HSV & Herpes Testing: The Houseguest a Lot of People Don’t Know They Have

Healthcare guidance, pricing, and availability may change. This episode is for educational purposes only and is not medical advice.

Rebecca: Let me share my screen. Okay. Whoa. Put my glasses back on. Oh, shoot. It must have been cobwebs in your sink. But she said, "If anybody's going south on Jane, I want everything figured out and, and tested." She was kind of, you know, a little bit Southern accent, you

Tristin: Yeah. That's funny. Love it.

Welcome to Please Health Me. I'm Tristan, and each week I bring real health questions from around the internet to my mom, Rebecca, a board-certified family nurse practitioner with 45 years of experience. Together, we try to make healthcare a little easier to understand so you know more about what's happening, what questions to ask, and what options you might have.

We're here to educate, not diagnose or treat medical conditions. What we discuss should never replace advice from your own healthcare provider.

Oh, and a quick heads up before we dive in. This episode felt like it needed a little something extra to go with it. We usually do a checklist, but this time we built you an interactive guide. It'll be linked in the episode description and on our site at pleasehealthme.com. If you've been tested and you have your numbers, you can plug them in and see what they mean right there based on everything Mom's about to walk us through. And really customize this episode to you.

All right. so this episode actually started with you. You told me that, you wanted to talk about herpes because it was such a hot topic when you had your clinic, and it came up all the time, just not even, medically. People were super anxious about it, confused about testing, worried about relationships, and then just, trying to figure out where it came from

Rebecca: Yes. herpes testing has always been a bugaboo for providers. people would come into the clinic extremely upset over the fact that a partner was recently told they had a positive herpes test, or they themselves had a positive test for herpes when they had never had any symptoms

Tristin: Yeah, and of course, in my true fashion, I went out and I did my pool of internet questions, and wow, it's crazy how much chatter is out there about this. but what I think really got me the most was how emotional the questions are. They're not just basic what is herpes questions. They're, do I actually have it?

Who gave it to me? And then, even deeper, can I still date? Can I give it to somebody when I don't have symptoms? So I wanted to bring some of those questions into the conversation today, but before we get into any of that, what even is herpes?

Rebecca: So herpes is a virus, and that's caused by HSV, which stands for herpes simplex virus. It spreads through direct skin-to-skin contact and is a lifelong viral infection because once you have the virus, it stays dormant in nerve cells for life

Tristin: So it's basically a house guest that moves into your attic, AKA your nerves, and never moves out. Most of the time, it's like this quiet guest up there, but every so often it comes downstairs and basically makes its presence known, and might even decide to trash your living room. okay, let's start where the testing ended up being the bugaboo for you, because this was the part I didn't expect.

We're always told, or even get from pop culture, that if you're worried about an STI, get tested. But with herpes, you said testing itself could sometimes create more confusion. Why?

Rebecca: yeah, it was actually easier to deal with people who presented with the classic symptoms of burning, itching, and lesions because it's pretty easy to diagnose herpes on exam. if the person comes in with a history of burning and tingling in the area, then red papules that become blisters, then dry and scab, that's herpes.

that's not to say it was an easy diagnosis to give someone. they were understandably upset. But the people who had never had symptoms of herpes and had a positive test after a blood draw were much harder to deal with

Tristin: Yeah, I'm sure there's a major difference between, "Hey, the house guest is obvious and trashing my living room," to those who were like, "I have a guest in my attic that I didn't even know was living up there." Like, that's just a scary movie just started.

Rebecca: You know, as providers, we knew that herpes tests were not always reliable and had high rates of false positives in people who had never experienced symptoms. So that's why I did not like doing them on people without symptoms. People would come in wanting to be tested for STDs and herpes because they were entering into a new relationship.

This was laudable, but it would also make me cringe because I would frequently get a positive test that would send the patient into a tailspin of anxiety and blame. I mean, we're talking about relationships and marriages and guilt. It was really upsetting for people, and it would take a lot of time to explain and reassure.

Tristin: Yeah, which is interesting because from the patient's side, getting every test sounds like a responsible thing to do. You feel, "I'm clean. I can tell my partner that I'm clean," and you feel, honestly good about that. And with a test, you think you're gonna get certainty, and instead you end up with this result you don't completely understand.

