QUESTION
Two months ago I found out that I had genital herpes. Apparently I've had it for a while since I haven't had sex in over six months. In the last two months, I've had an outbreak every few weeks. Why is this? I do feel slightly depressed. Could this be the reason? Also, what is the chance of getting genital herpes from giving and receiving oral sex when there is no outbreak present? What is the difference between Valtrex and Zovirax and do you have to take the herpes medication all year long or just at the time of the outbreak? Please help me -- I'm only 24 and I think this is taking over my life.

ANSWER
Herpes is a very common infection -- about one in five adults in the United States has genital herpes; but as many as 90% of these infected people don't know they have the virus.

Transmission can occur from people with no symptoms. People with herpes shed active virus about 3-8% of days.

People with repeat outbreaks may benefit from daily suppressive therapy -- speak to your doctor about whether this might be right for you. Daily suppressive therapy means taking herpes medicine every day to prevent outbreaks. Some people are able to take the medicine right before outbreaks, when they first notice symptoms. The medicines are very safe and each way works for some people.

Both Zovirax and Valtrex are very similar medications that differ mainly in how often one has to take the medication. Zovarix is acyclovir and Valtrex is valacylovir which gets converted to acyclovir.

Oral sex can definitely result in herpes transmission, although with Herpes type II, the genital kind, it is much less likely to be transmitted than type I. Condoms have recently been shown to reduce herpes transmission.

To your health,
Dr. K