What is genital herpes?
Genital
herpes is a sexually transmitted infection (STI), which has existed
for thousands of years. The infection is often feared and misunderstood,
so it is important for you to have accurate information. Genital
herpes is caused by the Herpes Simplex Virus (HSV). The word herpes
is derived from the Greek word "herpein" which means "to
creep." This may refer to the unique ability of all herpes
viruses to set up a lifelong presence in the body by traveling up
the nerve pathways after an initial infection. The herpes virus
remains in a dormant state in the nerve roots for long periods of
time. A variety of triggers, such as prolonged exposure to bright
sunlight, fever, menstruation, stress and localized skin trauma,
can cause the Herpes Simplex Virus to reawaken. This process will
lead to a recurrence of symptoms or a more actively contagious state
without recognizable symptoms (known as asymptomatic shedding).
Two types
of the Herpes Simplex Virus are known to exist, Herpes Simplex Type
1 (HSV-1) and Herpes Simplex Type 2 (HSV-2). HSV-1 causes cold sores
or fever blisters in and near the mouth. HSV-1 accounts for only
one-third of new cases of genital herpes and is transmitted during
oral-genital sex. Another form of HSV-1 is herpetic gladiatorium
or "wrestler's herpes," which is a skin infection transmitted
through direct skin-to-skin contact.
HSV-2
causes lesions in the genital area and is responsible for two-thirds
of new genital infections. It is very rarely the cause of oral infections.
This page deals primarily with HSV-2.
Is it common?
As we
learn more about the virus, we now realize that it is more widespread
than once thought. It is estimated that 40 million people in the
US alone, are affected by herpes.
How is it transmitted?
Herpes
is spread through microabrasions during vaginal, oral or anal sex
with an infected partner. It is most easily spread when a blister
is present, but it is often spread at other times, too. Some people
notice itching, tingling or other sensations before they see blisters
or sores on their skin. These are called prodromal symptoms and
they are a warning that the virus may be present on the skin. Herpes
is most likely to be spread from the time these first symptoms are
noticed until the area is completely healed and the skin looks normal
again. Sexual contact, including any oral, vaginal or anal contact,
poses a very clear risk of transmitting the virus to your partner
during this time. In addition, it is possible to spread the infection
from one part of the body to another by touching the blisters, so
be sure to wash your hands thoroughly or wear gloves if applying
lotions or creams. Avoid touching your eyes after touching lesions.
Although
herpes is most contagious when symptoms are present, it can also
be transmitted during asymptomatic periods. Occasionally recurrences
can go unrecognized by the infected person because they may be mild,
atypical or in areas that are difficult to see (such as the cervix
or the anus). Current research shows that the virus can even be
shed without causing any symptoms. Many people are totally unaware
that they have the herpes virus. Using condoms or dental dams during
every sexual encounter can reduce the risk of transmission. Even
with condoms and dental dams, there is still a risk of transmission
since herpes can spread from areas not covered, such as thighs or
buttocks. Having multiple sex partners increases your risk of getting
genital herpes and other sexually transmitted infections.
What are the symptoms?
Initial
primary infection:
usually occurs 2 to 10 days after the virus enters the body. Symptoms
may include:
Painful
blisters on the genitals (including the anus), thighs or buttocks
that eventually crust over and are completely healed in 2 to 4
weeks.
Fever
Vaginal
discharge
Discharge
from the urethra
General
discomfort, muscle aches, and headaches
Painful
urination or difficulty urinating
Pain
with intercourse
Itching
Tender,
enlarged lymph nodes near the groin
Recurrent
infection:
HSV-2 is more likely to recur than HSV-1 on the genitals. Symptoms
are usually milder and of shorter duration than the initial outbreak.
Symptoms may include:
Localized
tingling and irritation (known as prodrome) 12 to 24 hours prior
to the appearance of blisters. This symptom occurs in 50% of all
cases.
Painful
genital lesions lasting 4 to 6 days.
Vaginal
discharge is a rare symptom in a recurrent infection.
