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Dr. C.
Dr. C., Board Certified
Category: OB GYN
Satisfied Customers: 3064
Experience:  30 years of experience and an award-winning educator.
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Ive had herpes simplex type 1 (oral cold sores), how did I

Customer Question

Ive had herpes simplex type 1 (oral cold sores) for years, how did I end up with herpes simplex type 1 (genital)? I did not know this was possible. Also, I am just getting over my first outbreak, its been three weeks since I was diagnosed by a swab test (a sample from a genital lesion) much longer is this expected to last? What are the average amounts/lengths of outbreaks from here on out for type 1? Also, what are the transmission rate percentages or chances with type 1 versus type 2 with a partner, arent they much lower? Thanks.
Submitted: 7 months ago.
Category: OB GYN
Expert:  Dr. C. replied 7 months ago.

Hi, It's Dr. C. Board certified Ob-gyne. I can help you today.

I'm sorry to hear about the herpes transmission. Type 1 herpes can be transmitted to the genital through either oral sex or with saliva from the same person. Most commonly this happens when someone uses saliva as a lubricant for masturbation. Most outbreaks last less than 14 days. Taking an anti-viral can shorten the duration. The recurrence of type 1 herpes on the genital varies greatly. Some people will never again have an outbreak after the first transmission while others will have more trouble. It depends on the strain of the herpes, their immune system and possibly dietary factors. For some people, high arginine foods cause herpes to be more active. The most common such foods are nuts and oatmeal. Most recurrence outbreaks last no longer than 4-7 days. Transmission rates are lower with type 1, below 10% and most likely below 5%. Taking the supplement lysine can help lower activity of the virus.

I hope this information was helpful. Please reply if I can clarify anything or add more details. I want to be sure you get the most helpful information for your situation.

Customer: replied 7 months ago.
I most likely transferred type 1 from my own mouth to my genitals? Because I recently had a new sexual partner and I was very very sore afterwards, especially my anal area and my thighs, for days and about 5 days later noticed three small spots on my perineum which i was told was just tearing from rough sex and lack of lubrication at my first doctor visit. and then two days later i had a huge outbreak of bleeding sores, mostly all over my perineum and anal area, only two small spots in the vaginal area. it had to have been some of the worst pain of my life, unable to go to the bathroom or walk or sleep along with flu like symptoms. i have finished my course of the valtrex and also been taking lysine ..most of my sores are gone or healing up but the anal itching is killing me and it has been three weeks. is it possible that i have type 2 instead of type 1 or are the swab tests accurate enough? it seems so severe for what they say type 1 should be. also, is the transmission rate of under 5-10% with suppressive medication and or condoms between outbreaks or without either? Thanks.
Expert:  Dr. C. replied 7 months ago.

Usually a purely herpes outbreak won't come on for 3-7 days after exposure. So the immediate symptoms weren't herpes the the ones that came on a few days later would be consistent in timing. If a woman performed oral sex on a man and then he inserted his penis inside a woman, the saliva can be transferred that way. Or if he performed oral sex on her, it could transmit from his mouth is he is herpes type 1 positive too. About 50% of people are herpes type 1 positive, so it's not rare. Herpes swab tests are the most accurate test possible if they are positive. They have a fairly high false negative rate but not false positive rate. With suppressant medication, transmission drops to about 1%. Condoms help some but because the virus gets into secretions easily, often the condom isn't good enough if "juices" get on the testicles or other genital skin which does commonly happen during sex.

Expert:  Dr. C. replied 7 months ago.

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