I have been receiving your newsletter for several years now and generally find it useful and helpful. As a 47 year old woman that contracted HSV-2 only five years ago from a former boyfriend, I usually gravitate towards the “Ask the Experts” section as I find that informative. I generally would never comment, however, one of your comments must have raised my blood pressure several notches. In response to a question about menstruation as a trigger for outbreaks, you respond: “While there are anectdotal reports from many women who feel that menstruation may be a trigger for their herpes outbreaks ...” Anecdotal?! As an FYI, the only reason that I am on daily suppressive therapy is that every time I got my period I would have a horrible outbreak!
Your concern is understandable. When we used the term “anecdotal” it was not meant to be pejorative or dismissive. The Helper goes through rigorous review and we must be careful with the language we use. Therefore, when discussing trigger factors for outbreaks, in this particular case menstruation, we employ caution when stating accounts of what people experience versus what has been researched or published. There has been no research that demonstrated any connection between menstruation and outbreaks. In fact, one study did demonstrate that there was no connection between asymptomatic shedding and the menstrual cycle. While not dismissing your account and those of others who cite menstruation as a trigger, more studies need to be conducted in this area to underscore a relationship between menstruation and outbreaks. Until this is done we can only refer to it as anecdotal evidence.
Brock BV, Selke S, Benedetti J, Douglas JM, Corey L. Frequency of asymptomatic shedding of herpes simplex virus in women with genital herpes. JAMA 1990, 263:418-20.