Can I have oral sex if I have genital herpes?

Can I have oral sex if I have genital herpes?

The quick answer is yes! However, there are a few things to understand because if we have learned anything about herpes, there is nothing simple about herpes simplex, and the word “probability” is at the forefront of many questions regarding it.

Notwithstanding that the stigma about genital herpes is much more prominent than oral herpes, HSV-1 and HSV-2 are both basically the same – a set of viral twins. {1} So the idea that one is worse than the other solely depends on one key factor: your immune response to the virus. Here’s why.

Most human beings exposed to the herpes simplex virus do not experience any symptoms or outbreaks. This is because most people have an excellent immune response and tolerate the virus so well, that they are entirely unaware that they even carry the virus. {2}

Individuals who experience frequent outbreaks and symptoms fall into a small group of people on the planet (within a world of 7.4 billion people).

  1. It is estimated that close to 80% of human beings carry the herpes simplex virus. {4}
  2. 1-2% of herpes positive individuals will experience frequent symptoms. (approx.100-200 million people). Most cases are due to a person suffering from an auto-immune issue and/or they are immuno-compromised. {2,3}
  3. 10% of people who do experience symptoms or outbreaks will generally stop seeing symptoms in about a month. {2,3}

How does herpes infect?

The herpes simplex virus can enter through many different parts of your body. Basic entry points include the mouth, vagina, anus, eyes, nose. These areas provided direct contact with mucosal epithelium, the cells that the virus needs to survive. Also a break in the skin like a cut or a scrape can allow access as well. Once inside an epithelial cell, herpes begins to replicate and makes its way to its new home within the ganglions within your nervous system. This is where the virus can lay dormant and hidden until an opportunity arises when the virus can awaken and reproduce freely. {5}

• Herpes establishes the primary infection within the host.

• Enters sensory nerve terminals at peripheral sites.

• Enters the trigeminal nerve ganglion.

• Establishes latency

• Reactivation of the virus. (traveling down the root ganglion, nerve branch).

* Reaches the epidermis and the epidermal-dermal junction.

• Results in recurrent infection. 

Source; sciencedirect.

Herpes simplex (type 1 or 2) does not infect your entire body like other forms of herpes, it lives within the nerve branch of the original infection and travels back and forth through that nerve branch. As an example with infections of the groin, the virus hides within the base of the spine, (the Sacral nerve). With oral infections, the virus hides at the base of the brain, within the Trigeminal nerve

The moment the immune system is low or compromised (with either of these two types), the balance between your immune system and the virus is thrown off. This tipping of the scale allows the virus becomes active. It begins to replicate and then particles of the virus travel down through the nerve branch to the site of the original infection. It emerges from the nerve branch and begins to reproduce exponentially within the epidermis so that it may infect a new host and propagate its species. 

A key take away here is that the herpes simplex virus will infect one dermatome (specific sections of your body) at a time and does not infect your entire body like chicken pox does. This is one of the reasons why many people will see outbreaks in the same area, every time. But this infers the question, was the virus introduced to only one specific area of your body (during the first infection), or did it infect other locations? At the same time? According to the virus’s behavior and biology, multiple site infections are indeed possible but proving that this took place will be very difficult to achieve. Only if proper shedding tests were performed and they were to show positive results (for multiple areas), this would be proof; and not just relying on the simple fact that if you see an outbreak, it is in that location.

The unknown factor

Since many infections can go unnoticed and the current blood testing methods are basically crap {6} (tests are 50% efficient and riddled with false readings), it is clear that obtaining a definitive answer to the question “Am I really positive?” is not without issue or aggravation. Honestly, herpes simplex should be renamed “herpes complex.” 

Without a doubt, people who experience herpes know exactly where that particular infection is located. They have experienced symptoms (emotionally and physically), and are pretty damn sure they are HSV positive. Still, many people wish to get back to experiencing the fun and good feelings of sex, so the question of risk tends to present itself. 

In a nutshell, if you experience frequent outbreaks, your chance of passing will be higher because the virus is more active. This also means that shedding will be more productive as well. If you do not experience symptoms or outbreaks, your risk will be lower because the virus is less active. Risk discussed here. Many physicians and medical staff (including some scientists) will flat out tell you there’s not much you can do to prevent getting herpes, and there is always a possibility that a person may be shedding viral material (this includes everyone). 

 It’s the general consensus of the scientific community that most people who are asymptomatic (showing no signs or symptoms; tingling sensations, sharp pains, outbreaks), may still shed the virus 10% of the time (about 8 to 15 times a year). These intervals of shedding can last 5 minutes, an hour, and even up to a few days. {7} Also, these episodes will take place in the absence of any symptoms. This is one of the main reasons why many scientists believe that asymptomatic shedding is the main cause of herpes infections and how they are unknowingly are transmitted. When we talk about risk, shedding is one of the most discussed subjects. This is why it is essential to understand the potential risk even though it is true that this risk is just a guess based on shedding data and how frequently you may or may not experience symptoms. 

 If you are a human being and plan to interact with other human beings, herpes infections are inevitable. Also, herpes simplex is not always an STD. Kissing a loved one, sibling, or a friend hello is NOT SEX. But when it comes to the subject of sex, the argument of engaging in “safer sex” practices can and should be argued. Condom use and dental dams do help prevent infection (including the prevention of other STDs). These methods will reduce the risk if properly used and should be considered. {8}

I heard a rumor.

You may have heard or read the sentence, “as long as you are not experiencing any symptoms or an outbreak, you should be fine.” For the most part, this is the standard response from many medical personnel and has become a standard idiom used by many, including me. The keyword here is “should” because the probability of shedding will always come into play when we discuss herpes and the simple fact you may already have been exposed to the virus years ago and are completely unaware.

If you have genital herpes, it’s an excellent guess that you received this gift during sex. There was either direct contact with your genitals from another mouth or a penis, or possibly a shared toy (used on each other during sex). It is easy to forget that most people aren’t just doing just one thing during sex; they are doing “many other things” such as oral and anal, as well. 

So, is it possible you may have herpes in other areas of your body? Sure, it’s possible, but unless you experience symptoms or an outbreak in that area, there’s no real proof. It’s just a guess that you do or don’t. If you have not experienced any symptoms or outbreaks as evidence and say that you don’t have it in other areas, you are not lying. In this context, I am simply proposing that it is possible and why these ideas are something to consider when speaking about risk. It’s really up to you…

So, can I have oral sex if I have genital herpes? 

Yes, of course you can. However, if you wish to protect your partner, here are some suggestions and a few things to think about.

1. Try your best to be aware of your symptoms and avoid contact during any time you are feeling them, especially if you are experiencing tingling or sharp pain sensations on your genitals or your mouth.

2. If you are experiencing an outbreak, always avoid direct contact with that area and do not allow others to touch it.

3. If you touch an outbreak or the area, wash your hands ASAP. Soap and water will deactivate the virus.

4. If you are experiencing a genital herpes outbreak and wish to engage in oral sex, please be aware the risk may still be present. It is still possible that you may be shedding from other parts of your body. A person who has HSV2 “can” also transmit the virus to their partner by giving oral sex, resulting in genital herpes. The virus “can” also be transmitted if a person who has genital herpes receives oral sex, causing oral herpes in their partner.The word “can” infers the possibility of this taking place. It does not mean that it “will” happen definitively with every coital act. {9}

5. Always disclose to your partner even if the risk is low. 

6. Never forget to ask your partner to be tested as well. Chances are they already have herpes.

&. There are more people with herpes than without. You are never alone.

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