Half a million people in the U.S. are diagnosed with genital herpes each year, and for some, the diagnosis is fraught with emotional issues and concerns. �What impact will herpes have on my sex life?� �How do I tell my partner?� Charles Ebel is the senior director for program development of the American Social Health Association, addresses these issues and more. Mr. Ebel is co-author of the book Managing Herpes, with Anna Wald, MD, MPH, and he directs the work of the National Herpes Resource Center (hotline #877.411.4377).
What impact will genital herpes have on my sex life? While it�s likely that herpes will bring some changes to your sex life, these certainly don�t have to be dramatic or interfere with your enjoyment of sex over the long term. For most people with genital herpes, the biggest concern regarding sexual relations is how to protect their partner (current or future) from contracting herpes. Important steps you can take to do this and prevent the spread of herpes are: avoiding sexual intercourse and direct skin-to-skin contact with herpes lesions during obvious flare-ups; and using condoms or taking other precautions, such as suppressive therapy, between outbreaks as a guard against herpes.
Medical studies show that suppressive therapy - taking antiviral medication every day - reduces the activity of the herpes simplex virus, and a recent study with one of the leading antivirals showed daily therapy also significantly reduced the risk of transmission. Regular condom use, too, has been shown to provide substantial protection. While research in this area continues, a combination of condom use and daily antiviral medication will likely provide the highest level of risk reduction available today (though not 100% protection).
It�s also important to keep in mind that:
The risk of spreading herpes is highest whenever symptoms, ranging from subtle tingling to painful lesions, are present.
Direct contact should be avoided from the first hint of symptoms until any skin lesions are fully healed and the skin surface looks normal again.
When symptoms are present, sexual activities that involve penetration, such as vaginal or anal sex create a high risk of transmission. Oral sex is also considered risky.
Condoms do not offer complete protection during outbreaks.
Refraining from intercourse during outbreaks can sometimes be difficult, but many people find creative ways to satisfy their sexual appetites, including sensual massage, mutual masturbation and fantasy.
How do I tell my partner? Telling your partner (or potential partner) that you have genital herpes can be difficult, but there are things you can do to make it easier. First, it�s important to realize that an honest discussion about sexual history is as important for you as it is for your partner. There are many sexually transmitted diseases, so it�s a good idea to talk about both partners� sexual histories.
Some people try to avoid telling their partner and think they can manage the situation by just avoiding sex during outbreaks and practicing safe sex in between. But withholding the truth has many disadvantages, including added anxiety and psychological stress, as well as ethical and legal implications. And, as you grow closer to your partner, you�re more likely to want to be honest, but it will be harder and harder the longer you wait. If and when you do finally disclose the truth, there will be two issues on the table. One is herpes. But the one that may cause more problems is the issue of trust.
Once you�ve decided to tell a partner about herpes, it may prove helpful to think through the process and anticipate some of the potential issues. Be prepared for a range of questions. Make sure that you have come to terms with herpes yourself and are able to speak about it clearly and confidently. Your mood and attitude will have a great deal of influence on how the news is received, so don�t be overly negative or gloomy. Expect that your partner will be accepting and supportive.
While every situation is different and no one should feel constrained to follow a script that doesn�t fit their situation, the following suggestions may make the conversation easier:
Consider the timing: people who�ve shared their experiences with herpes support groups tend to agree that it�s usually best to allow a relationship to develop a bit before bringing up the subject and before becoming sexually active.
Don�t interrupt a passionate moment to bring up the subject. While this may seem a logical time, your partner may be angry with you for spoiling the mood, and this may color the entire conversation.
Many people choose to plan a time and place for the conversation and the consensus is that talking to a partner about sexual history works best when both individuals are relaxed and undistracted.
Choose a private location that�s relatively free of interruptions.
Consider practicing what you�ll say out loud. Knowing what you�ll say and actually speaking the words in advance can help you feel more prepared.
In describing herpes, keep things in perspective. Stress how common it is and that there are effective medications available to treat it.
Finally, remember that you want a two-way conversation. Once you�ve said what you want, it may be a good idea to ask your partner some questions to elicit his or her thoughts. You might say for example, �What do you know about herpes?� or �Do you know anyone who gets cold sores?
Be prepared for your partner to express some confusion or distress, especially at first. Remember that it took you time to adjust and it may take your partner some time as well.
Most people will react well, especially after given some time to process the information or gather more facts on their own. Regardless of how your partner reacts, you should feel good about initiating the conversation and being honest with your partner.