How is it diagnosed?
Your medical
provider may be able to diagnose herpes based on a physical exam
if you have typical symptoms such as painful blisters, swollen glands
or fever. This can often be confirmed by a viral culture, which
is most accurate early in the course of the disease (when lesions
look like fluid-filled blisters). There are blood tests that may
be useful, but only in certain circumstances. Most blood tests screen
for antibodies to HSV so they cannot be used to diagnose a very
recent infection. Your medical provider will decide which tests
are appropriate in your case.
How is it treated?
Although
there is no cure yet, herpes is a very manageable infection. Your
provider will be able to prescribe antiviral medication. Early treatment
with antivirals may shorten the course of the painful skin lesions
and reduce viral shedding. This may lessen the chance of transmitting
the virus to a sexual partner. The same medication may be used to
reduce the duration and intensity of future outbreaks.
If you
have an active infection:
Follow
the full treatment prescribed by your provider.
When
you have blisters, use disposable gloves to apply medication.
Wear
loose clothing and cotton underwear to allow circulation of air
and avoid pressure on the skin which may cause more blisters.
Your
provider may prescribe a pain reliever if necessary or you can
take Tylenol or Ibuprofen.
Avoid
aspirin if you are under 20 years old (due to its connection with
Reyes Syndrome, a rare neurological syndrome associated with aspirin
use to treat illness with high fever).
Avoid
sharing towels or clothing.
Do
not use douches, perfumed soaps, feminine hygiene deodorants or
other chemicals in the genital area.
Avoid
a lot of sunlight or heat since they may cause more blisters.
A
warm bath may be soothing.
If
urination is painful, it may help to squirt tepid water over the
genitals while urinating.
Avoid
sexual contact with others when you have an active infection.
Are there possible complications associated
with genital herpes?
Complications
are rare, but you should be aware of the following:
Herpes
Keratitis
The eyes
are vulnerable to herpes and can become infected when someone touches
an active infection and then transfers the virus to his/her eye
by touching or rubbing. Herpes Keratitis can eventually lead to
blindness if not treated. Warning signs include:
A
prolonged feeling that something is in the eye
Pain
Irritation,
redness, swelling or eye discharge
Unusual
sensitivity to light
If you
experience any of these symptoms in association with an active herpes
infection, you need to see a medical provider immediately.
Neonatal
Herpes
This is
the transmission of herpes from mother to newborn. A newborn is
very susceptible to herpes since the immune system is not developed
to ward off all infection. The danger is greatest in women having
their first herpes attack during labor. To be safe, many obstetricians
will advise cesarean sections whenever active herpes sores are present
during labor to prevent the baby from coming into contact with the
virus. Any pregnant woman who has ever had herpes should inform
her obstetrician so that certain precautions can be taken to insure
a healthy newborn.
Is there any relationship between cervical
cancer and genital herpes?
Current
research does not show a connection between herpes and cervical
cancer. It appears more likely that other viruses such as HPV (genital
warts) may be linked to cervical cancer. Like most women, women
with genital herpes should have a Pap smear test on a regular basis.
How do I deal with the emotional stress
of having herpes?
The emotional
stress of dealing with herpes can be more difficult to cope with
than the physical discomfort caused by the virus. Herpes is a common
infection. You are not alone. It is normal to feel frustrated, angry,
guilty or isolated. There are many resources to help you through
this experience:
The
National Herpes Hotline
1-919-361-8488
This hotline provides accurate information and appropriate referrals
to anyone concerned about herpes. Health specialists can address
questions related to transmission, prevention and treatment of herpes.
The hotline also provides support for emotional issues surrounding
herpes such as self-esteem and partner communication. The hotline
is open from 9:00am to 7:00pm Monday through Friday.
Providence
HELP
(affiliated with Family Services, Inc.)
401.331-1350
This local support group is for people concerned about herpes. The
group provides a safe, confidential environment where participants
can get accurate information and share experiences, fears, and feelings
with others who are concerned about herpes.
Links you can use
For more
information about herpes, you can visit:
