Sexual intercourse. Some people find that the friction of sexual intercourse irritates the skin and brings on symptoms. Using a water-based lubricant can help reduce irritation. Don't use one that contains the spermicide nonoxynol-9, however. Nonoxynol-9 can irritate mucous membranes, such as the lining of the vagina. Oil-based lubricants are a no-no, too. They weaken latex, making condoms more likely to break. Even if the friction of intercourse seems to be a trigger for symptoms, it probably won't cause a flare-up every time.
Hormones. Hormonal changes, like those that occur in the menstrual cycle, can affect genital herpes outbreaks.
Surgery, weak immune system. Trauma to the body, such as having surgery, may make herpes symptoms appear. Having a weakened immune system does, too. People whose immune systems are weakened by HIV or chemotherapy, for example, tend to have outbreaks more often than people with normal immune functioning.
Remember that triggers may not be the same for everyone, and doctors are not certain how much lifestyle affects herpes symptoms. If you think one triggers your symptoms, ask your doctor what you should do about it.
The American Social Health Association: National Herpes Resource Center. Terri Warren, RN, Westover Heights Clinic, Portland, Ore. Joanne Grosshans, manager, Herpes Resource Center, American Social Health Association. MELINEplus Medical Encyclopedia. "Stress management" and "Herpes labialis (oral Herpes simplex)." Cohen, F. Archives of Internal Medicine, Nov. 8, 1999.