Living With Herpes

It can be distressing to be diagnosed with genital herpes, not only because of the pain and discomfort outbreaks can cause but also because of the stigma many people feel after learning they have an incurable sexually transmitted infection (STI).

People with genital herpes often report feeling "guilty," "ashamed," and like "outcasts' after their diagnosis. But, the simple truth is that genital herpes is far more common than most people imagine.

According to a 2018 report from the Centers for Disease Control and Prevention (CDC), around 12% of the U.S. population—roughly one in eight people—have herpes simplex type 2 (HSV-2), the primary cause of genital herpes. Moreover, around 21% of those between the ages of 40 and 49 have the virus, many of whom are unaware they are infected.

Living with herpes has its challenges, but with treatment, education, support, and lifestyle choices, you can have a healthy and normal life.

This article offers advice on how to cope with a genital herpes diagnosis, including ways to overcome stigma and disclose your status to others. It also discusses ways to prevent the spread of the virus through sex and pregnancy.

Education

If you've been diagnosed with genital herpes, try not to panic. You were probably diagnosed because you experienced a first outbreak, also known as the primary infection.

What is important to understand is that the first outbreak is often the worst and, by experiencing an outbreak, you can recognize the early signs if another were to occur.

After your diagnosis, your healthcare provider will prescribe antiviral drugs to bring the virus under control. It is important to understand how to take and store the drugs, including when to dispose of expired drugs.

To begin normalizing herpes in your life, it is important to educate yourself. Ask your healthcare provider questions and seek quality educational materials to better understand:

• What herpes is
• How herpes is spread
• What the early signs of an outbreak are
• When to start treatment to reduce the severity and duration of outbreaks
• How to prevent the herpes sores from getting infected
• When daily suppressive therapy may be needed to control frequent outbreaks
• How to prevent the spread of the virus to others

Partner Notification

Genital herpes is generally not a notifiable disease, although you may be encouraged to notify sexual partners of your diagnosis. This allows them to get tested and seek treatment if needed. This, in turn, helps reduce the further spread of infection.

With that said, not everyone with HSV-2 gets symptoms. This is referred to as an asymptomatic infection, meaning that you have the virus without the outbreak. Even so, they can still pass the virus to others through a process called asymptomatic viral shedding.

Asymptomatic shedding is when HSV-2 accumulates on the skin without any outward symptoms. This can happen at any time, and there is no way to predict when shedding might start. Most people get herpes through asymptomatic shedding.

Dealing With Stigma

When you are first diagnosed with genital herpes, you may want to find someone to blame. Try not to. Most people with herpes don't have any symptoms, so your partner may not realize that they are infectious and carriers of the disease.

It is important to recognize that blame is at the heart of herpes stigma. In society, people are often blamed for getting an STD because they are "promiscuous," "irresponsible," or "dirty." By seeking to blame others, you are contributing to the stigma.

In the end, herpes is a virus. Yes, it is spread by sexual contact, but, even with condoms and other forms of barrier protection, the virus can still be unknowingly passed. And, because a person can be asymptomatic for years, there may be no way to tell who gave the virus to whom.

By approaching genital herpes as a medical condition without blame and judgment, you can begin to normalize herpes in your life and not be held captive by attitudes and beliefs that you know are not true.

Disclosing Your Status

Telling your partner you have genital herpes may be one of the hardest things about living with the virus. Whether you've been together for years or the relationship is new, the conversation can be difficult. Still, it is one you need to have.

To prepare for the discussion, become comfortable with all relevant information about herpes. This includes knowing how herpes is transmitted and how to reduce the risk of transmission.

Short of violence and abuse, accept that any emotional reason is possible and try not to take the reaction too personally. If needed, give your partner a day or two to wrap their heads around the news before bombarding them with too much information.

Whether you've been together for years or are just starting a new relationship, recommend that your partner get tested. And not only for herpes but for other STIs as well.

By knowing the status of both partners, couples can deploy safer sex strategies to protect each other and seek treatment for STDs than can be cured.

Preventing Herpes

A herpes diagnosis doesn't mean the end of your sex life. Some strategies can significantly reduce the risk of infection to your partner over the long term.

The consistent and proper use of barrier protection is a good place to start. This includes external (male) condoms, internal (female) condoms, and dental dams (used as a barrier for oral sex.

With that said, condoms and dental dams do not offer 100% protection against herpes. This is because the virus can be passed through skin-to-skin contact and not all skin can be covered with a condom or dental dam.

To further reduce the risk of transmission, you should avoid having vaginal, anal, or oral sex during an active outbreak. You should also stop sex as soon as you feel an outbreak coming on. This is called the prodromal phase and the virus is actively being shed. Prodromal symptoms are non-specific and can develop hours or days before an outbreak.

Finally, suppressive therapy can reduce the risk of transmission. This preventive strategy requires the partner with herpes to take a daily antiviral pill like Zovirax (acyclovir) to keep the virus under control. By doing so, viral shedding is reduced.

Suppressive herpes therapy is recommended for couples in whom one partner has HSV-2 and the other does not.

Pregnancy and Family

You can get pregnant and have children if you have herpes. If you are the female partner, you may be advised to start suppressive therapy a month before your due date to keep the virus fully suppressed.

Generally speaking, the risk of mother-to-children transmission of HSV-2 is relatively low. This is because the mother's immune system makes protective antibodies that are passed to the baby through the placenta.

If infection were to occur, it would usually be when the baby passes through the birth canal and comes into contact with active lesions.

Seeking Support

Getting to the point where you can wrap your head around a herpes diagnosis can take time. Keeping the news pent up may only add to the stress.

To better cope with the diagnosis, seek support from a friend, family member, or colleague you can trust. Find someone who you know will protect your confidentiality and neither be judgmental nor an alarmist.

If you can't find someone from your family or within your social circles, seek support from a counselor or a support group. Both in-person and online herpes support groups understand what you are going through and can offer advice, support, and medical referrals.

If you are still unable to cope and are feeling extreme anxiety or depression, do not hesitate to ask your healthcare provider for a referral to a therapist or psychiatrist who can offer one-on-one or group counseling. If needed, medications can be prescribed to treat extreme anxiety or depression.

Summary

As troubling as it may be to learn you have genital herpes, you can live a normal, healthy life by taking control of your condition. This starts with educating yourself about what herpes is, how it is passed, and how to protect others from infection.

By educating yourself, you will be better equipped to disclose the diagnosis to sexual partners and help them seek testing and treatment if needed. It can also help you overcome stigma and chart a path forward that can involve dating, family, and children.

If you are struggling to cope, do not hesitate to seek support from loved ones, support groups, or healthcare professionals.

A Word From Verywell

Genital herpes can be extremely distressing, but it doesn't necessarily need to be life-altering. The first thing to remember is that the disease has no set course. Some people may experience the first outbreak and only have an occasional outbreak now and then. Others may be faced with frequent outbreaks.

Whatever occurs, by recognizing the signs of an outbreak and acting immediately, you can reduce any disruption that herpes can cause to your life and well-being. Learning to cope can also reduce the stress that may contribute to a herpes outbreak.