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The Complete Guide to Having Sex With Herpes

The Complete Guide to Having Sex With Herpes

Learning that you have genital herpes can be a difficult experience. Although herpes is very common, many people assume that a positive HSV-1 or HSV-2 diagnosis spells the end of a normal romantic and sexual life. The reality is that it’s completely possible to have a fulfilling sexual and social life if you have herpes, whether you have HSV-1 or HSV-2. In fact, while many people with herpes panic upon experiencing initial symptoms of the virus, most people with herpes find that maintaining romantic and sexual relationships is far easier than expected. Having sex with herpes is normal, so long as you take the right precautions.

In this guide, we’ll cover everything related to having sex when you have herpes, from letting your partner know about your HSV-1 or HSV-2 infection status, to using antiviral medications, condoms and other methods of protection to reduce your risk of transmitting the virus.

First Off, Having Herpes Isn’t as Uncommon as You Might Think

What we call “herpes” is actually several different types of the herpes simplex virus. These are HSV-1 (herpes simplex virus type 1) and HSV-2 (herpes simplex virus type 2). Each type of the virus acts differently in the body, infecting different nerves while causing identical symptoms.

HSV-1 is the most common form of the herpes virus. It affects anywhere from 50% to 70% of the world’s population under 50 years of age, meaning about half of the people you talk to every day are likely to be infected.

HSV-1 usually affects the skin on or around the lips, causing cold sores. However, it’s possible (albeit rare) for HSV-1 to spread to the genitals and cause genital herpes outbreaks.

Despite being extremely common, most people with HSV-1 never experience any symptoms as a result of being infected with the virus. This means you can have a lifelong HSV-1 infection but never notice a single cold sore outbreak.

HSV-2 is the form of herpes most commonly associated with genital herpes. While it isn’t quite as common as HSV-1, it’s still an extremely common infection. Study data from the WHO data shows that more than 400 million people worldwide have HSV-2, or 11% of all people aged 14 to 49.

In short, if you have herpes, you’re not unusual, unclean or unhealthy. You also shouldn’t feel as if you developed the virus because of unsafe or unsanitary sexual behavior. Herpes is by far the world’s most common sexually transmitted infection and anyone can become infected. 

Before You Think About Sex, Focus on Treating Your Herpes

While herpes doesn’t need to limit your sexual or romantic life in the long term, it’s best to take a break from sexual activity once you first find out that you’re infected.

Most people with an active herpes infection find out about their status during the initial outbreak of the virus. Initial herpes outbreaks (often called “primary herpes”) usually happen within two to four days after you become infected with the virus, and can take two to four weeks to heal. 

During these initial days, the virus undergoes a replication process in your body, taking over cells and spreading at a rapid pace.

Genital herpes eventually spreads to the spinal ganglia, where it stays as a dormant virus in the body. Oral herpes settles in the ganglia (a junction of nerves) behind the cheek bone. It can take up to two weeks for herpes to “set up camp” in your body before an initial outbreak.

During an initial outbreak, you’ll notice a variety of symptoms, from flu-like fatigue and muscular aching to a fever. The most obvious sign of a herpes infection is the development of sores on the lips (cold sores) or on the genitals, groin, legs and buttocks.

You should avoid having sex during an initial outbreak of herpes. This is because the virus is at its most contagious during a physical outbreak. During the first outbreak, your body also hasn’t had time to prepare its own immune response to the virus.

Combined, this makes your risk of infecting other people with herpes very high during the first outbreak.

Instead, you should speak to your doctor. Initial outbreaks can be painful and unpleasant, both for oral and genital infections. Antiviral medications such as valacyclovir can be used to speed up the rate of healing, allowing your body to recover from the initial outbreak faster.

Many doctors will also recommend the use of pain medication to control the headache, muscle pain and other discomfort that can occur during an initial herpes outbreak.

In summary, during an initial herpes outbreak you should avoid all sexual activity. If you have an oral herpes infection, you should also avoid kissing your partner, as well as sharing glasses and utensils. Focus on treating the outbreak. Once it’s healed, you can refocus on your sex life.

Recurrent Herpes Outbreaks and Their Effects on Sex

While some people with herpes never experience any symptoms, many people will experience occasional outbreaks of oral or genital herpes.

Because herpes is an incurable virus, these outbreaks can continue to occur for life, making it important that you have a treatment plan worked out with your doctor.

The most common medication used to treat herpes (both oral and genital) is valacyclovir. Our guide to valacyclovir explains more about how this drug works to treat herpes outbreaks, with information on common dosage protocols for oral and genital herpes.

Your risk of infecting your sexual partner with herpes is as its highest during an outbreak, since the herpes sores that can develop during this period contain large amounts of highly infectious viral fluid. As such, it’s best to avoid all sexual activity during recurrent outbreaks.

This can sound frustrating, but the reality is that herpes outbreaks tend to become less frequent as your body develops its immune response. Most people with HSV-1 only ever experience one to two outbreaks per year, which typically take one to two weeks to heal.

People with HSV-2 usually experience outbreaks four to five times per year, with each outbreak lasting for one to two weeks.

Once you have a prescription for an antiviral drug like valacyclovir and understand how to use it to treat herpes symptoms, treating herpes outbreaks becomes fairly easy, making the impact on your ability to maintain a normal sex life much less serious than you might think.

How to Tell Your Partner You Have Herpes

Before we get into the practical side of having sex with herpes, it’s important to cover another topic that many infected people worry about—telling their sexual partner about their infection status.

If you are aware that you have herpes, you need to tell your sexual partner. Even when you avoid sex during outbreaks, use condoms and follow other safe sex practices, there’s still a risk of transmitting the virus. This makes it essential that your sexual partners are informed. 

Many people feel anxious about telling their romantic interest that they have herpes, for reasons that are very understandable. Nobody likes to disclose that they have an STD, especially to the person they’re sexually and romantically interested in.

However, done the right way, letting your partner know that you have herpes doesn’t have to be a stressful or negative experience, and they should know that dating someone with HSV-2 or HSV-1 is still worthwhile.

First, before you disclose to anyone that you have herpes, it’s important to check which type of the herpes virus you’re infected with. Our guide to herpes tests covers the most common herpes testing methods and explains how you can get tested to see if you have HSV-1 or HSV-2.

If you have HSV-1 and only develop herpes sores on your lips, disclosing your status to your sexual partner is fairly straightforward. After all, upwards of 50% of the population has HSV-1, meaning there’s a good chance that your partner as has the virus.

If you have HSV-2 or an HSV-1 infection that affects your genitals, disclosing your status could be more challenging. The best approach is to explain how common herpes is and focus on how manageable and mild the virus typically is.

It’s also important to explain how the herpes virus spreads, and how safe sex practices such as using condoms or dental dams in combination with suppressive herpes medication like valacyclovir can help lower the risk of spreading the virus.

Finally, it’s important to pick the right setting. Don’t tell your partner you have herpes when the two of you are in bed together about to have sex, and definitely don’t be irresponsible by telling them about your herpes status after you’ve already had sex.

Instead, choose a natural moment in conversation to quickly, clearly and casually explain your situation. Share statistics about how common herpes is and stay upbeat—statistically speaking, there’s a chance your partner might also have been waiting to tell you the same thing.

If you’re considering a serious relationship with someone, it can also be worth getting tested for herpes together. If your partner already has the same type of herpes as you (remember, many people with herpes don’t even know they have it), your situation is a lot less complicated.

Explaining to your partner that you have herpes doesn’t need to be difficult. Most people are kind, sympathetic and understanding, especially after you put the virus in context by sharing statistics about how common herpes really is. Though HSV-1 and HSV-2 transmission probability is still existent, it's generally not as serious as reactionary internet articles would have you believe. Just be open, honest and safe.

How to Have Safer Sex if You Have Herpes

Even if you have herpes and your partner doesn’t, you can easily have a fulfilling sex life while minimizing your risk of spreading the virus.

It’s important to note the use of the word “minimizing” above. Even if you follow every safe sex guideline and use antiviral drugs to suppress herpes within your body, it simply isn’t possible to completely eliminate the risk of spreading the virus to your partner.

However, a few small steps can go a long way towards reduce your transmission risk. These steps include:

  • Never having sex during a herpes outbreak. Outbreaks are when the most “viral shedding” occurs, meaning your risk of infecting someone else with herpes is higher when you have blisters, open sores or herpes scabs on your genitals.

    This is also true for oral herpes, which can spread to the genitals through contact and cause genital herpes to develop.
  • Use antiviral medication. Antiviral medications such, as valacyclovir, stop the herpes virus from spreading within your body, reducing the level of viral shedding that occurs even when you aren’t experiencing an outbreak.

    Studies show that you’re 48% less likely to transmit herpes to your partner if you take valacyclovir for suppressive herpes therapy—a reduction in virus acquisition risk from 3.9% to 1.9%. HSV 2 transmission probability drops drastically, but it's still worth noting that there will always be some level of risk.

    This is particularly important for men, since women are more likely to catch HSV-2 from men than vice-versa.
  • Use condoms. While condoms don’t completely eliminate the risk of transmitting herpes to your partner, they do make a huge difference.

    Study data shows that condom use reduces the per-act HSV-2 transmission probability from male to female by 96%, and by 65% from female to male. In short, using a condom cuts your risk of herpes transmission to one third or one twentieth of what it would be without protection.
  • Use a dental dam. Dental dams protect you or your partner’s genitals against diseases that can spread through oral contact, such as oral herpes.

    If you have infectious oral herpes and have oral sex with your partner, there’s a risk that it could causing genital herpes to develop. A dental dam acts like a condom for oral sex, shielding your partner from direct contact and reducing the risk of transmitting the virus.
  • Accept that there’s still a risk of infection. Finally, it’s important to be aware that even with the safe sex practices listed above, it’s still possible for the herpes virus to spread to your partner.

    This means that both you and your partner need to understand and accept the risks and implications that come with a herpes infection before having sex.

Herpes affects billions of people worldwide, with HSV-2 alone affecting more than 400 million people. This means that if you have herpes, you’re definitely not the only person who’s had to have a pre-sex conversation with your partner about the virus.

With the right combination of a positive attitude, antiviral drug use and safe sex, having herpes doesn’t need to spell the end of your sex life. Having sex with herpes is still possible, so long as you follow the advice above and, like millions of other people with herpes, be smart, safe and open with the people you love about your status.