DEAR DR. DONOHUE: I am a 40-year-old woman whose life is over and ruined. I have a herpes infection. I burn and itch all the time. I cannot take herpes medicine because I am allergic to it. I don’t know how to live in such agony every day of my life. Please advise. My doctor wants me to see an infectious-disease specialist. What good would that do? – Anon.

More than 50 million North Americans have genital herpes. Anywhere from 500,000 to a million are infected every year. None of these people has to live a celibate life, and none of them is in daily pain from herpes. There are points to your story that don’t add up.

The first outbreak of herpes generally starts as a cluster of small red bumps. The bumps evolve into tiny blisters and then progress to a sore. A woman might have a vaginal discharge and sometimes feel pain on urinating. In two to six weeks, the sore pain and discharge clear. Periodically thereafter, similar outbreaks occur, but symptoms are almost always less intense.

Transmission of the virus is most likely when there is a visible rash or in the day or two preceding the rash. In the pre-rash stage, people often have a tingling, burning or itching sensation in the spot where the rash is about to appear. Infected people ought to abstain from sexual relations when the herald symptoms are present or when the rash is visible. Condom use at other times provides a substantial reduction in the risk of spreading the virus.

Your symptoms do not sound like herpes. I have never seen a person in whom or reports in the medical literature that herpes causes constant, daily, unremitting symptoms. Definitely see the infectious-disease specialist. That doctor can perform some tests that establish the nature of your symptoms. You need more than a visual inspection of your rash to prove the diagnosis.

Herpes is an epidemic infection. The infection is often misunderstood. The recently published herpes pamphlet offers all the herpes facts and treatments. Readers can obtain a copy by writing: Dr. Donohue – No. 1202, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: At age 43, my husband had a heart attack, which he survived. No one in his family has had one. His father is alive and active at age 83. My husband was a faithful jogger, a prudent eater and a nonsmoker. How could he have had a heart attack? Could it be stress? He worked 80 hours a week. – M.C.

Stress is a factor in some heart attacks. For most heart attacks, an interplay of many factors is found. I must admit, your husband did everything that is supposed to protect a person from heart attacks. The only things you did not mention were his cholesterol and blood pressure. If both were normal, then stress is a reasonable answer.

Stress stimulates the release of stress hormones. For the short haul, those hormones are protective. They gear a person to fight or flee. For the long haul, those hormones are destructive. They make blood platelets sticky, and that causes clots to form in heart arteries. They play a number of other tricks that threaten heart health.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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