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A genital herpes diagnosis is often burdensome and embarrassing, but it doesn’t signify the end of your sex life. Having sex with herpes is safe for you and your partner as long as you take the proper precautions. This article will discuss what you need to know about having safe sex with herpes.
How common is herpes?
Before we dive into how to have a healthy sex life with herpes, know that if you have a herpes infection, you are far from alone.
Herpes is caused by the herpes simplex virus (HSV), which is categorized into two types: HSV-1, which typically causes cold sores outside the mouth and lips, and HSV-2, which is a sexually transmitted infection (STI) causing genital herpes. While HSV-1 is most commonly transmitted orally, it can also be spread during sex and lead to genital herpes.
HSV is prevalent in the United States, with an estimated 572,000 new genital herpes infections in 2018 for people aged 14 to 49 (CDC, 2022). And worldwide, over 491 million people are infected with HSV-2 (WHO, 2022).
Can you have a sex life with herpes?
While there is no cure for HSV, sex with herpes can be safe and satisfying if you are honest with your sexual partners and take precautions to prevent the spread of infection (more on those later). This means that it’s very important to understand how herpes is spread in the first place.
How is herpes spread?
Genital herpes spreads through skin-to-skin contact with someone who has a herpes infection, either by touching their herpes sores or the skin in the genital area, or by coming into contact with body fluids (saliva, semen, vaginal discharge, etc.).
Oral herpes caused by HSV-1 can also be spread from the mouth to the genitals (from a person’s skin or their saliva) during oral sex).
What happens during a herpes outbreak?
- Painful lesions or small blisters around the genitals, rectum, or mouth
- Body aches
- Swollen lymph nodes
Recurrence of herpes outbreaks is common and may happen several times a year. However, symptoms during a recurrence tend not to last as long or be as severe as the initial outbreak.
You should not have sex during an active herpes outbreak because you are more contagious and likely to spread the infection to your partner.
What if I don’t have any herpes symptoms?
Most people with a herpes infection are asymptomatic and don’t know they have it. Others might have mild symptoms that can be easily confused with other skin conditions.
Even if you don’t have active symptoms, there is still a risk of transmission. Studies have shown that over 10% of people with an asymptomatic HSV-2 infection had genital shedding (when the virus continues to make particles that can be spread to others), compared with around 20% of those with symptoms (Tronstein, 2011).
This is why being transparent and communicative with your sexual partners is necessary. Just because you can’t see the virus, that doesn’t mean it’s not there and that they can’t contract it.
How to tell your partner you have herpes
Telling your sexual partner that you have herpes can be difficult. Rest assured, there is no reason to be ashamed. A herpes infection can happen to anyone and is not associated with reckless behavior or a lack of cleanliness.
While a conversation about herpes can be awkward, being honest with your partner is the best way to maintain a healthy sexual relationship. Making it a priority to share facts and teaching them how to manage the virus can put your partner at ease.
A few conversation starters can include:
- What type of herpes you have (oral herpes vs. genital herpes)
- How the virus is spread
- Ways to prevent infection (condoms and medication)
- When to abstain from sex (during active outbreaks)
When and where you disclose your herpes diagnosis should be considered as well. For example, telling your partner immediately before or after having sex is not a good idea. Creating time and space to talk about it can help both of you feel safe and supported.
Additionally, getting tested for sexually transmitted diseases (STDs) with your sexual partner can build trust and connection. STD testing is done at a healthcare provider’s office or a community clinic, and it involves a quick blood test, urine sample, or swab culture.
How to have a healthy sex life with herpes
A healthy sex life with herpes can be a reality with honesty, good communication, and knowing how to manage and prevent spreading the infection to your sexual partners.
Healthcare providers and public health experts have outlined ways to have safer sex and prevent the spread of herpes with various treatment options.
Don’t have sex during a herpes outbreak
The number one rule for someone with an HSV infection is never to have sex while having an active herpes outbreak. The virus is highly contagious and will likely infect your sexual partner. This includes vaginal, anal, and oral sex.
Try herpes medications
Taking antiviral medication, such as valacyclovir (see Important Safety Information) or acyclovir, may reduce the rate of herpes transmission during sex and lower the recurrence rate. While antiviral medication does not cure HSV, it does relieve pain and itching and helps sores heal faster (Corey, 2004; MedlinePlus, 2018).
Herpes medication can be used to treat an outbreak or to prevent recurrences. Suppressive therapy is herpes antiviral medication taken twice daily for five days to prevent flare-ups. It works by stopping the virus from multiplying and spreading to healthy cells.
Side effects of valacyclovir may include (MedlinePlus, 2018):
- Upset stomach
- Diarrhea/ loose stools
Condom use is a great way to prevent STIs, including herpes. While they don’t eliminate the risk of transmission, condoms and dental dams make a difference.
A study on condom use to slow the spread of HSV-1 and HSV-2 found that condoms were 96% protective against HSV transmission from men to women and 65% effective at preventing transmission from women to men (Magaret, 2016).
Having unprotected sex (without a condom), even with a dormant herpes infection, can increase your partner’s risk of infection. Wearing a condom during oral, anal, and vaginal sex promotes sexual health and safety.
Having sex with herpes: the bottom line
The herpes simplex virus is a widespread STI. You should not be ashamed if you develop an infection. It is possible to have safe and fulfilling sex with herpes—as long as you take the proper precautions.
Remember to abstain from sex during an active outbreak, use condoms for protection, and consider taking herpes antiviral medications to prevent the spread of infection to your sexual partner or partners.
Finally, it is always a good idea to get tested for STDs at a local clinic or provider’s office to protect you and your partner. This is an activity that you can do together. Being honest with your partner about your infection and keeping the lines of communication open can build trust and help create a healthy, active sex life.
If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
- Centers for Disease Control and Prevention (CDC). (2022). STD Facts- Genital Herpes Fact Sheet. Retrieved from https://www.cdc.gov/std/herpes/stdfact-herpes.htm
- Corey, L., Wald, A., Patel, R., et al. (2004). Once-daily valacyclovir to reduce the risk of transmission of genital herpes. The New England Journal of Medicine, 350(1), 11–20. doi:10.1056/NEJMoa035144. Retrieved from https://pubmed.ncbi.nlm.nih.gov/14702423/
- Magaret, A., Mujugira, A., Hughes, J., et al. (2016). Effect of condom use on per-act hsv-2 transmission risk in hiv-1, hsv-2-discordant couples. Clinical Infectious Diseases, 62(4), 456-461. doi:10.1093/cid/civ908. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4725379/
- MedlinePlus. (2018). Valacyclovir. Retrieved from https://medlineplus.gov/druginfo/meds/a695010.html
- Tronstein, E., Johnston, C., Huang, M., et al. (2011). Genital shedding of herpes simplex virus among symptomatic and asymptomatic persons with hsv-2 infection. JAMA, 305(14), 1441–1449. doi:10.1001/jama.2011.420. Retrieved from https://jamanetwork.com/journals/jama/fullarticle/896698
- World Health Organization (WHO). (2022). Herpes simplex virus. Retrieved from https://www.who.int/news-room/fact-sheets/detail/herpes-simplex-virus
Dr. Chimene Richa is a board-certified Ophthalmologist and Senior Medical Writer/Reviewer at Ro.