Emotional strain of genital herpes concerns reader

Q. I desperately need your help. I was diagnosed with genital herpes three years ago, and this diagnosis has left me full of emotions. I am crying as I write this letter.

For fear of scorn and rejection, I cannot disclose this to anyone. I won’t ask for a prescription because if I got it filled, anyone who works in the store would know, even the kids they hire after school.

Are there any over-the-counter vitamins I can take to help with the discomfort and pain? I feel tremendous pressure to maintain this secret. The only reason I haven’t killed myself is because I have kids. I am afraid I could pass this on to them, so I constantly wash my hands and disinfect the house and car.

A You are not alone. It is estimated that one in five Americans (45 million) is infected with genital herpes. Counseling can sometimes help overcome the emotional strain of this infection.

There are effective antiviral medications to prevent outbreaks or shorten the duration of an attack (Current Opinion in Infectious Diseases, February 2008). Your doctor could prescribe acyclovir (Zovirax), famciclovir (Famvir) or valacyclovir (Valtrex).

You should not worry about the pharmacy where you buy the medication. Your privacy is protected. If you prefer, though, you could use an online or mail-order pharmacy service. That way you wouldn’t even have to go to a pharmacy.

The virus that causes genital herpes is spread primarily by sexual contact, so you won’t infect your children. Of course, during an outbreak, frequent hand-washing is advisable.

Q. I take hormone replacement in the form of bioidentical hormones from a compounding pharmacy. The prescription is a triple-estrogen compound with progesterone. The compounding pharmacist stated that because all three forms of estrogen are used, the risk that accompanies Premarin or Prempro does not exist. Conventional hormone replacement does not contain all three forms of estrogen.

Is this accurate? I have tried conventional hormone replacement in the past and was completely miserable, while I feel great using the bioidentical product.

A. Conventional hormone replacement therapies such as Premarin and Prempro contain a variety of estrogenic compounds. These are, however, estrogens that horses make, so they may be somewhat different from the estrogens your pharmacist used in compounding your prescription.

There are many claims that compounded hormone therapy is safer than conventional HRT. There are no studies to prove that statement, however. The Food and Drug Administration considers claims that bioidentical hormones are safer or better than conventional therapies to be false and misleading.

To better understand the pros and cons of hormones, we are sending you our Guide to Estrogen: Benefits, Risks and Interactions.

Q. I have a history of sleeping problems. I just started taking half an acetaminophen PM tablet (1‚Ñ4 the adult dose) just before bed. This allows me to sleep through the night. Is this safe?

A. If pain is not an issue, you don’t need the acetaminophen. The PM part of the pill is diphenhydramine (DPH). This is the antihistamine found in Benadryl, and it makes people drowsy. At the dose you are using, there should be few, if any, side effects.

X In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of The Vindicator or e-mail them via their Web site: www.PeoplesPharmacy.com.

2008 King Features Syndicate Inc.