Patient: Hi. I got a red bump on the shaft on my penis about a month ago, it doesn’t itch or hurt, but it’s not going away … maybe a genital wart? About 2 weeks ago I got about 4 more red bumps further up the shaft of my penis. They were kind of itchy, more just discomfort, but not painful. Also had a little bit of itching around my stomach, thighs etc.The last unprotected sex I had with a girl was about 4 months ago.
Symptoms: Itchy thighs and butt cheeks. Red lesions on shaft of penis.
Doctor: Genital herpes is an STD caused by two types of viruses. The viruses are called herpes simplex type 1 and herpes simplex type 2. It can cause sores on your genital or rectal area, buttocks, and thighs. You can get it from having sex, even oral sex. The virus can spread even when sores are not present. Mothers can also infect their babies during childbirth. Symptoms of herpes are called outbreaks. You usually get sores near the area where the virus has entered the body. They turn into blisters, become itchy and painful, and then heal. Sometimes people do not know they have herpes because they have no symptoms or very mild symptoms. The virus can be more serious in newborn babies or in people with weak immune systems. Most people have outbreaks several times a year. Over time, you get them less often and the symptoms become milder. The virus stays in your body for life. Medicines do not cure genital herpes, but they can help your body fight the virus. This can help lessen symptoms, decrease outbreaks, and lower the risk of passing the virus to others. Correct usage of latex condoms can reduce, but not eliminate, the risk of catching or spreading herpes.Unfortunately, herpes is a frustrating infection; essentially, if one partner has genital herpes, the other partner is at risk of contracting herpes, whether or not sores are present. This is true whether you’re having oral, vaginal, or anal sex. It’s up to you and your partner to decide what level of risk you are comfortable with. When sores are visible, the risk of transmission through sex and skin-to-skin contact (around the area with sores) is highest. When no sores are visible, the risks are less certain, but there is a possibility of the herpes virus being present on the surface of the skin even without causing a sore — this is called viral, or asymptomatic, shedding. Viral shedding can occur at anytime and usually occurs near where active herpes sores appear.Because herpes can occur on parts of the body that aren’t covered by a condom, and because of the possibility of viral shedding, transmission can happen during vaginal, anal, and/or oral sex, even if you’re using protection. Viral shedding occurs a few days per year at the most; however it’s not possible to pinpoint the “shedding” days, so take this into consideration when making your decisions.For safer oral sex, using a condom (for oral sex on a penis) or a dam (for oral sex on a vulva or anus) is still safer than nothing at all. A dam is a thin, square piece of latex that is placed over the clitoris, vulva, or anus. You can also use a non-lubed condom by pulling off the ring and cutting along one side to make a rectangle; or, use a small piece of plastic wrap (preferably non-microwavable wrap because it is less porous). And just to be clear, herpes can be transmitted by either the giver or receiver of oral sex. It is possible for the person giving oral sex to get herpes if their partner has genital herpes and a sore is active or there is viral shedding. It is also possible for the person giving oral sex to give herpes to their partner, if they have an active herpes sore or viral shedding on their mouth.One piece of good news is that people who have herpes can choose to take medication as “suppressive” therapy. Taking herpes medications (typically valacyclovir) can help reduce the frequency of outbreaks and help reduce the number of viral shedding days throughout the year. In fact, the Centers for Disease Control (CDC) recommends suppressive therapy for people with herpes, to help prevent transmission to partners.Please visit your doctor for more information, or advice specific to your circumstances.