And there was a lot of discussion about this. For example, Alex 26 in Chicago says, "I've never had any visible sores and thought I was good. I had a new partner, and we decided to be responsible and go test for everything. My herpes titer was positive for HSV-1. I couldn't believe it. I don't understand, and I don't know what I'm supposed to do."

yeah, Alex had a house guest, and they did not know it was there. What would you like Alex to know?

Rebecca: this is what I mean about testing. When there have been no symptoms in the past, what makes this worse for her is that HSV-1, we can't distinguish where in the body she was infected or when. It can mean she acquired the infection as a child in a non-sexual way from close contact with a family member or sharing utensils or another child shedding the virus.

But it can also mean she acquired it as an adult through oral sex from someone with oral viral shedding

Tristin: Wait, so it could be from a family member when she was a kid or from a partner as an adult. And of course, the test can't tell the difference with that wide swing of scenarios. So I'll go out on a limb and I'll guess the oral sex part is why HSV-1 is showing up below the waist more

Rebecca: yes, it is. Genital HSV1 is on the rise because of oral sex, obviously, especially in college students and young adults. this positive tells her that she acquired the virus at some time in her life, and the positive thing about this is that she's lucky to never have had any outbreaks, and also that shedding occurs early in HSV1 infection, and it drops rapidly over, after over the first year.

so she may have been positive for a very long time, so she may not be shedding virus very often at all. The downside is we don't know where she is positive, oral or genital. So where she would be shedding from if she is shedding virus. I think this helps explain why herpes is so prevalent.

Up to eighty to ninety percent of people with genital herpes are unaware they are infected and that they can shed virus asymptomatically. So you can see there should never be a blame game going on here

Tristin: Wow. Okay, 80 to 90% don't know. So the person you're dating probably has no idea, and honestly, you probably don't either. again, this could be perceived as a scary movie with some houseguest up in everyone's attic.

Rebecca: Are you on to something with Halloween or something?

Tristin: maybe.

Rebecca: Okay, so on top of all of that, if that wasn't enough, there is a possibility of a fal- a false positive test. the HSV EIA one and two is the test name used for herpes. The labs use what they call an index value when they report the result. So just a lot of tests, there are ranges of positives and negatives indicated in number values.

So in herpes, an index of less than 0.9 is negative. A value of 0.9 to 1.0 is equivocal, meaning unclear or misleading, and over 1.1 is considered positive. But an index value range of 1.1 to three has been shown in studies to have a false positive rate of 60%.

Tristin: Wow。

Rebecca: The CDC recommends testing with a second method called the Biokit Rapid Test or Western Blot before considering your test is truly positive, but that's easier said than done

Tristin: Hold on. So if my patient portal says 1.5 positive, I'm in the range where it's wrong more than half of the time, so I might not even have a house guest at all. I can totally understand why people would want confirmation. So how do I get that test?

Rebecca: Well, as I said, there are two tests that are supposed to help confirm a positive result. The Biokit, which I couldn't find any information on, or the Western Blot. So you might think you can go to a lab and get this done, but no, you have to obtain a Western Blot kit from the University of Washington Virology Research Center.

The test kit is free, but that is where the good deal ends. once you have your kit, you must take it to a local lab for a blood draw, and that is if they would do this without an order from a provider, otherwise you have to go to a provider for the order. The sample must be spun in a centrifuge and then sent back to UW frozen.

So the testing fee of that is $250 to $300. The blood draw is probably $25.50. then you have overnight shipping, which can be $50 to $100 since it's packed in dry ice, and no insurance covers this.

Tristin: Yeah, so it's like, "Yay, free kit," but then you're met with a lab that may or may not draw your blood, a centrifuge, dry ice, and around 300 to $450 just for one test

Rebecca: not simple. and it's no wonder that the latest from the CDC and the USPSTF, which we talked about before as a group of experts, is that they don't recommend testing at all for asymptomatic people.

Tristin: うん、

Rebecca: So all we can do is counsel people about their low index tests, let them know they aren't accurate at that level.

I know it's poor comfort, but it's important. if you repeat the test in three months and the result increases into the positive range, then you know it was a recent exposure and you are positive. But if the number is still in the one to one to three, you still can't be sure you're really positive.

Tristin: Okay. So the first thing is don't just see the word positive and stop there. If, maybe if you work at, in that lab at UW, you could get the actual result. Um, maybe. If not, you can always take another shot at retesting. But, it's really important to understand what kind of test you had and what that number means, and I think we all just freak out if something comes back in with positive, so best just not to freak out

Rebecca: exactly, and everyone did, and it's difficult to explain all that, in the timeframe you have in the clinic. but it's true. you wanna look at the number value and understand those numbers before you freak out.

