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oxford45

change in ob location

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oxford45

I have had herpes for 20 years. About 5 years ago my outbreaks, which had lessened and were less frequent, moved from the vaginal area to the rectal area. I have been happily married for 13 years and have 3 wonderful children. When I asked my gyn about this she said that the virus travels up and down a nerve bundle, so I assume nerves that supply both of those regions are in the same nerve bundle. It is very hard to find information that confirms this though. It is important to me though, because my husband, who has always been overly suspicious and a little controlling, believes that I have had annal sex with someone and have been cheating on him. It has really put a strain on our marriage. He insists on knowing who I’ve had an affair with and I have never been unfaithful to him. As far as we know, he has not contracted herpes. I have had annal sex with him maybe 2-3 times in the course of our marriage. Has anyone had a similar experience or know anything about this type of "migrating"

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RealisticGal
I have had herpes for 20 years. About 5 years ago my outbreaks, which had lessened and were less frequent, moved from the vaginal area to the rectal area. I have been happily married for 13 years and have 3 wonderful children. When I asked my gyn about this she said that the virus travels up and down a nerve bundle, so I assume nerves that supply both of those regions are in the same nerve bundle. It is very hard to find information that confirms this though. It is important to me though, because my husband, who has always been overly suspicious and a little controlling, believes that I have had annal sex with someone and have been cheating on him. It has really put a strain on our marriage. He insists on knowing who I’ve had an affair with and I have never been unfaithful to him. As far as we know, he has not contracted herpes. I have had annal sex with him maybe 2-3 times in the course of our marriage. Has anyone had a similar experience or know anything about this type of "migrating"

First of all, I'm sad to hear you have to deal with a suspicious, controlling partner. I don't find anything "happy" about that. :madd:

That said, his suspicions of infidelity are a very typical (but unfounded) reaction.

As you have suggested, there is more than one nerve pathway leading to the surface of the skin. They look a lot like a tree --- with a big trunk that branches off into many smaller paths.

Anyone who has genital herpes could have lesions show up anywhere in what we call the "boxer shorts" area at any time.

You could think of it as a person who drives the same way to and from work every day for years, then decides to take a different road one day.

That "boxer shorts" area, where lesions might show up, includes the:

  • lower abdomen
  • lower back
  • buttocks
  • anus
  • perianal area and perineum
  • entire vulva (labia majora and labia manora, opening to the vagina, mons pubis, clitoris, vestibule, etc.)
  • inner vagina

  • urethra
  • cervix
  • penis
  • scrotum
  • upper thighs

This "boxer shorts" area is more precisely called the "sacral dermatome." It identifies where the nerve pathways come to the surface of our skin from the sacral ganglion, which is where genital herpes goes during dormancy.

I have yet to find a really good drawing to illustrate all of the sacral nerve pathways. Here's a not-too-bad one that shows part of the area I mentioned above:

837.gif

In this drawing, the sacral and pudendal nerve pathways are in yellow. As you can see, they go a lot of places, but they all start at the same root (ganglion).

Here is a drawing that shows the concept a bit more clearly. It shows the trigeminal nerve pathways, which are the ones involved in oral herpes:

250px-Gray778_Trigeminal.png

Trigeminal nerve, shown in yellow.

As you can see, it branches off and comes to many different points on the surface of the skin. A person may have experienced oral herpes sores at the top left corner of their mouth for years and years, then suddenly they could get one beside their nose. It is caused by the same old oral herpes infection...nothing new.

Same deal with genital herpes.

So, to sum up: your anal lesions are symptomatic of your long-established genital herpes infection.

Hope this helps.

:wavey:

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oxford45

Thanks RealisticGal, this helps more than you know. The information makes sense to me and will hopefully make since to hubby. He asked his Dr about this and he told him ob's were alway in the same location and never changed. Some Dr's know so little about herpes.

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RealisticGal
Thanks RealisticGal, this helps more than you know. The information makes sense to me and will hopefully make since to hubby. He asked his Dr about this and he told him ob's were alway in the same location and never changed. Some Dr's know so little about herpes.

That is so frickin' irresponsible on the part of his doctor. It really burns me up when they give out information in areas they don't really know much about. This happens a lot with HSV, unfortunately, because it seems most general docs are not at all familiar with it.

You should also look at the Herpes Handbook published by Terri Warren, RN/ANP. She is a specialist in the field of STIs/HSV. She does address the fact that outbreaks can pop up in different spots in that book, I am pretty sure. I'll take a look really fast and post again if I can find where it is in the book.

Sometimes it is better if the info comes from a medical "expert" rather than just some anonymous person on a forum. That way it can "stand up" against his doc's misinformed crap.

:madd:

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RealisticGal

Okay, I found it...

That wasn't difficult --- found it right away.

Here is how Terri Warren explains the fact that HSV outbreaks may move around:

Where Does Herpes Show Up?

"HSV 2 can cause symptoms anywhere in the boxer-shorts area. That’s

because the virus lives in a group of nerves at the base of the spine

called the sacral ganglia. This group of nerves supplies sensation to the

entire pelvic area, not just the genitals, so outbreaks of genital herpes can

appear on the buttocks, hip, thigh, lower abdomen, anus, gluteal cleft

(that would be the “plumber’s crack” area), and, of course, on the geni-

tals. Outbreaks are not limited to the site where you were first infected

with the virus. For example, you might get outbreaks around the anus,

but that doesn’t necessarily mean that you first got herpes from anal sex.

The virus can travel along any nerve to get to the surface of the skin, not

just the nerve it came in on. I tell my patients that there are lots of ways

to get from New York to Seattle: you can take the interstates directly,

or you can take the back roads and other highways and still get there.

Herpes is the same. It can go back out the way it came in, or it can

follow a different nerve in the same nerve group and end up somewhere

else in the boxer-shorts area. And locations can vary from outbreak to

outbreak. Some people always have recurrences in the same location,

and other people have outbreaks that move. But if your outbreaks move,

don’t assume that you’re doing anything to move them. The virus just

picks a different nerve on which to travel. And no, we don’t know why

its travel plans change. So far, it’s managed to keep that a secret."

You should be able to download the entire Handbook here:

The Updated Herpes Handbook

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RealisticGal
thanks again, you have been very helpful..I am going to download her book.

Hi oxford45 ---

I am sure you will find Terri's Handbook very helpful!!!

Take care of you... :itsme:

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QueenJane

I would love to download Terri's book, but the link above leads to a page that says "it's not here". Can you help? Thanks!

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RealisticGal
I would love to download Terri's book, but the link above leads to a page that says "it's not here". Can you help? Thanks!

Sorry about the bad link. This one should work:

Updated Herpes Handbook

:wavey:

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