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Do oral contraceptives increase asymptomatic viral shedding?
Hello Dr. H
I am a woman with HSV 2 and I have had the virus for about 12 years. I rarely have OBs (I cannot remember the last time I had one).
I am dating an absolutely fantastic guy and I'd really like to keep him HSV-free. We've discussed my status and I've relayed to him that the transmission stats of my passing the virus to him are about 4% per year with avoiding sex during OBs, about 2% per year with Valtrex and down to 1% if I am on Valtrex and we use a condom.
I am taking Valtrex. I have recently gone on the pill as we'd like to stop the condoms. However, he has said he read online that taking the pill increases asymptomatic shedding in women.
My question is a) is this accurate - there's a lot of poor information online and b) if my being on the pill DOES increase my rates of shedding the virus, by how much ie. significantly? or minutely? c) how does my being on Valtrex and on the pill change the stats of passing the virus to him - we would move from a 2% annual rate to X%?
I appreciate your help.
I am a woman with HSV 2 and I have had the virus for about 12 years. I rarely have OBs (I cannot remember the last time I had one).
I am dating an absolutely fantastic guy and I'd really like to keep him HSV-free. We've discussed my status and I've relayed to him that the transmission stats of my passing the virus to him are about 4% per year with avoiding sex during OBs, about 2% per year with Valtrex and down to 1% if I am on Valtrex and we use a condom.
I am taking Valtrex. I have recently gone on the pill as we'd like to stop the condoms. However, he has said he read online that taking the pill increases asymptomatic shedding in women.
My question is a) is this accurate - there's a lot of poor information online and b) if my being on the pill DOES increase my rates of shedding the virus, by how much ie. significantly? or minutely? c) how does my being on Valtrex and on the pill change the stats of passing the virus to him - we would move from a 2% annual rate to X%?
I appreciate your help.
MEDICAL PROFESSIONAL
Welcome to the forum, and congratulations to you for a level-headed understanding about you herpes and your responsibility in protecting your partner. And to him for his apparent understa nding of the situation.
To my knowledge, hormonal contraception haas little or no effect on shedding. That might have been the case years ago, when oral contraceptives delivered much higher doses of hormone than they do now. I cannot imagine that the current low dose pills have any measurable effect. I'll check the latest scientific literature and post a follow-up comment if I find conflicting information. But for now I see no worries.
Regardless of this, your guesstimate of a 2% annual risk rate probably is too high. This many years after your initial infection, and with only rare outbreaks, it's a good bet you shed virus infrequently. There are no good data on is, but HSV-2 transmission seems to be quite uncommon in presence of such longstanding infection.
I hope this helps. Best wishes for a happy and healthy relationship. HHH, MD
To my knowledge, hormonal contraception haas little or no effect on shedding. That might have been the case years ago, when oral contraceptives delivered much higher doses of hormone than they do now. I cannot imagine that the current low dose pills have any measurable effect. I'll check the latest scientific literature and post a follow-up comment if I find conflicting information. But for now I see no worries.
Regardless of this, your guesstimate of a 2% annual risk rate probably is too high. This many years after your initial infection, and with only rare outbreaks, it's a good bet you shed virus infrequently. There are no good data on is, but HSV-2 transmission seems to be quite uncommon in presence of such longstanding infection.
I hope this helps. Best wishes for a happy and healthy relationship. HHH, MD
Certainly daily suppressive therapy would also help to negate the risk too don't you think?
I don't recall them breaking down any of the suppressive therapy studies into women taking the bc pill but since the risk is small of increased shedding and we know suppressive therapy is very effective in reducing shedding, shouldn't be an issue correct?
Perhaps we've just come up with a research study for someone? :)
grace
I don't recall them breaking down any of the suppressive therapy studies into women taking the bc pill but since the risk is small of increased shedding and we know suppressive therapy is very effective in reducing shedding, shouldn't be an issue correct?
Perhaps we've just come up with a research study for someone? :)
grace
MEDICAL PROFESSIONAL
Thanks, Grace. I stand corrected. I was unaware of that study.
TMTFP, I'm not sure this necessarily is a serious consideration in estimating your risk of transmission to your partner, in view of your longstanding infection, taking Valtrex, etc. The risk is definitely on the low side.
TMTFP, I'm not sure this necessarily is a serious consideration in estimating your risk of transmission to your partner, in view of your longstanding infection, taking Valtrex, etc. The risk is definitely on the low side.
http://www.ncbi.nlm.nih.gov/pubmed/15844064 for reference as to what I based my reply in the herpes forum on.
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