Tristin: Yeah. And I saw that a lot in, in some of the questions, that I was going through. So that helps with the testing piece, but another thing I noticed in the questions was that people use herpes like it's one single thing, and I started seeing HSV-1, HSV-2, oral herpes, genital herpes. So can you kinda help straighten that out?

Rebecca: Sure. there are two types, type one and type two. Type one is typically the oral lesions that historically we used to call cold sores. I think people still do, but it's herpes. And type two is typically genital, buttocks, anal areas, ba- basically below the waist lesions. But with the prevalence of oral sex, herpes type one now accounts for up to half of first episode genital herpes. herpes type two causing oral herpes is uncommon, and while it happens occasionally, it rarely causes recurrent outbreaks because it doesn't establish well in the nerve endings in this area

Tristin: So even the shorthand of HSV-1 equals mouth and HSV-2 equals genitals isn't really enough anymore

Rebecca: Right. The Good thing about type one, like I said,if you have type one in the genital region, it recurs far less frequently than herpes two, and viral shedding also declines rapidly over the first year. I would have patients who had an outbreak very rarely, sometimes with years in between, while others who had type two had them four or more times a year.

So it was likely that those who had those few outbreaks had a genital type one.

Tristin: Which also explains why two people can both say, "I have herpes," and have really different experiences with it

Rebecca: Exactly right

Tristin: The other thing I ran into was another whole category of questions that were basically people looking at like a bump or a rash and thinking, "Oh no, is this herpes?" here's a couple that I pulled around this. So Maya, 25, in Austin says she shaved, had sex that night, then noticed bumps in the vaginal area.

Then I saw another person who was told a spreading itchy rash was that impetigo?

Rebecca: The Tygo.

Tristin: Impetigo. Okay, never would've gotten that. And then was later told it was HSV. and their question basically is how do I know when something is herpes versus something else?

Rebecca: Well, I mean, the fact that Maya shaved then had sex, her bumps are probably due to friction on newly shaved hair follicles, which can irritate

them. if symptoms subside in a few days and don't escalate to the bumps, the blisters, the irritation, all that kind of thing, this irritation is from the follicles, and it's called folliculitis.

That's the term you would use. In the other case, the provider was confused about what it was, I'm assuming because it was on their lips, which could mimic impetigo. impetigo in the genital area is rare in adults. More of a child thing. Again, herpes has a clear path of symptoms.

You first feel tingling or burning in that area that will break out with red bumps, and then they become blisters. It alternates between painful and itchy, and then blisters break, the area dries and scabs over. This is a 10 to 14-day process, and if you're not using any antiviral medication. So if those don't match your symptoms, you likely don't have herpes.

Tristin: Okay, so for Maya, it may just be irritated hair follicles from shaving. If it doesn't turn into blisters in a few days, that's actually a good sign.

Rebecca: Mhm

Tristin: And for the person who was told

impetigo first, even a provider can get it wrong on the first look. So knowing that pattern, tingling, then bumps, then blisters, then scabs, gives you something to kind of go back with, "Here's what happened in this order.

Could this be herpes?"

Rebecca: Right. I mean, sometimes people don't come in with all those lovely, bumps or blisters or scabs to look at. it- they're in a certain, timeframe of that outbreak. so sometimes it could be a little confusing, but if they know that history and that history happened to them, that's what it is.

Tristin: Yeah. And once everybody knows it's herpes, then naturally that's where the blame game immediately kicks in. Like, "Who gave me this?" And there were some interesting stories that came through on this one. Lauren, 31, in Denver, has dealt with acne around her mouth for years and didn't think twice about a spot on her lip.

After oral sex, her boyfriend developed genital symptoms, and she later tested positive for HSV-1, and she feels horrible and says essentially, "I did this to him." How much of that is guilt? How much of that guilt is fair when someone genuinely didn't know?

Rebecca: many people start the blame game. "Who gave me this? My partner gave me this." they're upset that someone would knowingly give them herpes, but this needs to be explained well that many people who either have tested positive without symptoms or don't know their status can shed virus at any time and potentially give an infection to someone.

That's why herpes is so widespread. not much consolation, but you can't blame people especially if they never had symptoms, they don't know.

