Dear Dr. Donohue: I have herpes. I am a 28-year-old woman who never previously had a venereal disease. I am shocked to have one now. I have always been careful about choosing my male partners. I can't believe this has happened to me. Will this affect my chances of having children? What do I do about having sexual relations?
M.N.
You have to put herpes infection in perspective. Many people are infected. It's estimated that 50 million Americans have the virus. All of them are free to marry and have children. As for sexual relations, be honest with your partners about having been infected. You should not have relations when you have a recurrent outbreak.
Recurrences lessen in frequency with the passage of time. It still is possible to transmit the virus without a visible outbreak, but condom use lessens the probability of passing the virus to others.
The herpes virus comes in two varieties: herpes simplex virus type 1, HSV-1; and herpes simplex virus type 2, HSV-2. HSV-1 is responsible for cold sores (fever blisters). HSV-2 is the cause of genital infections. However, either virus can lead to genital infections (and cold sores). HSV-1 is becoming a more frequent cause of genital infections.
Skin-to-skin contact is the method of transmission. A first outbreak of genital herpes may cause fever, headache, muscle pain, pain on urination and enlargement of groin lymph nodes. In men, an outbreak of small blisters appears on the penis. In women, the same happens in the vagina and on the external genitals. The blisters turn into sores. The sores heal in one to two weeks. Some infected people never have any visible manifestations of infection, but they are able to transmit the virus. About onethird of people never experience a recurrence. Another third have less than three outbreaks a year. The final third have more than three yearly outbreaks. People can spread the virus even when there are no obvious signs of infection.
Acyclovir (Zovirax), famciclovir (Famvir) and valacyclovir (Valtrex) shorten an outbreak. If recurrences are frequent, these medicines can be used on a daily basis to suppress them.
Dear Dr. Donohue: When I was about 10 years old, I got the mumps. Now I am 30 and have been married for three years. My wife and I want to have a family, but we aren't having any luck.
Do you think the mumps made me infertile?
In about 40 per cent of men who get the mumps after puberty, the virus also travels to the testicles. That results in impaired fertility in only 13 per cent. Sterility almost never happens. If both testicles are infected, then sterility might be a problem.
Before puberty, testicular involvement is rare, and infertility isn't a problem. You were only 10. It's highly unlikely that the mumps caused you to be infertile.
Consult a doctor so both of you can be examined. An answer to the question why you aren't having the family you want will be found, and a solution, if possible, will be suggested. Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him at P.O. Box 536475, Orlando, FL 32853-6475.
