terri it will definitely be something my husband and i will discuss when he comes home i know i always give in to my heart but i will open to listen to him amd what he really wants as well , we are trying to start a family. When we do have a baby should i avoid kiss them when they are very little? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
48 months ago
If you have an active cold sore, you should not kiss a baby.  Otherwise, the kind of kiss you will give a baby is not going to transmit herpes to a baby if you are not having symptoms.  I strongly believe that your family will sort this out in a safe way that preserves a fun and rewarding sex life and life for any future little ones.

Terri
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