[Question #5590] Unprotected sex between two new partners who already have HSV-2.

21 months ago
I am male and had unprotected sex with my girlfriend for the first time without a condom.  Both of us already have HSV-2 from past partners--I have it at genitals and she has it at genitals and mouth, though only one original outbreak occurred at the back of her mouth 13 years ago.  We had vaginal intercourse and she performed oral sex on me.  At the time of the sex, we believed we were both clear of any outbreaks, but unfortunately just the next day I felt the indicating pains of the beginning of a new outbreak.
I am concerned that if I did expose her to "my virus" she could now possibly develop new locations at or inside her mouth and vagina where future outbreaks may surface.  Furthermore, I am concerned that through this possible exposure she could have an imminent outbreak (after being free from outbreaks for 7 years).
She believes that since she already has it in both areas for many years that nothing will change for her regarding locations of outbreaks, and not get a new outbreak from this, since we both have HSV-2 and the virus I may have potentially passed to her is nothing new to her body.
Can you explain if one of us is correct?  Or perhaps correct either of our theories about this?  Thank you!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
21 months ago
I'm with her on this one.  It would be unusual to contract a new strain of herpes in the first place and even if that did happen, it would be very unlikely to change the outbreak pattern one already has as that is moderated by her immune system.  If I were the two of you, I wouldn't think twice about this any more.  I am assuming you have both been tested for other STI infections prior to unprotected intercourse?

Terri
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21 months ago
Dear Terri...Thanks so much for you answer.   Yes, we have no other STIs.   For my own education, I have heard that each of these viruses--HSV1 and HSV2--prefer certain types of body tissues where they are most likely to infect and recur (not certain, but this may explain why HSV1 is generally known as an oral herpes and HSV2 as a genital herpes?)   But apparently, both can infect and recur in the mouth and/or genital regions.   I would love to hear your general commentary on this topic.  But also my specific question would be:  is it more difficult to get HSV2 in the mouth from oral sex with an infected partner (especially given that asymptomatic shedding can and does occur).  Thank you!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
21 months ago
HSV 2 oral infection is quite uncommon due to the site preferences that you describe.  I've seen it but not often.  HSV 1 is a bit less picky than HSV 2 about where it lives.  It prefers the mouth for sure but with more and more oral sex being openly practiced (and enjoyed) in our society, the demography of HSV 1 infection has changed greatly.  Now, most new cases of genital herpes in the US are HSV 1, rather than HSV 2.  HSV 2 causes the majority of recurrences, however.  The literature is also now describing "mixing" of the two types, making antibody testing perhaps more of a challenge than previously.  An interesting new avenue of research

Terri
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21 months ago
Thanks very much again Terri.  My final question:  I have had a difficult lifetime experience with HSV2.  I got it at 19 and had many many outbreaks in my 20's.  Almost all the outbreaks occurred at or near where the penis shaft becomes the glans (just about everywhere along that circumference multiple times over the years).  By my early 30's, while the outbreak frequency decreased, I noticed that I had lost a lot of sensitivity (maybe 50%) in my entire penis and scrotum area, especially at the glans which should be the most sensitive.  In my mid 30's, I tried to address this by investigating with various doctors (I had a theory that so many outbreaks "burned out" my nerves) but there was no conclusive diagnosis (i.e. various tests showed nothing abnormal ).  I am now 52 and the sensitivity has dropped over the years to a level I would say is 10% to 20% of what it was before getting HSV2.   Concurrently (and maybe just coincidentally) my libido has dropped in the same time frame since my 30's to nearly zero.  Jointly this makes sexual intercourse with my girlfriend very challenging (especially with a condom which is why we decided to try eliminating their use).  Other than this, my general health has always been consistently excellent with no other issues.  I  am just curious if you have ever come across anything like what I described in the male populations you have treated or studied as it remains such a mystery to me?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
21 months ago
i have not come across this, related to herpes, no, but I've certainly seen many many many men who have decreased libido in their 40's, 50's and 60's and it has been troubling for them.  This does not address your question about decreased sensitivity but I would encourage you to speak with your provider about your concerns and obtain a prescription for erectile dysfunction medication and see if it helps.  I think you will be pleasantly surprised.

Terri
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