Christmas is over, the sales are on and I have hardly caught my breath after being away in the US for 3 weeks! How can it POSSIBLY be the end of the year already??!
We had the most marvelous time with our friends on the cruise to the Bahamas, even though the weather coming out of New York harbour was dreadful for 2 days and again for 2 days going back in! But we enjoyed yarning about things with old friends and new. Business was done, contacts made, plans revised for 2011, and altogether a good preparation for the work ahead. Then the snow in Vail, Colorado was fantastic! My son, Francois skied while I lazed (and shopped) and lazed again.
Here in sunny Queensland, the rain is beating down (we get most of our rain in the Summer, folks) while in Hobart they are on snow alert. Go figure. Problem is getting up on one’s hind legs to get going again now that I am back at work.
This year I will be working away on the book, and hopefully getting it to the publishers early in the New Year. Then I have to talk seriously to the women who missed my last half-day and 2-day seminars, and see if we can fit in another one before I go to Hobart in March. The webinars are a good idea in the meantime, but I feel the personal contact at a face-to-face seminar does make a difference. Let me know if you agree…
This month I am concerned about a couple of things of particular female interest.
The First Is A Bit Of A Shock, But You Need To Know
In the last 12 months I have seen around 4-5 women with outbreaks of genital herpes unexpectedly (i.e. they have not been playing around, but clearly someone has.) The sensation of herpes is one of PAIN, rather than itch like candida/thrush. Typically the first outbreak hits the hardest, with some of these women unable to walk straight because of the pain at the vulva. The lesions are very typical and the appearance alone is often enough to make the diagnosis, although I always send off a swab to be sure, to be sure.
It is essential that the woman gets on to an anti-viral such as Famvir or Valtrex ASAP to control the pain, the lesions and the infection from being transmitted to someone else.
I am always asked “How could this have happened?” The short answer is always “Through sexual intercourse”, even though there are loud protests that there has been no one other than the usual partner, for her.
I have even had men in the office with their distraught female partner, protesting that they have never had an outbreak and could NOT have been herpes positive. Alas, that is not quite correct. A person (especially a man) can be herpes positive, without ever having had an obvious outbreak, as their genitals are on the outside and the virus dies more easily on external genitalia, and if the man has been in good health and having good hygiene, he may have washed off enough virus to avoid having the outbreak, but his immune system is still affected and he still carries and sheds the virus!
Or, of course, he may be lying. It may have been so long since his original attack, or any attack, that he may have ‘forgotten’ it. The mark in the blood stays for life and there is evidence to suggest that the virus goes on being shed forever.
What is the difference between Herpes I and Herpes II? In the old days, long gone, when I was a young doctor, it was supposed that Herpes I was the typical cold sore herpes and only occurred on the lips. We all knew to avoid kissing someone with a cold sore, or avoid drinking from their cup or glass. And so it was thought that Herpes II was restricted to the genital form and was more virulent and had more side effects etc etc.
But then oral sex took over the world and suddenly we were getting Herpes I lesions in the vulva and Herpes II lesions on the mouth. So now it is impossible to tell without a swab and/or blood test what the infection status of any individual is.
What does this mean for my hormonal patients, or my menopausal patients?
It means a lot.
This is a time of life changes, both hormonal changes and lifestyle changes. This is a time when divorce is high, when finding another sexual partner may be high on a woman’s list of priorities, when she may need all the love she can find, wherever it is from. But she may be flirting with trouble if she does not have a set of STD checks, and insist the new man does also, prior to having unprotected sex. If he loves and respects you enough (as my Mum would say) he will do it.
If you have had the misfortune to have contracted herpes already, and very many women do (some of whom do not tell their partners, like men!) then it is recommended that you take anti-viral medication daily to stop the shedding of the virus and avoid any chance of passing it on to a person who is still herpes negative.
If the partner is also herpes positive (for either I or II, whichever is the infection we are dealing with) then there is no need for anti-virals as the other person is already infected and their immune system is already dealing with it, we hope.
This is a touchy subject but one which comes up often in the clinic and it is always distressing. It is far less distressing to ask him to have an STD check than it is to tell him you have contracted herpes, probably from him!
The Second Issue
The second problem is not strictly medical but causes a lot of distress, some of which boils over into clinic discussions. It is the subject of money. On every second show of Judge Judy some wench has given money to some ne’er-do-well who has either flown away with it, or who denies it was a loan, but says it was a gift. Women are far too generous for their own good.
I hear this a lot from distressed middle-aged women who should know better and who are therefore ashamed to take any public action to recover their funds. Relatives of the man involved are sometimes to blame, by inciting the man to consider it a gift from “that silly old cow”!!!@#$%$#@!
The scenario is typical. She has savings, he has none. He has a ‘pressing problem‘ which she wants to help him with. She hands over the money with the clear expectation that it will be returned, he uses it, then denies it was a loan, and she has no paper evidence of a loan.
The Moral Of The Story Is
‘Money never changes hands unless there is a paper to support the nature of the transaction.‘
It is either a loan or a gift, and the piece of paper should be signed while he is still in the mood to get the money from her i.e. not after the transaction!
Be warned girls. Get his viral status and his financial status straight before you give away your heart, body and bank balance!