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Health Guide / Herpes

Having sex with herpes: how to have a healthy sex life

chimene richa

Reviewed by Chimene Richa, MD, written by Amy Isler

Last updated: Jun 09, 2022
5 min read

table of contents

  1. How common is herpes?
  2. Can you have a sex life with herpes?
  3. How to tell your partner you have herpes
  4. How to have a healthy sex life with herpes
  5. Having sex with herpes: the bottom line

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.

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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?

The initial herpes outbreak typically lasts about two to four weeks. Symptoms of a herpes outbreak include:

  • Painful lesions or small blisters around the genitals, rectum, or mouth
  • Fever
  • Body aches
  • Headache
  • 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
  • Vomiting
  • Headache 
  • Diarrhea/ loose stools
  • Constipation

Use condoms

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.

Disclaimer

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.

References

  1. 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
  2. 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/
  3. 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/
  4. MedlinePlus. (2018). Valacyclovir. Retrieved from https://medlineplus.gov/druginfo/meds/a695010.html
  5. 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
  6. World Health Organization (WHO). (2022). Herpes simplex virus. Retrieved from https://www.who.int/news-room/fact-sheets/detail/herpes-simplex-virus
chimene richa
Chimene Richa, MD

Dr. Chimene Richa is a board-certified Ophthalmologist and Senior Medical Writer/Reviewer at Ro.

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Important Safety Information for Valacyclovir

What are valacyclovir tablets? 

Valacyclovir tablets are a prescription antiviral medicine. Valacyclovir tablets lower the ability of herpes viruses to multiply in your body. 

Valacyclovir tablets are used in adults:

  • to treat cold sores (also called fever blisters or herpes labialis) 
  • to treat shingles (also called herpes zoster)
  • to treat or control genital herpes outbreaks in adults with normal immune systems
  • to control genital herpes outbreaks in adults infected with the human immunodeficiency virus (HIV) with CD4 + cell count greater than 100 cells/mm3
  • with safer sex practices to lower the chances of spreading genital herpes to uninfected partners. Even with safer sex practices, it is still possible to spread genital herpes. Valacyclovir tablets used daily with the following safer sex practices can lower the chances of passing genital herpes to your partner.
    • Do not have sexual contact with your partner when you have any symptom or outbreak of genital herpes. 
    • Use a condom made of latex or polyurethane whenever you have sexual contact. 

Valacyclovir tablets are used in children:

  • to treat cold sores (for children ≥ 12 years of age)
  • to treat chickenpox (for children 2 to < 18 years of age) 

Valacyclovir tablets do not cure herpes infections (cold sores, chickenpox, shingles or genital herpes). The efficacy of valacyclovir tablets has not been studied in children who have not reached puberty.

What are cold sores, chickenpox, shingles, and genital herpes? 

Cold sores are caused by a herpes virus that may be spread by kissing or other physical contact with the infected area of the skin. They are small, painful ulcers that you get in or around your mouth. It is not known if valacyclovir tablets can stop the spread of cold sores to others. 

Chickenpox is caused by a herpes virus called Varicella Zoster Virus (VZV). It causes an itchy rash of multiple small, red bumps that look like pimples or insect bites usually appearing first on the abdomen or back and face. It can spread to almost everywhere else on the body and may be accompanied by flu-like symptoms. 

Shingles is caused by the same herpes virus that causes chickenpox. It causes small, painful blisters to appear on your skin. Shingles occurs in people who have already had chickenpox. Shingles can be spread to people who have not had chickenpox or the chickenpox vaccine by contact with the infected areas of the skin. It is not known if valacyclovir tablets can stop the spread of shingles to others. 

Genital herpes is a sexually transmitted disease. It causes small, painful blisters on your genital area. You can spread genital herpes to others, even when you have no symptoms. If you are sexually active, you can still pass herpes to your partner, even if you are taking valacyclovir tablets. Valacyclovir tablets, taken every day as prescribed and used with the following safer sex practices, can lower the chances of passing genital herpes to your partner.

  • Do not have sexual contact with your partner when you have any symptom or outbreak of genital herpes.
  • Use a condom made of latex or polyurethane whenever you have sexual contact. Ask your healthcare provider for more information about safer sex practices. 

