Suppressive Therapy: Valuable Treatment for Recurring Herpes Outbreaks

Since I contracted herpes, whenever I’ve gone to the gynecologist she’s always asked me to estimate how many outbreaks I experience per year.  I’m always taken back a bit by the question since, without medication, I tend to have about two outbreaks a month.  I guess that amounts to 24 outbreaks a year, give or take a few, but by the time I’ve done all the math out loud the doctor is already looking at me like I’m some immuno-deficient freak.  A friend of mine went through a similar situation recently when she told her doctor she seemed to have 12 outbreaks per year, pretty much every month around the time of her period.  It appears that the year is the smallest unit of time a doctor has to gauge the frequency of one’s outbreaks.  I suppose for many people that is as low as it needs to get.  But for those of us who calculate our number of outbreaks by the month, or week, it may be time to go on suppressive therapy – that is, taking a daily anti-viral medication to prevent outbreaks from even occurring.

I have been on suppressive therapy for almost six months now.  Before that I spent about two and a half years using episodic treatment and exploring alternative medicine, and before that I spent three years on suppressive therapy.  The whole time I have taken either Acyclovir or Valtrex.  Before getting herpes, I was never one to rely on daily medication.  In fact, I’m pretty suspicious of corporations and the US health care system as a whole.  Therefore, I believe that people who don’t suffer outbreaks (or experience them very rarely) should not go on suppressive therapy.  Also, those who don’t have herpes should not use suppressive therapy as a way to try and prevent transmission from their partners.  It is not a vaccine.

If I could go without the anti-virals, I certainly would.  But I have to admit, those little pills have really helped me be able to live a normal life.  Not only do I not experience any outbreak at all when I’m on suppressive therapy, but I’m also confident that taking Acyclovir daily is decreasing my level of contagiousness (which is probably higher than most).  The only disappointment has been that my doctor originally told me that after being on suppressive therapy for a year or two, I could stop and would have few, if any, outbreaks.  Unfortunately that hasn’t been the case, and now I’m working on strengthening my immune system and waiting for a cure while I pop pills each day. 

So the upside to suppressive therapy is I feel healthy and good while I’m on it!  What are the downsides?  Well, for one I am bad about taking my medication regularly and on time.  Typically suppressive therapy is one pill (in my case, 400 mg of Acyclovir) twice a day, ideally 12 hours apart.  Since I already take fiber in the morning for digestive problems, and it’s not recommended to take medication with fiber supplements, I try to take my Acyclovir with lunch and before bed (roughly noon and midnight).  But it just doesn’t always work out as planned and I sometimes feel light symptoms.  (I'm convinced the stress of remembering to take the medication is counteracting some of its benefits.)