TresSugar

Hump Day: Is My Cold Sore Contagious?

TresSugar — Wed, 12 Aug 2009 06:00:00 -0700

Welcome to Hump Day, TrèsSugar's sex advice column! Are you confused about sex? Do you have trouble having an orgasm? Is there something you'd like to try but you're worried it's too weird? Send your questions to TrèsSugar, and our friend Dr. Charlie Glickman from Good Vibrations will offer his sound advice!

Today's Question:

“I know that cold sores are the same virus as herpes. Is it a bad idea to go down on my boy when I have one? Is it transmissible that way?” To hear what Dr. Glickman has to say, read more.

Dr. Glickman's Answer:

YES!!!

There are two types of herpes virus: HSV-1 and HSV-2. Oral herpes is usually HSV-1 and it’s estimated that 80 percent of the population has been exposed to it. Genital herpes is usually HSV-2 and it’s estimated that 25 percent of women and 12 percent of men have it. However, genital herpes can be caused by either version of the virus, so going down on someone when you have a cold sore (another name for a herpes outbreak) can spread it. To make things a bit more complicated, only about 1/3 of the people who have genital herpes are aware of it - either they’ve never had an outbreak or the outbreak was very mild. (See herpes.com for more info.)

Part of what makes herpes tricky is that it can be transmitted even when you don’t have a visible outbreak. The virus lives in your nervous system and every so often, it’ll come to the surface. It’s especially likely to happen when you’re sick or have been stressed for a while. There’s evidence that the virus starts shedding from the skin (and is therefore potentially contagious) before any visible symptoms. It’s a low risk, but it’s a possibility. To make matters worse, if the site of the shedding isn’t covered by a condom, it can be spread even when you’re practicing safer sex.

While herpes can be uncomfortable, it doesn’t represent nearly as much risk as other sexually transmissible infections (STIs) such as chlamydia, gonorrhea, syphilis, human papilloma virus (HPV), or HIV. Having said that, there’s evidence that HSV-2 makes HIV transmission more likely. See this article for more information about how that works.

It’s also worth mentioning that I’ve seen a lot of people get really upset about STIs when they don’t get nearly as upset about any other health issue. I’ve also seen a lot of people who have all sorts of judgment about STIs but think nothing of going to work and sharing their flu germs (or worse)! STIs can be unpleasant, annoying, or life-threatening, but they don’t mean anything about the person who has them any more than chicken pox or measles do. Negative attitudes about STIs are a holdover from before we invented antibiotics and when diseases such as syphilis were seen as the wages of sin. But now we know that they’re just germs and we don’t need to shame people for having them. (Not that I’m saying that you’re doing that, but I wanted to mention it.)

The best thing that we can all do is to get tested for STIs regularly, even if you’ve never had a symptom. Lots of people have STIs and don’t know it. Check your local Planned Parenthood or other agency for information, although I recommend going with anonymous testing in order to ensure your privacy.

And safer sex is always a good choice. It’s easy to do, with a little practice. Using a lubricant can make safer sex more enjoyable since latex tends to have a bit more friction than skin. Try a silicone-based brand if you’re prone to yeast infections. Water-based brands are a bit easier to clean up since they rinse away.

If you or your partner don’t like the way condoms feel, try a different brand. The Japanese-process condoms such as Maxx and Skinless Skin are more sheer than other types. Or you could give Skyn a whirl. It’s made from polyisoprene, rather than latex, so it’s very sheer and both people will get more sensation.

Given that you have oral herpes, you might want to talk with your boyfriend about using condoms for oral sex. If you go that route, change the condom before having intercourse. That will make sure that you don’t spread the herpes virus to your vulva or vagina. It’ll also reduce the risk of your condom breaking; teeth can cause small abrasions that weaken the condom.

For an excellent, sex-positive read on safer sex, check out The Hot Guide to Safer Sex . It’s full of helpful advice and great tips.

Why Are STDs Now Called STIs?

DearSugar — Fri, 21 Mar 2008 08:00:00 -0700

I'm sure many of you were taught about STDs in your sex ed class yet you've probably noticed that I refer to them as STIs, so why the change in terms?

STD stands for sexually transmitted disease. STI stands for sexually transmitted infection. STI is a more politically correct term, since the word disease can have negative connotations or social stigmas attached. Plus, when people think of diseases, they think of something you get and have forever, but many STIs are curable, so using the term infection is actually more accurate. The term disease also implies that a person has visual symptoms, which is not always the case with STIs. Many of them such as chlamydia, gonorrhea, herpes, and HPV are asymptomatic. So for all these reasons, the term STD is gradually being replaced with STI. What do you think about the switch?

Source

Genital Herpes 101

DearSugar — Thu, 20 Mar 2008 08:00:00 -0700

A couple days ago I posted Handle This: He Has Herpes and some of your comments let me know that we could all use a refresher course on this STI.

Genital herpes is highly contagious, and is passed on through sexual contact. It's caused by a strain of herpes simplex virus (HSV), which enters your body through small cuts in your skin or mucous membranes, and then causes outbreaks of painful sores on your privates.

