[Question #6874] Genital Herpes transmission risk

12 months ago
Hello, I have had genital herpes for 2 years.  I am a straight white male.  I haven't had an outbreak since December 2019.  

I had unprotected sex with my GF and she fully knows the risks of gential herpes.  I am currently taking 1000mg of Valtrex a day. I took a pill about an hour before we had sex.  I noticed no lesions or clear blisters or anything.  I didn't have an prodrome either. 

 I do have scarring on my penis from a previous outbreak.  I was "inside" her vagina for about 10 minutes and it wasn't vigorous or anything.  I did feel a tingle on a previous outbreak area for a quick second but I am thinking it was psychosomatic as I was nervous about it. What are the chances of me giving her genital herpes from this one time?
12 months ago
I did notice a "lesion" on the head of my penis the day after we had unprotected sex.  I noticed it after i wiped my head with toilet paper.  It looked like a small white head half the size of pin top.  Very small.  Then the white head disappeared  after 10 minutes but looks like a "chunk" in that area is missing.    No pain.  No fluid that I can see either.  After sex, I didn't wash myself with soap and water, just used wipes.   So vaginal fluid was probably still on me.

I have never had a lesion on my head before, always on the shaft.    I went to urgent care and he said it was from a scratch or trauma.  An online DR through my insurance said it didn't look like herpes.  Now I am overthinking and wondering if it is a herpes lesion.  But it doesn't look like what I have historically seen on myself which is clear fluid blisters that pop and form a open lesion.  

So now I am wondering if it was a herpes lesion and it was there when we had sex and I was on 1000mg of Valtrex could she get it?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
12 months ago
In my experience, lesions on the head of the penis by themselves are unusual for herpes recurrences.  And yours was so small!  I seriously doubt that this was a herpes outbreak.
So here's the deal about herpes medicine:  in order to reduce the risk of transmission to your partner, you should be taking medication every day.  It is only fully effective after taking it for five days.  The way you are doing this is insufficient to offer any protection against transmission.  The dose would be 500 mg of Valtrex daily for at least five days prior to having unprotected intercourse with an uninfected partner.  Taking 1000 mg of Valtrex an hour prior to intercourse is just not going to be very helpful at all, though your heart is in the right place! You just needed a little more information, I think.

Terri
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12 months ago
I meant to add I have been taking my medication everyday for the past 3 months.  I missed a day or two the last time I wrote.
12 months ago
I meant to say I have been taking 500mg to 1000mg of valtrex daily for about 3 months except where I have forgot for a day or two.  Some DR say its ok to take 1000mg but definately no more than that and others say 500mg.  Hope that clears up the confusion.  But, yes I have been taking it for 3 months straight basically.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
12 months ago
The usual dose for daily therapy is 500 mg once a day of Valtrex but for people who are unable to suppress their outbreak at that dose, you can safely increase to 1000 mg with a consultation with your health care provider.  I personally always start with 500 mg once a day and see how that goes.  Again, lesions just on the head of the penis are uncommon - not impossible but in my experience, more uncommon.  And they don't disappear as you described.  This might be more consistent with a very mild fungal infection, candida balanitis.  Check out pictures on the internet.  They will always be more extreme but worth looking at, I think, to see if what you had going on is similar.

Terri
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