I am a 30 year old female who recently had a 10 panel STD test done in light of some odd symptoms I was experiencing vaginally. I tested positive for HSV1 but negative for 2. Unfortunately I also had been previously treated for gential warts 10 years ago, was told I was in the clear and moved on. I now have a suspicious bump on my mons pubis I am concerned is recurrence. Since I have not had any gential symptoms swabbed, I am unsure of what location I am infected with HSV 1. My symptoms is a recurring  long vaginal fissure near my clitoris that has a roundish bit at the end, it  clear s within 2 days and is not painful or weepy. My husband does get oral cold  sores so I'm concerned  about possible oral to genital transmission. My questions are:

1) is it possible to still have the same genital wart infection 10 years later?

2) I want to have a baby and I feel as though my chance at motherhood is gone. If I am infected with HSV1 genitally as well as HPV, is pregnancy and birth even an option for me? Would I have to have a c section? Is having children even a good idea? I don't think I can take it if my child is ill because of me.

3) does this mean I will never clear my HPV like others do?

Thank you.

First, there are many causes of skin bumps, anywhere on the body, and the mons pubis is not an especially ommon site for genital warts. Most likely the bump is not a wart. As for HSV1, perhaps you know that half of all adults in the US (up to 90% in some countries) have positive HSV1 blood tests. Most are the result of oral infections, usually in childhood. Although a substantial minority result from genital infection (acquired by oral sex), genital herpes due to HSV1 recurs infrequently and is not commonly transmitted sexually to partners. When recurrent outbreaks happen, they last at least 7-10 days. Therefore, I doubt the "fissures" you describe are herpes. Also, people with HSV are immune to new infections with the same virus type, i.e. HSV1 or HSV2. Since you and your husband both have HSV1 (his cold sores, your positive blood test) you cannot re-infect one another. Finally, neonatal herpes -- infection of newborns with HSV -- is very rare, even when genital herpes is present. If and when you are pregnant, you'll need to tell your obstetrician about your and your husband's herpes, as a precaution.

To your specific questions:

1,3) Genital warts or other HPV infections (e.g., abnormal pap smear) sometimes recur years later, but it's not common. And as noted above, there are plenty of other more likely explanations for a skin bump in the pubic area (or anywhere else). The HPV infection that caused your warts 10 years ago probably is long gone.

2) Of course you can safely become pregnant and have healthy children. Neither HSV (including genital) nor HPV is a serious concern. (If all women with HSV or HPV had to avoid pregnancy, that would mean 90% of all women world wide could never have babies!) You really needn't worry at all about this. Best wishes for successful conception one day:  when that happens, tell your Ob about your past HSV and HPV, as a precaution -- but truly, this is nothing to be worried about.

I hope these comments are helpufl. Let me know if anything isn't clear.

HHH, MD

One last question: Would taking valtrex during my last trimester be useful in preventing HPV resurgence? If I do also have genital HSV1, this would also help prevent issues on that front as well correct? 

Thank you.

Valacyclovir (Valtrex) or its cousin acyclovir is often given to women with genital herpes during the last month of pregnancy (not the full last trimester). However, this is done almost exclusively for HSV2, not HSV1. The purpose is to prevent an outbreak near the time of delivery, which would require cesarean section instead of vaginal delivery. It is not a normal practice for women with HSV1, even when their herpes is known to be genital and not oral. The risk of an outbreak and transmission of the virus to the baby is nearly zero. That said, these drugs are entirely harmless for both mom and baby, so it's possible your Ob would consider prescribing it. As I said above, your herpes history is something to discuss with your Ob once you're pregnant and start prenatal care. Until then, don't give this another thought. The chance you'll be struck by lightning is far higher than your risk of transmitting HSV1 to your baby!

Thank you for your help. One last thing, since I had warts years ago, is it likely I will develop them during pregnancy? I've read that the immunosuppression during pregnancy can cause infections that were dormant to become active again? 

Thanks!

That completes the two follow-up comments and replies included with each question and so ends this thread. I hope the discussion has been helpful.