Valtrex and oral herpes transmission?

Originally Published: August 13, 2010
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Dear Alice,

I know that Valtrex can be used to reduce the risk of transmission of genital herpes, but what about oral herpes? I have oral herpes and my partner doesn't. He's afraid that I'll give him genital herpes if I give him oral sex, and I don't blame him. If I take Valtrex, will that help reduce the chance of me transmitting my herpes through oral sex?

Sincerely,
Stuck with cold sores

Dear Stuck with cold sores,

Those lesions are a real pain (literally) when they crop up in your mouth, and they aren't any more enjoyable when they occur in the nether regions. Despite the differing bodily geography, oral and genital herpes are strains of the same virus, or Herpes Simplex Virus (HSV). Oral herpes (HSV-1) and genital herpes (HSV-2) are both easily spread by skin-to-skin contact. In fact, 62 percent of Americans have oral herpes (which is asymptomatic for many of them) so you shouldn't feel like a pariah. However, because it is still possible for your partner to contract oral herpes of the genitals and develop symptoms if you perform oral sex on him, it is great that you're interested in taking precautions. Many options exist for people with herpes to prevent giving it to someone else.

The benefit of using medications like Valtrex (valacyclovir) on top of precautions such as using condoms and dental dams during vaginal, anal, and oral sex is that they decrease the duration of outbreaks, which is the period when the herpes virus is the most contagious. Medications may actually reduce the frequency of outbreaks by up to 70 or 80 percent, which will not only be great for you but ought to please your partner, too, if he is a fellatio fan. Even still, sharing isn't always caring so you may want to take the extra precaution of avoiding sex with your partner altogether until seven days after the sores have healed. This could be a great opportunity for you and your partner to discuss other turn-ons that may not carry the same risk, such as phone sex, cyber sex, sexting (the equivalent of phone sex using text messaging), or mutual masturbation.

When deciding on a medication, discuss with your health care provider the best options for you. Generally, for people who have infrequent outbreaks and are not sexually active, episodic regimens may be the way to go. This means that antiviral medications are taken at the first indication of an outbreak (for instance, a tingling in the soft tissues of the mouth where a cold sore is developing). For those who are sexually active and/or have frequent outbreaks, daily suppressive therapies may be best. For students at Columbia wishing to speak with a health care provider about their treatment options, call Primary Care Medical Services at x4-2284 or log onto Open Communicator to make an appointment.

If you're already on medication, the best advice is to try to hold off on oral sex until after your cold sore heals. In relationships, there are certainly more enjoyable things to share than herpes!

Alice