I work in a sexual health clinic...ama

[Hereandthereandeverywhere]

Go for it! Nothing is too much

I hope it is ok to ask this please: (& I have name changed)

I am in my late 50s. 12 years ago after a wonderful weekend with an old flame, I found I had herpes. It was incredibly painful, and I was tested, and so was he, and he said he had no prior knowledge of having this, I was devastated. I have tried my best to live with it as best I can, and have had a 10 year relationship since then. During the 10 years, my partner never caught it. I also have suffered cold sores on my mouth for the past 8 years (I never had prior to the 12 yrs ago).

I've had less and less frequent outbreaks (& they were less and less painful) to the point that I can't remember the last one, it was about 2-3 years ago. I've had cold sores on my mouth approx once a year, but nothing 'down there' for a long time.

My partner and I have recently split up and I am not doing v well over it, and am devastated. This week I'm having my first bad outbreak in a long time. (from the stress/upset?)

I'm concerned how this may now impact new relationships going forward, and am wondering if any advice/knowledge/treatment has changed in the past 12 years as I haven't really looked into it since then as it wasn't really a concern.

I am post menopausal, so pregnancy is not a concern, but of course, STIs still are.

What is your best advice to me please on a) how to manage/treat outbreaks please? b) how likely is transmission to a new partner if I am not having an outbreak at the time we have sex, and if we use condoms?

I realise I am probably naive having only had limited sexual experience, but am increasingly anxious about this, especially as I thought it had gone dormant. I'm so upset it has recurred. Thank you.

Also, what’s your advice for absolute bolts and braces approach? I’m currently single - no sex a long time. If I met someone I would ask to see their clean results, ask to use condoms for a while until trust established etc. I don’t have any birth control, so that would need looking at but I’m 44 and no periods for over two years. The thing that worries me too if that with hiv don’t they have to have waited 7 weeks since any unprotected sex for a hiv test to be accurate. How can you verify that as someone who isn’t them?…. Ugh I just find I’m so risk averse now that I’d rather remain alone for life!

Still using cis! If you want to differentiate please call us biological women or just women. We do not have anything biologically or socially in common with trans women unless you think artificial hormones dresses and make up turns a man into a women somehow

Language is really important. Did you mean a female in a relationship with a female ie a lesbian relationship? I don't understand what a cis female identifying person could be unless you actually meant female?

Oh bless you! Herpes is horrible. I would contact your local clinic and ask for some antiviral medication. It may be too late this time, but you'll have it to hand if you get another outbreak. Quite often people will get a prodrone (a tingly feeling before the blisters start) so you'll be best placed to stop or reduce the outbreak. If you find you start getting flares often, you can take supressive therapy ling term. In terms of transmission, as long as you're not having a flare, no need to worry about partners. 80% of sexually active people carry the virus, which is why we don't test for it. There's no need to disclose you have it.

You're right. Its 45 days from exposure to accurate testing. I guess, like with all things, you'll need to do your own risk assessment about what you're comfortable with. You could, for example, use condoms for the first 7 weeks of the relationship, both get tested and then decide from there what you're happy with.

Thank you for replying quickly. Yes, I get a weird tingling in my legs, and I just know it is coming.

When you say, no need to worry about partners unless I'm having a flare, does this mean that if I am lucky enough to find a new loving partner, we would be ok to not even use condoms (once established there are no other STIs etc)? (if I'm not having a flare) or should I still always use condoms now forever because of the possibility (is shedding a risk still?).

Does the fact that it has come back now after several years indicate it may start to recur more frequently, or could it go dormant again?

Thank you

as a professional working in this field, I am horrified by some of your comments. Whilst men may be part of the issue, you are coming across as very judgmental which may put men off seeking sexual health services. Your job is not to add personal opinions!

This 100%

@Hereandthereandeverywhere @Ginburee

Just wanted to thank both of you and anyone else who works in GUM clinics. The care, kindness and lack of judgment you show to patients have been a literal lifesaver for me and, I'm sure, many others. A GUM doctor was the first person in my life to ask me questions about abuse and then to refer me on to therapy for childhood abuse. She reduced me to tears with her kindness.

