Guide til herpes

Herpes

At Peech, we want to break down the taboos surrounding sex and sexuality, so in this series of articles, we're discussing sexually transmitted diseases. We would like to emphasize how sexually transmitted diseases do not make you gross or wrong or any other negative stereotype associated with STDs - it's merely infections, that in most cases can be treated easily and quickly. Give our articles about HIV and AIDS, clamydia, gonorrhea and genital warts a read as well, and learn something new about STDs

Even though herpes is one of the most common sexually transmitted diseases in Denmark, it can still be a challenge receiving the diagnosis.  Many might associate a positive herpes diagnosis with the end of their sexual- and romantic life. But herpes does not have to be the end of anything, if you are simply informed and know which methods to use, to minimize the risk of transmitting the virus to others

What is herpes?

The infection commonly referred to as herpes is actually two different types: herpes simplex virus 1 (HSV-1) and herpes simplex virus 2 (HSV-2). HSV-1 is most commonly associated with little sores or blisters on or around the lips, mouth and the face in general. These are known as  cold sores. But HSV-1 can also be transferred to the genitals. HSV-1 is the most common form of herpes, and at the same time the type of herpes that often give little to no symptoms. This is reason you can have herpes without even knowing. 

HSV-2 is found on the genitals, presenting as sores or blisters on the penis, scrotum, around the anus, labia, vagina, but also on the upper part of the thighs or the buttocks. 

Herpes is a chronic virus, which means that if you get herpes, it will lay dormant in your nerves for the rest your life, with no cure. It sounds scary, but it does not mean that you will constantly experience sores and blisters, or constantly feel affected by herpes. Instead, you will experience outbreaks, which will vary in frequency from person to person - some people only experience one active outbreak their entire life, others have an outbreak every few years, and others again have an outbreak with only a few months in between. A herpes diagnosis is not the end of the world, and for most people it's not even noticeable in their everyday life. 

The symptoms of herpes

Herpes is transmitted through contact with skin or the mucous membranes. That means it is transmittable through vaginal-, anal-, or oralsex, but also through touch of herpes sores, like when you're kissing. When you have contracted herpes, the first symptoms will usually show up after a few weeks. But it is also possible for the virus to lay dormant in the nerves, not presenting itself for months or even years. If you would like to read more about the test for herpes, as well as your options for management at your own doctor or at free clinics, you can read our guide here. 

When the symptoms of herpes are active, it's called an active outbreak. When you experience an outbreak, singular or little groups of blisters will occur in the skin, as well as redness on the genitals or on the mucous membranes. After a few days the blisters will burst, leaving little sores that will heal after a little while. The first outbreaks of herpes will give the most severe symptoms, but with time the outbreaks become more mild and shorter in duration (for most people). After the first few times, you'll likely experience an outbreak again as a result of stress or when your immune system is compromised, like when you're sick. 

The first few times you experience an outbreak, you might get influenza like symptoms, with headaches, fever and sore muscles, as well as sores and swollen lymph nodes. That is why you might receive treatment in the form of pills the first few times you experience an outbreak, which will shorten the duration and severity of the outbreak. Even though a lot, but not all, will experience an outbreak again, most won't receive any more treatment. Treatment is usually only given to those who have frequent outbreaks, around 6-12 every year. The medicine then works in a preventive manner, and you take it every day. 

At the same time, you need to be aware that you can have a sexually transmitted infection without having any symptoms. So if you have unprotected sex with others, it's always a good idea to get tested. 

So can I ever have sex again?   

Having herpes does not mean you can never have sex again. But you do need to take your precautions, so you minimize the risk of transmitting herpes to your partner(s). Herpes is most infectious when you have an active outbreak in the form of blisters or sores. During this time, you should avoid oralsex or kissing if you have herpes on the lips, and sex if you have herpes on the genitals. When the sores are healed and your mucous membranes feel back to normal, the risk of transmitting herpes is a lot lower. But not having an outbreak is not the same as then not being able to transmit herpes. It's a lot less likely, but it is still possible to transmit herpes without an outbreak! That is why you need to use condoms or dental dams during sex if you have herpes, to minimize the risk of transmitting herpes to others. But please be aware that neither condoms nor dental dams give 100 % protection against herpes, as you can still have herpes sores in places, that condoms/dental dams can't cover, like on the upper thigh. 

So, the fact that herpes can always potentially be transmitted to partners, active outbreak or not, means that there is always a minor risk associated with sex. That means it's important to tell your partner(s) if you have herpes, so they are aware of and can accept the risk of getting herpes. It might not be the most comfortable conversation, and many might feel like it's easier not saying anything, as long as you don't have an active outbreak. But as herpes can still be transmitted without an outbreak, even though the risk is minor, your partner(s) deserves to know. You should also remember, that you are far from the only person who has had the discussion - studies show that 20 % of adult danish people have herpes on the genitals, and up to 80 % have herpes on the face.

Besides, your partner(s) simply need to know, so they can make an informed decision. When telling others, it's best to choose a safe space - both for their, but also for your sake. They might have questions or doubts, that you can answer openly and honestly without the indirect pressure of still having to have sex, if you for example had the conversation in bed right before getting started. At the same time, it's a way to protect yourself, if the person you tell it to reacts negatively. If you ever experience negative reactions when telling others about herpes, please remember that you have done nothing wrong and you are not a bad person, simply because you have herpes. You have a virus which two thirds of the world does as well, and you have simply done as you supposed to, which is to inform.        


Sources:

https://www.ssi.dk/sygdomme-beredskab-og-forskning/sygdomsleksikon/h/herpes-simplex-virus-infektion

https://www.bispebjerghospital.dk/afdelinger-og-klinikker/dermato-venerologisk-afdeling/klinik-for-koenssygdomme/sygdom-og-behandling/liste-over-kønssygdomme/Sider/Herpes.aspx