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Menopause, Estrogen, Progesterone and HSV-2

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I'm curious to know if anyone knows how menopause and/or hormone replacement therapy can influence female-to-male transmission rates.


I'm menopausal and recently diagnosed with HSV-2. Upon diagnosis, my gynecologist told me antivirals were not appropriate for me because I don't have outbreaks but I've done my own research and want to explore taking antivirals to reduce possibility of transmission. I also now wonder if occasional yeast infections are actually irritation due to HSV-2.


My recent relationship ended due to the diagnosis and I'm embarking on dating again and want to be able to reassure prospective partners that I'm doing whatever I can to reduce the odds of transmission. I'm also fairly recently menopausal and have not yet explored HRT but considering it, mostly to help with hormone related insomnia. I have an appointment to discuss both HRT (probably a combination of estrogen and progesterone) and Valtrex (or similar).


I'm wondering if any of you know if menopause and/or supplemental estrogen and progesterone can influence HSV-2 irritation and/or shedding/transmission. For instance, I've read here that people tend to get more outbreaks during menstruation and I believe HRT causes artificial menstruation. But I also would assume dryness caused by menopause could cause problems that could influence transmission. Not sure. Thoughts?


Oh...one more question. I've seen comments about Valtrex maybe causing dryness? Is that something I need to consider, too? I've already successfully discontinued other drying medications to help alleviate menopause symptoms.

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Being male I will address the antiviral issue...They can be an effective means of reducing shedding when taken suppressivly. I would try to find another doctor who would be more open to prescribing them.


It just occurred to me that you may be from the UK based on what your doctor told you. If that's the case you may have to start fibbing a little about outbreaks or other herpes related symptoms to get them to budge on the antivirals.

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Hello @optimist, I am41, and have been through menopause following a hysterectomy at 27. I have been on HRT for about six or seven years. I just saw my GYN yesterday for the first time since being diagnosed with HSV2. He advised that my hormone pellet therapy would not cause any issues regarding transmission or symptoms. He also said that my recent yeast infection diagnosis that my primary told me to treat with OTC meds, was likely H, as were several UTI symptoms this year. I have only had one minor OB with three small sores(not small pain though). But he freely prescribed suppressive therapy. My husband already has the virus,so transmission is really not a concern for me. However, antivirals certainly reduce the transmission risk.


I was also diagnosed with lichen sclerosis yesterday, as if the H and hormone issues aren't enough going on down below. It causes several symptoms that are similar to an OB. I asked about increased dryness due to both issues and he said it is different for individuals, but the dryness shouldn't worsen. In the past, I have used Replens on occasion for dryness. The best thing though for me was PUR natural lube.


Not sure if this was any help, but I am new to this :)



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  • 2 months later...

I just saw this post. I know it's a bit late. I went through menopause surgically many years ago. I was 42 and am now 58. I was briefly on HRT until I developed breast cancer (it was hormone receptive ) so I was taken off HRT. Fast forward 14 yrs. I developed vaginal atrophy. .....serious dryness. My gyno allowed me to try the lowest dose of vagifem which is HRT inserted into vagina (very tiny white pill). Well, it woke everything up down there and I mean everything!!! Nerves were jumping. I had serious tingling and itching just exactly like H prodrome. I was so freaked out by it that I called the FDA to see if these were side effects reported by others. They said yes and it would go away in two weeks. 5 weeks later it was still happening so I stopped it as I could not distinguish between HRT side effects and prodrome. Now I'm using over the counter replense and it's not working for me. It took two months for the tingling and itching to subside. It was a crazy ride!

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  • 1 year later...

I take natural HRT (estrogen cream on my vagina daily to build up thinning of walls and dryness was my menopausal issue too - and it works as once back on board, I could have lots of great sex with my partner at the time... le sigh lol), progesterone and testosterone pills. Nobody seems to be concerned with my being on antivirals in combo with.

I just switched to Valtrex ax Acyclovir was not working going on 4 months. So, I will see if I have any off side effects. I was more concerned about my liver, as I have an autoimmune disease PSC that kills my bile ducts and the possible Stevens Johnson Syndrome side effect- had an episode of this back in 2016 due to a medication.

My point? :) Is both my hepatologist (liver doc) and GYN are fine with me on Valtrex... SJS, HRT and PSC disease and all.


I say go for it and find a new doc. It's about your Peace of Mind. I'd suggest starting with Acyclovir as it seems to the most commonly used and have the least amount of side effects over long term use.



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K75 - my itchy tickly issues I thought yeast I think too have been H. Hormone treatment has been great for me and argh on the breast cancer caveat! And sorry about the added diagnosis - harsh. When I need lubrication I found Vit E suppositories were the best. Natural and I can break them to size as needed. Little messy, but worth it.

I know when I used them during my itchy, tingly phase a few weeks back, it felt better - but not sure if it was a negative to the H - a question for my doc.

Hang in there - I'm with you just with different damn issues.


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