Tristin: Right. And I think that's a really important distinction. You know, like going back to the guest upstairs, not everyone knows that they have one in their attic. You know, knowingly hiding something from a partner is totally one situation. Not knowing you have that guest or not recognizing something and, thinking it, you know, a cold sore is not herpes is a very different situation

Rebecca: Right, right

Tristin: Yeah.

So then that takes us, of course, right into the next question people had, and there were many. If somebody tells you they have herpes, what does that actually mean for having sex with them? So interesting one I pulled, Chris, 29, in Seattle, says the woman he's seeing told him that she had genital herpes six months ago but hasn't had another outbreak.

She isn't taking daily medication and told him she can't transmit it unless she's having an outbreak. And he wants to know, is that true? Can you have sex with someone who has herpes without automatically getting herpes?

Rebecca: If only one partner has a herpes history, the transmission rate without taking any preventative measures is about 10% per year, and that's from the viral shedding we talked about. The highest risk of shedding occurs just before the person's outbreak, but it can actually occur at any time. He didn't say what type of herpes she had, which affects the rate of shedding.

he also didn't say he knows he has a negative herpes test. Does he know his status? Maybe he is a- asymptomatic and can also shed. it's not uncommon at all that people don't know or, they don't think that they can give, herpes unless they have lesions. I mean, It's been such a confusing subject.

So if she says that, it doesn't mean she knows that and is just saying that. She may just not know

Tristin: Yeah. So it's not no outbreak means no risk. There's still a risk because of the shedding you were talking about. Yeah

Rebecca: measures like taking suppressive antiviral medicine and consistent condom use can reduce the transmission to risk, to about 1% to 2% a year. Very

Tristin: Wow. Oh yeah, okay. That's interesting. That's a huge difference. And I think it's helpful because it turns from this, scary yes or no thing into an actual conversation between two people. there is a risk, but there are ways to reduce it, and both people kinda get to decide what they're comfortable with

Rebecca: Right. it's a personal decision. I mean, he may ultimately decide, "I don't want to take the risk with this partner." but as he dates others, he continues the risk, and maybe another woman will not be as forthcoming as she was

Tristin: Yeah, that's fair. And this was something that came up a lot when reading about this topic. It wasn't so much about the physical as it were about people that were diagnosed and how to navigate the dating scene again, and this was part of the questions that honestly hit me the most. They were talking about whether anybody would ever want them again.

Rebecca: Right, right

Tristin: And we had several versions of this, like Sophie, 27, in Boston, has genital HSV and says she feels like her attractiveness disappeared with the diagnosis. And Marcus in 23, Atlanta, said he has matches and people interested in him, but he keeps avoiding them because he's terrified of having to disclose.

And another woman said a partner initially told her HSV wouldn't matter, and then ended the relationship after she tested positive. I mean, are these the kind of things that you saw in your clinic?

Rebecca: Yes, every version of that. it really affects people. I used to think, "Okay, okay. Yes, you have herpes. It's not the end of the world." But for a lot of people, emotionally, it feels like it is. I've had people say, "I'm never having sex again because I don't wanna give it to anybody." That's horrible. I mean, it can affect how people see themselves, relationships, dating, intimacy.

I would try to tell them how prevalent it is, and the best thing is just to be forthcoming. since it is so prevalent, people have found ways to adjust or control. Maybe there should be a dating site where you check the box HSV one or two, and then n- you never have to say anything. I mean, someone could see it and say, "Oh, okay, I have HSV two also.

No big deal."

Tristin: Yeah. I mean, honestly, that might actually already exist and we just don't

Rebecca: Yeah, maybe.

Tristin: when was the last time you were on Tinder or Grindr, Mom? Or me? Never. I haven't either. but I-- And actually it brought up an interesting point because Grindr, I know recently, within the last couple of months, bought up a health company and have a health platform, I should say.

And yeah, they put sexual health and sexual education in, I think, some of their missions, and that was, like, a big statement for them to say, "Hey, everybody has health things going on. Let's make this part of the community and part of the conversation and everyone safer."

Rebecca: Yeah. Well, that's good, good for them

Tristin: yeah, it's kinda interesting.

what was cool though, and going back to that, I did also find another side about the more positive, kinda going back to the Grindr conversation and making it more of a not a taboo topic. Nina, 30, in Portland said that she was so terrified to disclose after getting genital herpes. Now she learned how to have safer sex conversation and started talking openly with partners and said she wasn't rejected by any of them.

