6 Things You Need to Know About Herpes Tests, According to Doctors Who Administer Them

In a perfect world, testing for STIs would be as simple as taking an online quiz. You’d plug in your answers, hit submit, and boom: Seconds later, you’d have your outcome. More importantly, the results would be accurate. Unfortunately, in the case of certain sexually transmitted infections — herpes included — securing your status isn’t straightforward. Without a herpes outbreak present (such as a cold sore), it’s extremely difficult to know whether or not you’re HSV-positive, and herpes testing is so flawed and misunderstood that doctors say it leads to unnecessary stress.

Picture this: You’ve started seeing a new partner and you two feel ready to have sex. You tell them you should both go get tested first and they happily agree. (Cheers to open communication.) From there, the two of you have blood tests and ask to be screened for STIs, including both types of herpes: herpes simplex virus type 1 (HSV-1), which most commonly causes oral herpes, and herpes simplex virus type 2 (HSV-2), which most commonly leads to genital herpes.

Neither of you has ever experienced symptoms, so when the test comes back and reveals that you’re herpes-positive, you’re stunned. You’re instantly hit with a minefield of emotions, including shame — no surprise, given the decades of the stigma surrounding herpes and other STIs. But wait: Did you know that most people are positive for HSV-1 and that most are asymptomatic, meaning they have no symptoms?

1. If you have zero symptoms, getting tested won’t help you.

The problem is that blood tests for herpes when no lesions or symptoms are present are often bullshit. I realize that’s a pretty strong word, but after speaking with doctors who have administered these tests, it’s become more and more apparent to me how misunderstood — and in some cases, just plain wrong — the results they give are.

Part of the reason they’re flawed has to do with the fact that most people have been exposed to HSV-1 or oral herpes. “For HSV-1, close to 100 percent of people in the U.S. are antibody-positive because they have been exposed at some point in their lives, though only a percentage of these individuals will actually get cold sores,” says Adam Friedman, the residency program director at the George Washington University School of Medicine & Health Sciences in Washington, D.C. He adds that blood tests can be misleading because they usually don’t detect the herpes virus itself and instead look at the level of antibodies against the virus, which is merely a sign of immune response to it.

2. There are two common blood tests used to identify herpes — and they’re often misleading.

“I had a patient once who underwent this test, which was positive, and was told she has herpes, which to her was devastating and life-altering,” Friedman says. “She burst into tears when I explained the significance or lack thereof with this test, which is very misleading.” There are two common blood tests used to identify herpes: IgG and IgM. The IgM test is still used by some doctors even though it has been denounced by the Centers for Disease Control and Prevention (CDC). According to the American Sexual Health Association(ASHA), IgM tests can lead to deceptive results, as well as false assumptions about how and when a person acquired HSV.

And that’s not all: IgM tests fail to accurately distinguish between HSV-1 and HSV-2 antibodies, leading them to provide false-positive results for HSV-2. In other words, if you’ve been exposed to oral herpes (which most people have), results of the IgM test could lead you to believe you’re positive for genital herpes, when in fact you simply have antibodies against HSV-1.

IgG tests, on the other hand, are more accurate but aren’t without their own issues. For instance, ASHA says that while an IgG test can distinguish between HSV-1 and HSV-2, the problem is that the time it takes for IgG antibodies to reach a detectable level varies from person to person. This means that even with accurate results, someone could get a false-negative if they have the test administered too soon after contracting the virus (physicians recommend waiting 12 to 16 weeks after possible exposure).

Aside from the two aforementioned blood tests, there are other FDA-approved gG-based blood tests that can offer accurate results, which the ASHA has broken down in this handy chart. However, the association also points out that these tests can’t determine whether the site of infection is oral or genital, which poses a problem for those who want to know their HSV-1- or HSV-2-specific status.

All of this tells us that sure, there are some currently available blood tests for herpes that can tell you your status — or give you some idea of it — but they’re still far from perfect. And when we’re dealing with an illness that’s highly and widely stigmatized the way herpes has become, most people are looking for airtight answers. This is precisely why so many doctors, as well as the CDC, do not recommend getting tested unless you have the common symptoms associated with herpes, such as itching, burning, or a blister.

3. Doctors don’t advise getting a blood test for herpes without any symptoms.

Hilda Hutcherson, assistant professor of obstetrics and gynecology at Columbia University Medical Center in New York, is one of those doctors. “I usually don’t do tests for herpes [unless] someone has a lesion or a sore, something I can see, [then] I will do a swab and take it to a culture or check the DNA on the materials I removed,” she says. “If there’s nothing there and I do a blood test and the blood test comes back positive, let’s say it’s positive for type 1, what does that really mean? Most people are positive for type 1.” She adds that someone could be HSV-1-positive and either have or not have genital herpes. The result “doesn’t mean much, and it makes people go crazy.”

Hutcherson’s motto is pretty simple: Why stress yourself over something if you haven’t seen anything — especially when it’s something as common as herpes? “Let’s say they have a blood test come in positive but they’ve never had a lesion. Now what? You may never get a lesion,” she says. It’s for this reason that she recommends people do not get tested for herpes unless they have a visible lesion that can be cultured and sent to a lab. Let’s say you get tested anyway and it comes back positive, despite the fact that you have no symptoms. What do you do?

4. Useful methods include testing an actual lesion.

Keep in mind that there’s no such thing as “safe” sex, only safer sex, which means using protection and being open and honest with your partner. “It can definitely happen,” Friedman says of the chances of transmitting the virus to a partner without a visible outbreak. “It’s called asymptotic shedding [and] there are studies showing that the rates of transmission of HSV-2 are the same for symptomatic and asymptomatic.” He adds that this is why using protection during sexual contact is so important, regardless of what blood tests say. Unfortunately, you can never ensure your risk of transmission will be zero, whether or not you know you have herpes, but using a condom or dental dam will get you closer to it.

