Woman sitting on bed with a cup of teaMultiple times each week, Integrative Gynecologist Katherine Thurer, MD, reassures patients that everything will be ok, that their lives will go on and be normal again.


These patients all have one thing in common: They’ve recently been diagnosed with the sexually transmitted disease herpes simplex virus (HSV), either type 1 or type 2.


“I have to talk them down off the cliff because of the stigma around it and because there’s treatment but no cure. They feel helpless,” Dr. Thurer says. “People given a new diagnosis don’t know how they’ll bring it up with new partners, but most people have probably encountered it before, even if they don’t know.”


HSV ranks among the most common sexually transmitted diseases in the United States, according to the Centers for Disease Control and Prevention. However, many don’t know they have it because they never experience symptoms.


Type-2 (genital herpes) tends to be more common among women (20.3%) than men (10.6%) in the U.S. because of the way it spreads during intercourse. Type-1 (oral herpes) is even more common, and tends to be acquired during childhood. The World Health Organization estimates that two-thirds of the population under age 50 has type-1, which can also spread to the genitals through oral sex.


Dr. Thurer says people often are shocked when they find out they have herpes. The test for it isn’t part of a standard STD screening because the most accurate way to diagnose it is by testing a lesion. Physicians also may use a blood test that checks for antibodies to HSV-1 and HSV-2, but this test can produce false positives and false negatives.


That’s why Dr. Thurer encourages patients to “be aware of your body, and watch for lesions. The best thing you can do is come in if you suspect an active outbreak.”


The Anxiety of Diagnosis

Carolyn did exactly that. Earlier this year, she began feeling an intense burning and pain in her vagina. She used a mirror to check herself and noticed a sore forming.


“I was terrified,” she says. “I’m in the healthcare profession, and am extremely cautious when it comes to sexual activity.”


HSV symptoms include:

  • Genital burning, itching, or tingling

  • Blister or ulcer

  • Any lesion that comes and goes in the same spot

  • Flu-like symptoms


Carolyn made an appointment with Dr. Thurer, who confirmed her suspicions. The symptoms were due to a herpes outbreak.


“Immediately, I knew that what I was feeling was validated, and I felt a lot of emotions: devastation, anxiety, fear,” Carolyn says.


She was also in extreme physical pain, and felt dirty about herself. “I flashed forward through my life. How am I ever going to be with somebody again?”


Dr. Thurer worked to calm Carolyn’s fears. “You’re going to be ok,” she said. “You’re a very strong person, and this is so common.”


Dr. Thurer explains, “It feels isolating, but it’s actually quite common. Eventually, you’ll figure out how to cope, and it won’t be the first thing you think of. Some people have one outbreak, and that’s the end. It’s also possible to have a mild outbreak and not notice, while other people are plagued by it.”


Most people who transmit HSV don’t know they have it, she adds. They’re most contagious right before an outbreak. Once people find out they have HSV, they go through a lot of self-guilt, worry, and often become accusatory about who gave it to them.


Now, Carolyn is wondering how she’ll explain her diagnosis to a future partner. She worries that he’ll think she’s always contagious or that he’ll judge her.


From an integrative medicine approach, Dr. Thurer encourages patients to practice stress management and support their immune systems. Outbreaks can happen under stress or when the immune system is compromised. She also adds that women with HSV should let their gynecologists know during pregnancy so the physician can take precautions if there’s an active outbreak during birth.


To manage her anxiety, Carolyn says she practices meditation and deep breathing. “The mind is a very powerful thing, and can get very paranoid,” she says. “Trying to live in the moment and not worry about things I can’t control has helped me wrap my mind around this horrible situation.”


She also sees an acupuncturist and supports her immune system through supplements and a healthy diet.


A New Normal

As part of accepting that new normal, Carolyn makes appointments with Dr. Thurer whenever she feels sensations that worry her. “I’ve gone to the doctor much more frequently just to have her look at things. I need clarification that my body is normal again.”


When outbreaks do occur, physicians may prescribe antiviral drugs to relieve symptoms or stop them from worsening. The treatment course typically lasts five to 10 days, and the medication can be taken as necessary. If a person experiences outbreaks regularly, daily antiviral medication can reduce the outbreaks and help keep HSV from spreading to sexual partners.


Dr. Thurer reminds Carolyn and others that they will continue to have a life beyond HSV, but in the meantime, “I’m there to hold their hands through the process,” she says.


In the months since her diagnosis, Carolyn is already feeling better mentally, and encourages others to surround themselves with positive people and learn to embrace the journey.

 

"Do not let this define who you are. Take as much time as you need to deal with it in a healthy way," she says, adding, “There are things we come across in life that we don’t always know the answers to or why things happen. Try to find yourself again. Do things that make you happy and feel good, whether that’s working out or getting a massage. And stay off the Internet.”


If you have questions about HSV, suspect you may have an outbreak, or want to talk with a patient like Carolyn, please call the Raby Institute at (312) 276-1212. Learn more about Dr. Thurer and her approach to integrative gynecology here.


The focus of integrative medicine is to restore this natural balance through the blending of conventional and ancient healing techniques.