I’m 52 years old and my doctor just told me I’m in menopause. Although I was diagnosed with herpes in my twenties, I haven’t had problems with outbreaks until recently. Now they’re coming at regular intervals. Is there a connection between menopause and increased herpes outbreaks?
While researching your question, we were surprised to discover that there has been little scientific research done on menopause and its relationship to herpes outbreaks. Therefore, we decided to consult an expert in the field—Dr. Gary Richwald, MD, MPH, communicable disease specialist and Medical Adviser, L.A. and Orange County HELP groups—for insight and answers. Dr. Richwald confirmed that there isn’t much in the scientific literature describing this problem, but there is anecdotal evidence that suggests that there may be a causal connection.
Stories from other women confirm that you are not alone in what you are experiencing. A significant number of women report having outbreaks during perimenopause when they had not experienced them since young adulthood, Dr. Richwald notes. This may be attributed to the physiological changes that women typically experience at the onset of menopause. As Dr. Richwald explains, “During menopause many women start to have more vaginal dryness due to a reduction in estrogen. When there is not enough lubrication, there are greater frictional forces during intercourse and we know friction causes herpes outbreaks.”
While this new development of more frequent and regular outbreaks can come as an unwelcome surprise, the good news is there are steps you can take to treat and manage this. Dr. Richwald recommends the following steps for menopausal women experiencing renewed herpes outbreaks:
- Emotional counseling
A number of menopausal women experience increased stress and some emotional insecurity. Emotional counseling may help relieve stress, which, in turn, may help control outbreaks.
- Lubrication counseling
Patients may be counseled on the different over the counter lubrications that may help relieve dryness during intercourse.
- Counseling on natural lubrication
Menopausal women need more time during foreplay for their bodies to make natural vaginal secretions than they did as younger women. Communication with one’s partner about the importance of foreplay and lubrication is important.
- Prescribe suppressive therapies (valacyclovir, famciclovir, acyclovir) and short-term estrogen use (if supplements can be taken) to restore lubrication and better function
It may take up to six months of estrogen therapy to relieve vaginal dryness. During that time, the antiherpetic medicines can help suppress the outbreaks until the hormone therapy can resolve problems the vaginal dryness.
You may want to talk with your healthcare provider about these steps, and ask about options in antiviral therapy, if you aren’t already on a course of antiviral medication already to manage outbreaks. Good luck!