No, I doubt that your pain has anything to do with herpes this time.  I think you can return to your regular dose now.  I am not concerned about hand to penis transmission no.  And your dosing definitely reduces any small risk that might be there.  I think your symptoms are likely due to hard stools and not herpes.

Terri

1.)  Having never had an outbreak on the penis and knowing the low likelihood of oral HSV2, do you consider unprotected oral sex safe?   What about if my partner performed unprotected analingis orally on me (again assuming no outbreak was present, but it is where my primary outbreak took place)?  Still fairly safe (albeit it always carrying some degree of risk, as any activity ultimately does in my case)?

2.)  Have you in your research or practice found any connection between genital HSV-2 and constipation and/or nerve pain?  I know some studies (on animals, on the case of constipation) have linked to it.  I'm an odd case of a diagnosed IBD, which would normally display as chronic diarrhea but in my case actually seems to be the opposite where I am chronically constipated, all of which seems to have started around the time of HSV acquisition.  I used to also get nerve pain down my left leg and pain in my lower back/tailbone region.  I don't know if I should attribute it to the HSV or not.

3.) My partner and I have been together for over 4 years, and we've largely stopped using condoms during sex (still on Valtrex for suppression and both understanding of the risk we take with that decision).  He has shown no signs of HSV-2, and he will get tested now and again to see if he's developed the antibodies for an asymptomatic infection.  Does the fact I am on suppressive meds (and maybe that I've had it for several years now?) change how he would present with the virus if he were to become infected?  Is he more likely to be asymptomatic or show mild symptoms with me on suppression, or does that not necessarily play a role?  I know my original outbreak was quite severe and caused many problems (urinary retention, etc.), so I'm just curious how he could present IF he ever does and what plays the biggest role there (strain of HSV, his immune system and genetics, my suppressive dosage, etc.).

Thanks again!  You guys are a wonderful help and resource here.

I would agree that it would be very unlikely to have continuing herpes pain for almost two weeks, yes.

Do you mean you giving oral sex or receiving oral sex?  If receiving, I would agree that the risk is low but definitely not zero.That applies to both your penis and your anus.

The only connection I have ever seen between constipation and herpes is during first infection, sometimes the nerves are so traumatized, we see people not being able to poop or pee.  I don't see that with recurrent disease.

I don't think we know for sure the answer to your question about the presentation on him being dependent on the amount of virus he would get with a new infection, which would likely be less with you on suppression.  I will say that if he has HSV 1 already and acquires HSV 2, he will likely have a milder first infection.

Terri