Like Hutcherson, Friedman also doesn’t recommend blood tests for herpes in the absence of symptoms. “The tests that are useful involve sampling the actual blister or cold sore,” he says, which can involve smearing scrapes of skin cells from the sore onto a slide, targeting the infected cells. As with some of the blood tests, though, this sampling test still won’t tell you what type of herpes virus is present. A viral culture, on the other hand, will tell you which virus you have, though it takes some time to come back. “Direct fluorescent antibody is by far the best,” Friedman says, “as you can get a result in a matter of hours which can be as useful as a culture.” Not all hospitals have access to this method, however.

5. If you get a positive result, don’t panic. It really doesn’t mean much.

All of this is to say that unless you have symptoms consistent with the herpes virus, why put yourself through the emotional turmoil of getting a blood test that may or may not give you legit results? As Hutcherson notes, if you do get a blood test and it comes back positive but you’re asymptomatic, what does that mean for you if you have nothing to treat? For many, due to the high rate of stigma still surrounding herpes, it can mean feelings of self-contempt, humiliation, and distress, all of which could be avoided if you aren’t experiencing any symptoms.

To recap, while there are some tests for herpes that can prove correct, none are 100 percent perfect, and blood tests are particularly problematic since they can produce false positives and negatives. We also know that the majority of the population has some form of herpes, so IMO it’s a mystery as to why we’re still making a big deal out of it. No one likes blisters or sores, but neither does anyone love having acne, a widespread condition (85 percent of young adults battle it) without the same level of attached shame.

6. The bottom line: Tests for herpes are more worry than they’re worth.

If you do have symptoms, don’t fret: If you know your status, you’re at an advantage in that you can talk with your doctor and find an antiviral drug that works for you. Medication can curtail the severity of your symptoms, as well as the number of outbreaks you get. Additionally, taking an antiviral daily will greatly reduce your chances of transmitting the virus to someone else. In case you missed it, there’s also a very promising new drug for herpes on the horizon, which researchers say could be the most effective one yet.

Take it straight from the pros and don’t put yourself through the stress of a herpes blood test if you don’t need to. And, whether you have symptoms or not, know that you’re not alone if you are herpes-positive.

Read more, please visit: https://www.allure.com/story/herpes-testing-accuracy

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Women with Herpes should Know the 6 Symptoms

What’s the first image that comes to mind when you think of herpes?

For doctors, it’s a rose. (Yes, the beautiful flower.)

“The classic description of genital herpes is ‘dew drops on a rose petal,’” says Peter Leone, M.D., an adjunct professor of medicine at the UNC School of Medicine. “You get these little blisters on a red base that hurt—and if you have that, the probability that you have herpes is pretty high.”

The problem is that most people with genital herpes don’t have any symptoms. Herpes is a super-common STD, and according to the Centers for Disease Control and Prevention, more than one in every six people has it. They just probably don’t know it.

Genital herpes spreads through skin-to-skin contact and is caused by two types of viruses: herpes simplex virus type 1, or HSV-1, and herpes simplex virus type 2, or HSV-2. The kind you have matters because it determines how you’ll be treated.

Herpes isn’t curable, but don’t freak out: It’s totally possible to manage it with the help of antiviral medications or daily suppressive therapy, and yes, you can still have a normal sex life.

Most doctors don’t test for herpes unless a woman is showing symptoms, and since that’s probably not going to happen, it’s one reason why so many people never know they have it.

In the U.S., 87.4 percent (!) of infected 14 to 49 year olds with HSV-2 have never been diagnosed, according to the CDC.

But if you’re curious or worried, stand your ground. “Women have a right to be proactive about this—it’s very easy for clinicians to be dismissive about the concern around herpes,” Leone says. “Don’t take no for an answer if you want to know your status.”

There are the most common herpes symptoms in women:

1. PIMPLES—AND NOT ON YOUR FACE

Well, at least it’s not as obvious as a big zit on your forehead? These tiny blisters don’t always occur, but when they do, there’s a good chance you have genital herpes. Like any miserable pimple, they eventually crust over and scab, says Jennifer Berman, M.D., a co-host on The Doctors. “It’s not necessarily on the genital area—sometimes it’s in the crease of the underwear or closer to the buttock,” she says.

2. A TINGLING SENSATION

It’ll be all over the affected area: your genitals, butt, or thighs. Tingling is one of the first symptoms of herpes in women, so if you just feel weird down there, take note, says Leone.

3. IRRITATION OR ITCHING IN YOUR LADY PARTS

“Sometimes women ignore this because they’ve been exercising or wearing yoga pants, and they just assume the itching or irritation is from wearing tight clothing,” Berman says. In reality, that sensation is often a symptom of genital herpes in women.

4. A FLU-LIKE FEELING

Blah. About 70 percent of women feel like they have the flu, with a headache, muscle aches, fever, and swollen glands during their first herpes outbreak, according to the University of Maryland Medical Center. Of course, you might actually just have the flu (congrats?), which is why it’s always good to get checked out.

5. A DULL, ACHING PAIN IN YOUR PELVIS

If you’re spotting between periods, grimacing during sex (never good), or noticing weird-for-you discharge, you might have cervicitis—a fancy way of saying your cervix is inflamed. It’s caused by a number of STDs, including herpes, and will go away when the underlying infection is treated, says Berman.

6. PAINFUL PEE

When pee splashes on a herpes ulcer or blister, it can burn, according to the Mayo Clinic. That’s just not pleasant, so get to a doctor and find out what’s wrong.

Read more:https://www.womenshealthmag.com/health/a19089809/herpes-symptoms-in-women/

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