HSV2 Genital Herpes

Dear Dr. Rob:

I am a 38 year old female who has had HSV2 genital herpes for almost 20 years. I currently have outbreaks every 1-2 years. I had my most recent outbreak two weeks ago. I did not experience prodrome prior to the outbreak. However, I have experienced prodrome before outbreaks and without outbreaks before. It usually goes away in 1 or 2 days. About a week after the lesion had healed, I begin experiencing pain and tingling in areas (buttocks, thigh) that I normally experience prodrome, however, there is no genital pain. I have had these symptoms for two weeks now without an outbreak. Coincidently, I began a low carb diet around the time I began experiencing this pain. Is it possible to have prodrome or neuralgia without outbreaks for this length of time? Could my dietary changes be causing activation of the virus causing nerve pain? Because I am hypersensitive to signs of outbreaks, could I be mistaking this pain for pain caused by herpes although it is identical except there is no pain at the normal lesion site?

Dr. Rob’s Response:

Dear 38 Year Old Female:

Yes, it is possible to have prodromes without an actual outbreak and they can last for a significant period of time. I can’t say with certainty whether your diet change has engendered increased activity of the herpes virus, but it is of course possible. It could be something other than herpes, but given your history it seems quite unlikely. 


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