DISCLAIMER: I’m no doctor. (And I don’t even play one on TV.) Any recommendations in this blog post — and on this entire site, for that matter — should be gone over with your doctor prior to acting on it. It’s just the smart thing to do.
There is no herpes cure (like a lot of sheisty snake oil salespeople out there would have you believe), but there are ways to keep the virus at bay. And medication is only the tip of the iceberg. My initial advice about medicating herpes is this: Don’t take it if you don’t have to. It’s a drug. And I try to stay as natural and drug-free as I can. You’d be amazed at how staying physically and mentally healthy can naturally suppress the virus (especially after you have given your body the 6-12 months to build up antibodies/immunity). That said, depending on your body, healthiness and a whole range of factors, taking herpes medication to make you more comfortable or to keep your herpes-free partner safe may be a viable option. Some people are under the impression that if they have herpes, they need to be taking herpes medication. That’s not necessarily true.
So before we even get into the actual medication options themselves, it’s important to determine for yourself whether medicating yourself is even necessary or beneficial. As far as I see it, there are only two solid reasons that you should take suppressive medication for herpes:
Suppressive therapy involves taking the medication on a daily basis to suppress the herpes virus. This form of medicating applies mainly to the two reasons discussed above. Taking suppressive therapy doesn’t mean you will avoid herpes outbreaks altogether, but suppressive therapy has been shown to lessen the frequency, severity and length of time of outbreaks. It also helps lessen viral shedding by around 50%.
Episodic therapy refers to treating herpes outbreaks on an as-needed basis as they occur. If you are single or otherwise not having sex with a partner who doesn't have herpes, this may be the option for you to lessen the severity and length of herpes symptoms. As you get more knowledgeable about your prodrome symptoms that signal an outbreak is coming on (tingling, burning, itching in the area of your outbreak or pain in your butt/thighs), you can take medication to attempt to cut the outbreak off at the pass. The sooner you can medicate at the first sign of an outbreak, the better.
There are three herpes antiviral medications available in tablet form:
Valacyclovir/Valtrex is more bioavailable, which makes it absorb quicker and you only need to take it once per day vs. taking Acyclovir twice daily. But ultimately, Valtrex becomes acyclovir in the body to help minimize outbreaks.
Depending on whether you're taking Valtrex (more bioavailable) or Acyclovir (less bioavailable), it might take a few days before it gets to work at minimizing symptoms and helping to protect partners from getting herpes. To be safe, after dry spells of not being in relationship, I would wait a week after starting to take acyclovir before having sex.