[Question #5219] Genital Herpes Type 1

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76 months ago
    Hello on July 2018 I got diagnosed with Genital Herpes Type 1 through a swab test. I had one mayor outbreak but there is something that worries me. I have been doing a lot of research lately and I have learned that Genital HSV-1 is supposed to have very few recurrent outbreaks per year.  I know for sure that after my initial outbreak I had another outbreak which manifested itself as a swollen bump on my genitals. After noticing this, I immediately started taking two Valtrex pills  each 500 mg daily for three days and the swollen bump ended up going away.  Then I had another one  ( I am not sure if it even counts as an outbreak because it was a very small bump that felt pretty hard it honestly resembled a pimple.  Now I just recently got another tiny tiny red dot on my genitalia but honestly I don’t even know if this is an outbreak or a pimple I having a hard time differentiating between the two.  I would also like to mention that ever since I got diagnosed I have been experiencing stress because of the social stigma and also because of other issues such as finances. I am not sure if stress could be a trigger for outbreaks or not. I have also felt in a fairly inconsistent basis tingling in my legs/ thighs which I know is the promodome . By the way I have been recently tested for every other std on the planet and have tested negative. I am just confused because if gential hsv-1 is supposed to have very few recurrences why am I getting these outbreaks? Would appreciate your advice! 
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Terri Warren, RN, Nurse Practitioner
76 months ago
I understand your confusion.  However, you are making the assumption that these things that don't necessarily sound like outbreaks are actually outbreaks.  For example, a very small bump that felt hard does not sound like an outbreak to me.  And as you mentioned, it is hard to sort out what's what!  The inconsistent tingling you are feeling may or not not be herpes.  Shortly after someone is diagnosed, everything that feel is possibly an outbreak while in reality, fewer things are.  If you want to know if a particular something is herpes, you could have it swab tested for the most accurate answer to that question.  The other thing is, the first year of having herpes is not representative of what recurrences will be like in future years.  The immune system is working hard to get familiar with this newest resident and that can take some time.

Terri
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76 months ago
I am honestly just a bit worried because I have heard that in rare cases Genital HSV-1 can behave like HSV-2. The fact that I may belong to this group gives me anxiety because that would mean that I might shed much more often and hence have a higher probability of passing it on to a future partner. Even at times when I am not stressed out I still get this occasional pins and needles feeling in my genitals and usually when I have this feeling  about a week or weeks after I get a very small bump that feels hard on my genitals and I immediately think it is an outbreak. The reason why I assume these are outbreaks is because I have read online that sometimes genital herpes outbreaks can resemble a minor skin condition such as a pimple. 
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76 months ago
Also today at work I felt a mild feeling of pins and needles on one side of my genitals that lasted about 3-4 seconds long. If I get another weird small bump on my genitals that would be the 5 th time it happens this year. Please I need your advice and guidance. Thank you 
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Terri Warren, RN, Nurse Practitioner
76 months ago
Something that last for a few seconds is unlikely to be activation of herpes virus.  If I really focused hard on my genitals, I could imagine some pins and needles feeling pretty quickly. 
You are correct that most HSV 1 sheds infrequently in the genital area.  There is really nothing that can be done to reassure except swab testing of the areas giving you these sensations.  You can certainly worry about it a lot but that won't give you the information you seek.  I would recommend that unless you are having lots of confirmed outbreaks (by swab) that you are no different than others with HSV 1 genitally

Terri
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76 months ago
So the pro dome feeling before an outbreak is supposed to be more constant not something that comes and goes and lasts a few seconds? Because with me  I would get a tingling feeling in my lower body ( mostly around my hip area) for a few seconds and then it would go away and I would not feel anything for days or a week or two and then I would have another random tingle....sorry I know I am being paranoid I just need the clarification. 

Also I would like to know what are my chances of passing the virus to a non infected parter? I am a female by the way

1. From a infected female to a uninfected male using both condoms and a daily antiviral
2. From a infected  female to a uninfected male being intimate without condoms but being on a daily antiviral pill

Are there any negative side effects of being on a daily pill for the rest of your life? Does it negatively affect your liver or kidneys in the long run? 
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Terri Warren, RN, Nurse Practitioner
76 months ago
Yes, for most people, prodrome last hours, not seconds. 
From an infected female to a male using condoms and medicines, about 1% a year, having sex twice a week.
without condoms, about 2% under the same circumstances.
We have more than 20 years of safety data and as one leading scientist says "it is safer than aspirin"  I have had patients on these drugs for 35 years

Terri
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76 months ago
Those stats are for genital Hsv1 correct? 
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Terri Warren, RN, Nurse Practitioner
76 months ago
Sorry, I should have been clearer about that.  We do NOT have stats for HSV 1, only for HSV 2, which these are.  The stats for HSV 1 can perhaps be extrapolated - we know that HSV 2 sheds on about 14% of days and HSV 1 about 5% of days, on average, so it's about 2/3 less.

Terri
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