Questions and Answers

These are the questions submitted to Ask Rachael About Sex with the Answers

Submit your questions to Rachael anonymously and the answers will be posted on this page in 5 days.

Dear Rachael,

        How soon after unprotected sex can you be tested? 

Rachael Answers: What a great questions!

Everyone knows that protected sex with a condom is the next best thing to using abstinence.  If you are someone who focuses on the negatives you already know the numbers of infection rates for the college group is not comforting.   In case you are not aware of what they are here is a smattering of information from South Carolina from mostly the CDC:

Charleston is ranked #22 of the top 100 cities for HIV/AIDS and STI diagnoses. (teenpregnancysc.org)

South Carolina is rated:
3rd in the country for Chlamydial and gonorrheal infections.  (CDC)

Nationally
17% of people 14-49 have Herpes. (CDC)
45% of people 20-24 have HPV. (CDC)

    Making a decision to get tested for STIs following an unprotected sexual encounter is a smart choice.  When can you get tested?  A more difficult answer to find than one would think.  After consulting with our student health services and seeking out information from test manufactures here are the estimates for common STI tests.  Please understand that this is an estimate and should be verified with the doctor administering the testing.

Dear Rachael,

I was kissing a guy a few days ago and it wasn’t until later that I noticed that he had a cold sore. I also gave him oral later that night, but I didn’t let him do anything to me.  A few days later, I developed a terrible sore throat and ulcers in my mouth. I went to the infirmary and found out that the ulcers were caused by the same cold sore virus and that it caused the infection in my throat. So now, I am freaking out that this guy basically gave me oral herpes and that I may have passed on genital herpes to him since I went down on him. Is that even possible to pass on that quickly and could he give me genital herpes if I ever let him go down on me?  I’m just clueless to this and I have no idea what it means now. Do you have any answers for me or any advice? Anything will help, Thanks.

Rachael Answers: Thank you for your question!  Please excuse the lengthy answer but it is a complicated topic.

First, don’t freak out.  It would be extremely unlikely that you would have passed on genital herpes to your boyfriend.  You said that he had a cold sore. This is usually a sign of a recurrence of type 1 herpes. This indicates that he has had past herpes infection and that he has antibodies against type 1 herpes. These antibodies give him protection against getting it in the genital area.

As for whether he could give you genital herpes if he went down on you, the answer is a little more complicated.  You are describing what sounds like an initial infection in yourself, which usually occurs inside the mouth.  As mentioned above, recurrences usually occur on the lip as a cold sore.  At this point, your body may not have yet developed the antibodies to protect you from contracting herpes in a second location.

Your body’s defense system develops these antibodies over the weeks to months following initial exposure.  There are blood tests available to check for these antibodies to type 1 and type 2 herpes, but you would need to wait about 4-6 weeks for these tests to be most accurate and helpful.  This test is different from the viral culture swab that is done of an actual lesion/ulcer.

If your boyfriend is a student here, you could both get this blood test done at Student Health Services. The herpes blood test with typing (for IGG antibodies) has a lab fee of $100.

If a person already has antibodies to Type 1 herpes (that is if he/she has had a past infection with type 1 herpes) then he/she is protected from getting Type 1 in a second location. However he/she may get recurrences of type 1 in the same general region of the body as the initial infection.

Now for some general information on herpes and oral sex:

There are 2 types of the herpes simplex virus. Type 1 usually occurs in the mouth in the form of cold sores and Type 2 usually occurs in the genital area. During oral sex, type 1 herpes can be transmitted to the genitals and occasionally type 2 herpes can be transmitted to the mouth.

Condoms and dental dams are recommended for use during oral sex to help decrease the risk of herpes transmission. A dental dam is a thin square of latex or polyurethane that can be placed over a women’s genital area during oral contact.  Condoms and dental dams are available in multiple flavors.  It is possible to make a dental dam out of a condom by cutting off the tip of the condom and then cutting down one side.

The guy I'm dating is on blood pressure medicine and has trouble orgasming. He says he enjoys the sex, but it is pressure for me to figure out when I have had enough. I guess it is always better when both people have similar experiences. He said his blood pressure meds make it hard for him to feel sensual. Do you think he may just have a low sex drive? Or is this normally the case with these types of meds.

Rachael Answers: I think it would be important for him to discuss this with his physician.

Certain types of blood pressure medicines can affect male sexual function. I would also want to know what other medical conditions he has. Diabetes and depression can affect sexual function, as can several of the antidepressant medications.  Also alcohol and drugs can affect sexual function.

If he and his physician feel that this is a medication side effect, he may be able to switch to a different medication. If he and his physician feel that he might have a hormonal issue, lab tests could be done for further evaluation. 

Can I get herpes from oral sex?

Oral sex is part of many college students’ sexual experience. Unfortunately, many people do not realize that there are risks of sexually transmitted infections (STIs) with oral sex. Herpes is the most commonly transmitted STI with oral sex. 

There are two types of herpes simplex viruses. Type I herpes usually occurs in or around the mouth in the form of “cold sores” or “fever blisters.” Type II herpes usually occurs in the genital area. However, during oral sex, type I herpes can be spread to the genitals, and occasionally type II herpes can be spread to the mouth.

Many people are not aware that they have herpes and herpes can be spread even when a person is not having an active outbreak. It is important to take measures to decrease your risk of getting or transmitting herpes when you have any form of sex.

Condoms and dental dams are recommended for use during oral sex to help decrease the risk of herpes transmission. A dental dam is a thin square of latex or polyurethane that can be placed over a women’s genital area during oral contact.  Condoms and dental dams are available in multiple flavors.  It is possible to make a dental dam out of a condom by cutting off the tip of the condom and then cutting down one side.

Other ways to avoid getting or transmitting herpes infections include: 
     Limiting the number of sexual partners you have, and knowing their sexual history
     Abstaining from having sex during active outbreaks or when you have a cold sore
     Taking suppressive medicine if you have a history of herpes.

Latex Dental Dam	Durex Flavored Condoms	Latex Dental Dam

 

Can condons protect against Herpes?

What a great question!  Herpes, syphilis, and genital warts (and other variants of HPV) are transmitted by skin to skin contact.  Herpes shows up as a sore or blister.  It prefers warm, moist environments which makes it likely to be in genital areas and the mouth.  If you would like to learn more check out the CDC’s informational brochure.  
 
When condoms are used for 100% of the time someone has sex it is shown to reduce the transmission of genital herpes by 30%.  This number is not a 100% because it is transmitted by infected skin coming in contact with noninfected skin.  If the herpes virus is present in an area covered by a condom then the likelihood of spread will be decreased.  If the virus is present on a part of the body which is not covered by the condom, it could spread. Herpes can also be spread during oral sex. Flavored condoms and flavored dental dams are recommended to help decrease the risk of transmission with oral sex.

Other ways to avoid getting or transmitting herpes infections include:    

• Limiting the number of sexual partners you have and knowing their sexual history
• Abstaining from having sex during active outbreaks or when you have a cold sore
• Taking suppressive medicine if you have a history of herpes.