So-

Rebecca: Oh, that's So nice to hear. And, that's important because people think they're alone. boy, they're not alone at all

Tristin: Yeah, exactly. And another person said that once she finally told people she had herpes, suddenly her mom said that she had it, and then another friend said they had HSV-1, and then somebody else knew somebody with HSV-2. It was almost like nobody knew how common it was because no one wanted to be the first person to say it out loud

Rebecca: Right. I mean, it's very widespread. it's a virus and people get it. The stigma around it can be much harder for people than the actual outbreaks

Tristin: Yeah. I mean, it's not me saying no big deal. Some of these people are really struggling. I'm just saying the shame shouldn't be, like, the heaviest part. And I think it can be really hard because there were also people saying, "No, this actually is a big deal for me. I'm getting outbreaks over and over again," which I can imagine could be really hard when you're dating.

We had a few questions like this. One person says they're getting outbreaks every month. So Erin, 32, in Minneapolis, had been outbreak-free while taking Valtrex, stopped taking it, and then had another outbreak around her period. Other people describe stress or shaving seeming to trigger theirs. What can somebody actually do, when these outbreaks keep coming back?

Rebecca: Well, the Advent of antivirals such as the acyclovir or the valacyclovir, which is Valtrex, for treatment was such a boon to controlling this disease. Before these medications, people would suffer through 10 to 14 days of changing symptoms. I used to become frustrated with providers who would dole out a certain amount and tell them to take two times a day for a week.

I t- I never did it that way. It's important to take a big dose right away when you first notice symptoms. The earlier, the better, because you can stop the virus in its tracks. I mean, you won't even have an outbreak if you are able to take a large dose right at the beginning. and as you take these medications, you'll get to know exactly how much and how long you need to take them to tamp down that virus.

Sometimes people will take three to five acyclovir 800s a day the first day or two, and that's all they need, and it's gone. same with Valtrex, maybe three times a day, the first day and it's gone. So again, you'll get to know what it will take for you, but generally, loading up early will stop the virus from rising to the surface, so to speak

Tristin: Yeah. So timing is everything, which, means you have to know when it's coming. So it's like when the house guest is coming down from that attic. so then it becomes how do you know when, they're on their way down? Or what do people actually feel before an outbreak?

Rebecca: yeah. People eventually get to know their own particular signs. For some people, it's the classic tingling or burning somewhere and you go, "Uh-oh." And then some people who have type 2 may notice abdominal bloating, simple as that, for a few days before, or extreme fatigue all of a sudden. "Oh, I'm so tired today," and then the next day, an outbreak.

a patient of mine gets a minor scratchy throat as if she's getting a cold before an oral outbreak. It's really individual, and you'll get to know what your symptoms are.

Tristin: So part of living with it is listening for that house guest making its way down

Rebecca: Right. And Make sure you have medication available. Don't wait until you need it and then discover you don't have any. 'Cause again, you wanna have it at home and on hand and start it really early. Earlier the better. if you have a provider that knows you have outbreaks, they should provide you with scripts and refills 'cause it's an ongoing process.

Tristin: And if somebody is having outbreaks constantly or feels like their medication is creating other problems from them, that's the point where they need to go back to their own provider and talk about their particular treatment plan.

Rebecca: They do

Tristin: So Mom, we had a few interesting outliers that I would love to explore with you.

we get some unusual questions, and we've even had them on other episodes, and they seem to be interesting to kind of explore for both of us. So first one I thought was interesting was about a side effect. And to summarize, I found this question: What if I'm having frequent outbreaks, but I also feel like Valtrex is affecting my mental health?

Is that a thing?

Rebecca: yeah, it is a thing. Valtrex has been known to cause neuropsychiatric adverse reactions in some people. the drug label states this. I'm not clear if she's taking suppressive therapy, which is a daily dosing. also, is she taking any other prescriptions that could be interacting with Valtrex?

if she's taking daily suppressive therapy, then she should not with this type of complaint. if she takes at onset of symptoms for just two or three days and tamps down the outbreak, maybe that can help by not taking it very long. But if you still feel adverse effects while you're doing that, you don't have any other choice than to stop the medicine.

I mean, look at stress. Why is it suddenly increasing? It is common to have some outbreaks with menstrual periods 'cause of the hormonal changes. but maybe in that vein, I don't know if she's on birth control pills, or even needs them. I'm assuming she does.

