Question:
Hey,

I just got a call from the doctor and they got all of my results in. They told me that i've got HSV1. What is that exactly? She said it isn't the std kind, so does that mean that my boyfriend doesn't have it? I'm confused though because i got the break out in my genital area, so i thought i had genital herpes? I'm so confused!!! Does anyone know exactly what this might be? She said that i have to insert something vaginally for a week, so does that mean i don't need to go on valtrex anymore? and can i still insert this medicine even if i have my period? If anyone knows, please help me out.

Answer:
Oh my land. The ignorance perpetrated by some healthcare "professionals" is sooo depressing. I honestly think half the time it's to spare themselves having to deal with the emotional fallout of the truth. (For instance, I was misdiagnosed in the ER when I had my first herpes outbreak, and thus given the wrong medication; days later, when I was still in agony and couldn't walk, stand, or sit, I went to see my Women's Health nurse practitioner and she took one look and knew immediately what was going on. She was disgusted when I told her about the ER doc.)

So. I am no expert, but I have done a lot of research since getting my diagnosis. YOU CAN HAVE GENITAL HSV-1. You can get BOTH HSV-1 and HSV-2 in EITHER place (oral or genital area).

I have HSV-1, and my outbreaks occur in the genital area. We know for certain that my HSV-1 IS genital, because I did not have any herpes antibodies when they first tested me, days after the outbreak started. Basically, when they do a "blood test for herpes" they are looking for the antibodies that your body has produced AGAINST the virus. If you don't have these antibodies at first -- which I know is not your situation -- it may be because your body hasn't had a chance to produce them yet. In that case, they will have you come in about a month later for a second blood test; in my case, this second test came back positive for HSV-1 (because by then my body had produced the antibodies to fight the infection).

Did your doc take a sample from the area where the outbreak is, in order to do a culture (ie, try to grow the pathogen in the lab in order to get enough of it that they can identify it)? That will definitively tell you what pathogen is causing the ob. If they haven't taken a culture, they REALLY should do so; my misdiagnosis happened when the doc just took a look and made the decision; he didn't take any cultures!! And he gave me drugs!! That I didn't need!! That is ridiculous.

I've never heard of a vaginal insert for herpes, so maybe herpes is NOT what's causing your ob. BUT, you should find out from your doc exactly what they are treating you for with this insert. When you go pick up the medicine from the pharmacy, ask them if it's ok to take when you have your period. They are there to answer questions just like that. I know treatments for yeast infections are ok to take during your period, but that might not be the case for your medicine.

As for the difference between the herpes types...

As I understand it, the main difference is the "site of preference" of each type of virus. The virus takes up permanent residence in your nerves, near to where the nerves enter the spinal cord. Supposedly the Type 1 virus "prefers" the nerves in the cervical (neck) region, which leads to oral herpes outbreaks, while the Type 2 virus "prefers" the nerves near the bottom of the spine, that supply the genitals. This means that Type 1 infection in the genital region should be less severe, with less frequent outbreaks, because the the virus is not living at it's "site of preference" (and ditto for Type 2 in the mouth). This has not been my personal experience, but that's some good news for you if herpes is in fact causing your ob. Note that the virus CANNOT travel from one nerve to another.

Now, it's hard to say whether your boyfriend has it or not with just this info. My bf has genital HSV-1; probably he got it from receiving oral sex from a previous girlfriend when she had a cold sore on her mouth. Neither of us has ever had an oral outbreak. Many people get oral HSV-1 as children, eg, when they are kissed by a relative who has a cold sore. It's this phenomenon that leads to the "everyone has it so why bother testing" attitude, which, as I've written before, is BOGUS.

Sorry this is so long; but I HATE it when doctors don't give their patients ALL the information they need to know in order to understand their illness and gain whatever peace of mind they can!