You should know that a person can pass herpes on to someone else even if they have no visible sores. Although there is no cure for genital herpes, the outbreaks can be controlled with medication, so a person with herpes can still be in a relationship and have sex (with protection, of course), without passing it on to his or her partner.

Want to learn more about how this STI is tested and treated? Then read more.

Symptoms	Small, painful blisters or open sores. After they ooze, they'll scab and then heal within one to three weeks. For women, sores may appear in the vagina, on the outside genital area, cervix, anus, or rear end. For men, sores may appear on the penis, scrotum, rear end, anus, thighs, or inside the urethra. Along with an outbreak of sores, a person may have flu-like symptoms including headache, muscle aches, and fever. Many people have no symptoms at all, or they'll have one bad outbreak of sores and then never experience another. Others can experience outbreaks up to 40 years after they first contract herpes.
How do you test for it?	A blood test can detect a herpes infection. If you have present sores, your doctor can take a fluid or tissue sample and test that, too.
Complications	Herpes will not cause death, but it can increase your risk of contracting other STIs such as chlamydia, gonorrhea, or HIV. A pregnant woman with sores can pass genital herpes on to her baby during delivery, which could cause brain damage, blindness, or death to the newborn. In this case, a C-section is usually performed.
Treatment	There is no cure, but oral, antiviral medications taken including Zovirax, Famvir, and Valtrex can help heal sores faster and prevent recurrent outbreaks. If taken every day, these meds may also help reduce your risk of passing it on to anyone else. If you have herpes, wait until all sores are healed before resuming sexual activity. Always use a condom to prevent passing it on to your partner, since this virus can be spread even when no symptoms of herpes are present.

Source

Oral Sex Doesn't Equal Safe Sex

DearSugar — Fri, 29 Feb 2008 15:00:00 -0800

I hate to bring up this not-so-fun topic, but I'm concerned. Many of my friends have dated guys that they wouldn't have sex because they were worried about STIs, but they didn't seem the least bit worried about having oral sex. When your mouth has contact with someone else's business, you can very well get a whole plethora of STIs - the problem is that many of these sexually transmitted infections are asymptomatic, which means you can't tell if someone is infected just by looking at them. That also means an infected person may not realize they even have an STI so they let their partner perform oral sex on them while unknowingly and accidentally passing the infection on to them.

Which STIs can be passed on through oral sex? To find out read more.

Gonorrhea: I know this is gross, but if you perform oral sex on an infected person, you can get gonorrhea of the throat.

Chlamydia: This can also infect the throat in the same way.

Genital Herpes: This STI is passed by skin-to-skin contact with a developing or existing sore. Unfortunately, even when there are no sores present, an infected person can still pass it on to their partner.

Genital Warts (HPV): This can be passed on when an uninfected person touches infected skin on their partner's genitals. So you don't even have to be having vaginal or oral sex in order to get HPV from someone else.

Syphilis: If a person performs oral sex on someone who's infected, and they come in contact with an open sore or a skin rash, they can get syphilis, too. Since lesions can appear on the genitals and on the lips and mouth, that means you can even get it from kissing an infected person.

HIV: This potentially deadly STI can be passed on through blood (including menstrual fluid), semen, vaginal fluid, or breast milk. So if a person performs oral pleasure on an infected person, and if they have a cut or sore in their mouth or on their gums, then they can contract HIV, too.

I know this is all very scary information, but knowing the facts will help keep you safe. Before becoming sexually active, you and your partner should get tested. It'll show that you respect one another, that you're responsible, and your sense of relief will make it all worth while when you do share that kind of intimacy.

Dear's Advice: If you are planning on having oral sex even though you're not sure about your partner's STI history, using male and female condoms and dental dams can reduce your risk tremendously.

Source

You've Got Mail (and an STI)

DearSugar — Fri, 15 Feb 2008 13:00:00 -0800

There may be nothing as awkward as informing a previous sexual partner that you've exposed him or her to an STI, but it's also one of the best things that you can do. Unfortunately, many people think that shame outweighs doing what's right, and thus, STIs continue to thrive. Now InSpot.org, a site based in San Francisco, assists people in anonymously notifying their partners about possible exposure to an STI through email. According to Reuters:

InSpot.org uses the E-Card model to send messages like "I'm So Sorry" to notify people that they may have been exposed to a disease. It also offers information about getting tested and treatment.

The goal of the site is to reduce the prevalence of diseases like syphilis through more timely treatment and awareness. Okay, I know the e-card model does seem kind of tacky, and yes, we'd all rather have the person just tell us directly, but I think an anonymous email is better than no email at all. Do you agree? Would you use this if the circumstances were right?

Source

What Do You Know About HIV?

DearSugar — Mon, 03 Dec 2007 10:00:00 -0800

Saturday was World AIDS Day, and I just saw an article about how the amount of cases of young Americans contracting HIV is on the rise. For young people aged 20 to 24, cases of new infection have climbed steadily, from 3,184 in 2001 to 3,876 in 2005 making it pretty clear that some people don't know how to protect themselves.