Who should not take valacyclovir tablets? 

Do not take valacyclovir tablets if you are allergic to any of its ingredients or to acyclovir. The active ingredient is valacyclovir. 

Before taking valacyclovir tablets, tell your healthcare provider: About all your medical conditions, including:

  • if you have had a bone marrow transplant or kidney transplant, or if you have advanced HIV disease or “AIDS”. Patients with these conditions may have a higher chance for getting a blood disorder called thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS). TTP/HUS can result in death.
  • if you have kidney problems. Patients with kidney problems may have a higher chance of side effects or more kidney problems with valacyclovir tablets. Your healthcare provider may give you a lower dose of valacyclovir tablets.
  • if you are 65 years of age or older. Elderly patients have a higher chance of certain side effects. Also, elderly patients are more likely to have kidney problems. Your healthcare provider may give you a lower dose of valacyclovir tablets.
  • if you are pregnant or planning to become pregnant. Talk with your healthcare provider about the risks and benefits of taking prescription drugs (including valacyclovir tablets) during pregnancy.
  • if you are breastfeeding. Valacyclovir tablets may pass into your milk and it may harm your baby. Talk with your healthcare provider about the best way to feed your baby if you are taking valacyclovir tablets.
  •  about all the medicines you take, including prescription and non-prescription medicines, vitamins and herbal supplements. Valacyclovir tablets may affect other medicines, and other medicines may affect valacyclovir tablets. It is a good idea to keep a complete list of all the medicines you take. Show this list to your healthcare provider and pharmacist any time you get a new medicine. 

How should I take valacyclovir tablets?

  • Take valacyclovir tablets exactly as prescribed by your healthcare provider. Your dose of valacyclovir tablets and length of treatment will depend on the type of herpes infection that you have and any other medical problems that you have.
  • Do not stop valacyclovir tablets or change your treatment without talking to your healthcare provider.
  • Valacyclovir tablets can be taken with or without food.If you are taking valacyclovir tablets to treat cold sores, chickenpox, shingles or genital herpes, you should start treatment as soon as possible after your symptoms start. Valacyclovir tablets may not help you if you start treatment too late.
  • If you miss a dose of valacyclovir tablets, take it as soon as you remember and then take your next dose at its regular time. However, if it is almost time for your next dose, do not take the missed dose. Wait and take the next dose at the regular time.
  • Do not take more than the prescribed number of valacyclovir tablets each day. Call your healthcare provider right away if you take too much valacyclovir tablets. 

What are the possible side effects of valacyclovir tablets? 

Kidney failure and nervous system problems are not common, but can be serious in some patients taking valacyclovir tablets. Nervous system problems include aggressive behavior, unsteady movement, shaky movements, confusion, speech problems, hallucinations (seeing or hearing things that are really not there), seizures and coma. 

Kidney failure and nervous system problems have happened in patients who already have kidney disease and in elderly patients whose kidneys do not work well due to age. Always tell your healthcare provider if you have kidney problems before taking valacyclovir tablets. 

Call your doctor right away if you get a nervous system problem while you are taking valacyclovir tablets. 

Common side effects of valacyclovir tablets in adults include headache, nausea, stomach pain, vomiting and dizziness. Side effects in HIV-infected adults include headache, tiredness and rash. These side effects usually are mild and do not cause patients to stop taking valacyclovir tablets. 

Other less common side effects in adults include painful periods in women, joint pain, depression, low blood cell counts and changes in tests that measure how well the liver and kidneys work. The most common side effect seen in children < 18 years of age was headache. 

Talk to your healthcare provider if you develop any side effects that concern you. These are not all the side effects of valacyclovir tablets. For more information ask your healthcare provider or pharmacist.

Keep valacyclovir tablets and all medicines out of the reach of children. General information about valacyclovir tablets Medicines are sometimes prescribed for conditions that are not mentioned in patient information leaflets. Do not use valacyclovir tablets for a condition for which it was not prescribed. Do not give valacyclovir tablets to other people, even if they have the same symptoms you have. It may harm them.

If you are experiencing a medical emergency, call 911 or seek immediate medical attention.

You are encouraged to report negative side effects of prescription products to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Please see the full Prescribing Information for complete safety information.