But,she could try continuous birth control pills so that you have a period once or twice a year, and then that hormonal change won't happen. Maybe that will help with the, the outbreaks.

Tristin: Okay. So that's good to know, and actually really interesting. the next one was about supplements. I actually feel like I've heard this before. The question actually is, "Do lysine, vitamin C, or other supplements help prevent outbreaks?"

Rebecca: Well, no. No studies have shown any benefit in prevention from taking either or both. if you feel that it helps you, there's no harm in taking them, but there aren't any studies to prove that they work

Tristin: Yeah. I wonder if it's like a marketing message. so the next one, I know we talked about the stigma and then also people wondering how to disclose. Maybe this is like more for the therapist world, but I would love your take from all your experience with people finding out their results. I saw a lot of what do I actually say when I tell a new partner I have herpes?

Rebecca: you should give them an understanding of what type you have, and that's why you should know what type you have. how often you have the outbreaks, how long you've had herpes. tell them early in the relationship, obviously before things are sexual, so they don't feel ambushed. if you're calm and caring, informative, they should respond in the same way.

I can't tell you how many people stress about this, and then the other person says, "Oh, I'm positive too, and I'm so relieved you brought it up first." you can make a plan going forward, such as discuss suppressive therapy. in my clinic, I had people who wanted suppressive therapy, and they knew what dose would work for them.

but not that many did. I mean, you shouldn't be having outbreaks all the time. that doesn't happen, unless you're, you know, high stress or whatever. don't think you're just gonna have this all the time, and it's just gonna be a huge problem for you.

some people start, where they have it quite often, and that's what kinda drives them to suppressive therapy.

Tristin: Ja

Rebecca: But consistent condom use, of course, is very helpful in preventing transmission

Tristin: yeah, I mean, earlier you mentioned that. That's a really good way to prevent. And then what about family? Like, if both partners test positive, is there any reason they need to tell their families?

Rebecca: Absolutely not. I mean, this is a personal subject between you and your partner. There's no reason anyone else needs to know other than your provider if you are female and pregnant with a genital herpes history, then your provider needs to know, but nobody else does

Tristin: Yeah. Yeah, that's fair. Wow, so we really covered a lot today. And, we started this because herpes was something you dealt with constantly in the clinic, and then I pulled the questions and realized people are still asking the exact kinds of questions you were hearing from patients: Is my test right?

Who gave this to me? Can I give it to somebody else? Will anybody ever wanna date me again?

Rebecca: Yeah. I mean, there's always still a lot of questions because we really haven't had good answers, for a long time, and we still don't have an answer anybody wants. I mean, I hope that someday we do, but, the first thing I would say is, if you have a positive result and never had symptoms, get your results and look at the numbers we discussed.

Talk with your provider and make sure you understand what that actually means, those numbers. And, understand that someone can give you herpes without knowing it, so don't immediately become angry and blame someone. they will feel bad enough, and you should discuss it with your partner, but understand how this virus works.

If you do have outbreaks, they can be controlled. Learn your own signs and have a plan and have your medication available.

Tristin: Yeah. I think my takeaway from reading all of those questions is that, there's the virus and then there's everything we built around the virus, such as, the fear, the shame, the blame, the idea that, you know, your dating life is over. And knowing what herpes actually is seems to take at least some of the power away from that second part.

Rebecca: Exactly.

Tristin: And if you're listening because you're in that panic searching the internet phase right now or worried that the unwanted house guest in the attic is going to make an appearance, hopefully this gave you a little more context and a few better questions to take to your own provider. So thank you to everyone whose questions we used.

And if you have a question, send it our way at pleasehealthme.com or @pleasehealthmepod on Instagram.

And don't forget, the interactive guide is in the episode description and at pleasehealthme.com. Got your numbers? Plug them in.

There are also questions to take to your provider, the pattern herpes follows so you know what you're looking at, and a telling a new partner script that you can customize so that conversation is a little easier to start. Think of it as house rules for your house guest

And thanks for listening to "Please Health Me."

Rebecca: Bye

Tristin: Bye.

Thanks for listening to Please Health Me. If you found this episode helpful, pass it along to someone else who might too. And if there's a health question you want us to talk about, send it our way at pleasehealthme.com. We'd love to hear what you're wondering about, because chances are, other people are wondering about it too.

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