The more we know about HIV, the virus that causes AIDS, the more of a chance we have to prevent it. So let's test your knowledge and definitely share this quiz with people you love so you can help protect them too.

Source

Take the quiz

News to Me: 1 in 10 Men Have Overlapping Sex Partners

DearSugar — Fri, 02 Nov 2007 11:00:37 -0700

Call me old-fashioned, but I only date one guy at a time. That means I only have one sexual partner at a time, and I thought that was what most people did. Apparently not. According to this ABC News story, a new study shows that one out of every 10 men, observed over the course of a year, had sexual relationships with more than one woman at a time.

If these guys are having sex with a bunch of different women, those poor unsuspecting ladies probably have no idea. Not only is it disrespectful - and pretty sleazy if you ask me - but the practice also may be contributing to the spread of HIV and other STIs. Of course, using condoms is a great way to prevent HIV and other STIs from spreading, but unfortunately, they don't protect you 100 percent.

I hope this study will increase awareness about how important it is to practice safe sex. My advice: Before you get intimate with a new partner, be sure that both of you get tested for all STIs, especially HIV.

What do you think about this news? Do the results of the study surprise you?

Source

What Do You Know About Genital Warts?

DearSugar — Mon, 17 Sep 2007 08:00:00 -0700

Ahh genital warts. One of your favorite topics, I'm sure!

I'm sure you learned about them briefly in your high school Sex Ed class, but how much do you really know?

Let's find out!

Take the quiz

STI Facts

DearSugar — Mon, 06 Aug 2007 10:40:24 -0700

If you are sexually active, it's a sad fact that we need to watch out for Sexually Transmitted Infections (STIs).

Knowledge is prevention, so take this quiz to test your understanding of STIs.

Take the quiz

Hump Day: I Don't Like Hormonal Birth Control, So Now What?

TresSugar — Wed, 02 Sep 2009 04:00:00 -0700

Welcome to Hump Day,TrèsSugar's sex advice column. Are you confused about sex? Do you have trouble having an orgasm? Is there something you'd like to try but you're worried it's too weird? Send your questions to TrèsSugar, and our friend Dr. Charlie Glickman from Good Vibrations will offer his sound advice!

Today's Question:

“I went to my OBGYN to ask about non-hormonal birth control. (The Pill basically ruined my sex drive.) She pushed the Pill and the Nuva Ring, and said that condoms have a 15 percent failure rate. I don’t like that she was pushing hormonal birth control. Is it possible for hormonal birth control to lower your desire, and if I don’t want to use it, what’s my best, and safest, bet?”

To hear Dr. Glickman's advice, read more

Unfortunately, yes, birth control pills can lower libido. There are at least a couple of reasons for that. First, the Pill inhibits the production of androgens by your ovaries, including testosterone. While ovaries don’t produce as much testosterone as testicles do, it’s still an important part of women’s sexual arousal. The Pill also seems to increase the production of sex-hormone binding globulin (SHBG). SHBG binds to testosterone, which further reduces the amount of it that you have available. On top of that, an article published in the 2006 Journal of Sexual Medicine found that some of these changes may last for quite a while after you stop taking the Pill. Some women report that the NuvaRing has similar effects, although others don’t have any change in their libidos and others actually have an increase in sex drive.

15 percent is a bit higher than many estimates for condom failure rates, but part of why it’s hard to pin down more precisely is that many of the reasons for condoms not working is user error. Here are some tips on reducing the odds of that happening. And since each brand of condom is a bit different, this page has lots of advice for finding the right one for you.

Even though condoms aren’t 100 percent effective at preventing pregnancy, they go a long way towards lowering your risk for sexually transmitted infections. But if your focus is on contraception rather than STI prevention, there are some other options. Intrauterine devices (IUDs) are a lot more effective and safer than is popularly believed. They are currently available with or without hormones, although it’s worth noting that the level of hormones that end up in your system is a lot lower than what you get from the Pill and the non-hormonal IUDs can cause heavier menstrual bleeding or cramps.

Unfortunately, most of the more effective forms of contraception either include some form of hormones or are irreversible. The only other way to avoid pregnancy is to keep sperm from coming into contact with the ovum. Obviously, condoms do that, but if you want other options, you might want to check out cervical caps which have about a 10 percent failure rate if you’ve never given birth vaginally and a 25 percent failure rate if you have. (You can reduce that with a spermicide.) You could also check out the vaginal contraceptive film, a strip of spermicide that you insert into the vagina where it melts and provides up to three hours of protection. It also turns out that withdrawal is more effective than was previously thought, with an 18 percent pregnancy rate. Since these other approaches are clearly less effective than implants, the Pill or other hormonal methods, a lot of people use more than one. Condoms plus cervical caps or condoms plus withdrawal improves your odds a lot.

I’d really like to see some other forms of birth control that don’t mess with women’s hormones; so many women report having all sorts of side effects. There are some gel products being developed that will (hopefully) be effective as both contraception and STI preventatives and at least some of them are working their way through clinical trials. So eventually, there will be something better for you but in the meantime, I hope this helps.