I would recommend GUM clinics as an easy, safe place to get diagnosis, treatment, information and care

On a side note, I am completely GC, yet so sad to see the attempts to derail this useful thread

Again, this is not an appropriate comment. I work in this field and GPs do not normally get it wrong at all. They do their best given the options available to them and refer when necessary. Gp bashing is not helpful, we should all be working as a team

I read the post as not judging men who come to the clinic but the men who cause the women to come to the clinic. Op has clearly said she doesn’t judge anyone who does come, male or female. In addition, this is a women’s forum so possibly not that many men reading this.

Yes, you're right. Your future partner is likely to already be carrying the virus so no need for any extra precautions. In terms of future outbreaks....who knows? Some people choose to take suppression during expected times of stress

If you could recommend one change from the Govt/NHS in their approach to either funding or managing sexual health clinics, what would it be? (You can say "give us more money" but it would be interesting to know ... give us more for money for what?
PS Please don't let the trans debate comments derail this. As a PP said, there is a whole board for that elsewhere. I don't much like the term cis myself, but I am very happy to overlook this for the sake of an informative discussion 😎

Thank you for sharing. Sexual health is so much more than 'just sex', perhaps why I love it so much. I'm so glad you had a positive experience at your clinic

And again!! You're lying. This is gross misinformation and wholly irresponsible. JFC.

You can have HSV-1 (usually oral, but can infect the genitals) or HSV-2 (usually genital, but can infect the mouth).

It's estimated that 13% (or 1 in 8, NOT 80%) of adults in the UK will have HSV-2 by the age of 40, 70% will have HSV-1.

While risks are low, the virus absolutely can be transmitted when a sore isn't present, and in fact most people will contract the virus from a partner when there are no visible symptoms (which makes sense, given having a visible sore might give people pause, and make them postpone until a later date!)

If you want to be morally decent, then you SHOULD disclose you have the virus before you engage in sexual contact. But given some form of HSV is common, as long as you use protection, and possibly antivirals, it shouldn't be a big deal for most potential partners.

Honestly, it's really irresponsible to have someone purporting to be a sexual health professional giving out completely wrong advice to people.

What would I do with extra money....I think I'd put it into outreach work. Its been proven that meeting people where they are is the gold standard for reaching marginalised groups and vulnerable people. I'd build relationships with hostels, refuges etc. And spend time in schools with young people. But thats just me! Sure others in tne field would have different ideas

Any future partner is NOT likely to be carrying HSV-2 though, which is the form of herpes that 'prefers' the genitals, and causes more frequent outbreaks than HSV-1. So it depends on the type of herpes that PP carries.

ETA: You're basically telling PP to 'not worry about' infecting any future partners. It's hugely irresponsible on your part. PP could absolutely infect future partners when not having an outbreak, and she needs to inform future partners that's a risk before having sexual contact.

Hi OP. I just wanted to say that the thread was really interesting. Thanks so much for posting it has been really interesting to read.

What causes BV? Does it always mean your partner has been sleeping with other people? Or can some men just give it to a woman despite being faithful?

Are you truly a sexual health worker?

You don't know men from women. You're giving out incorrect advice about STIs. This is scary.

BV is simply the vaginal flora being out of wack. Until recently, it wasn't thought to be sexually transmitted. Its very common and can usually be caused by soaps, bubble bath or douching. Femresh is the worst culprit.

Does your clinic have an understanding of vaginismus? I find GPs often don't even know what it is, and its been a barrier to me getting smear tests, internal contraception, transvaginal ultrasounds etc.

Also, does your clinic offer pain relief for coil fittings? Again, something that is such a barrier to women getting the coil/internal IUD, yet most GPs absolutely will not offer any pain relief other than 'take some ibuprofen before you come for your appointment'.

Does your clinic just offer sexual health services or also contraceptive advice and menopause clinics? I worked in family planning many years, but we also offered sexual health clinics and menopause clinics, but it seems uncommon to find them all combined now.