Genital herpes is a sexually transmitted disease caused by two herpes simplex viruses (HSV type I and type II). Herpes is transmitted from person to person via direct skin-to-skin contact during unprotected oral, anal and vaginal sex. HSV I usually causes fever blisters and cold sores on the mouth, but can also cause sores on the genitals. HSV II usually causes sores on the genitals (vagina, penis, anus) and the skin around those areas but is not usually transmitted to the mouth area. IN college students, most genital herpes is actually caused by HSV-I, transmitted during unprotected oral sex. HSV is different from other common viral infections because once it is introduced into your system, it lives there forever, often with periodic symptoms or without symptoms at all.
Why worry about Herpes?
Genital herpes is seldom a severe or dangerous infection by itself, although it can cause psychological distress because of the nature of the sores and the length of time the virus stays in your system.
The open sores of herpes do play a role in the spread of HIV. A person with a herpes sore is three to five times more likely to acquire HIV if exposed to an HIV-positive sex partner. Also, people with HIV and herpes have an increased amount of HIV fluid in their open herpes sores, which increases the risk of transmitting both diseases to a partner during unprotected sex.
Pregnant women who have a first episode of genital herpes near delivery may transmit herpes to their infant, which could be a serious, even deadly, problem. Fortunately, infection of infants is rare among women with recurrent genital herpes.
What are the symptoms of Herpes?
Many people have genital herpes but don’t know it because they have no symptoms. Others have very mild symptoms. For people who do have symptoms, who are symptomatic, the first outbreak is usually the worst. It lasts the longest, is most severe and often very uncomfortable. The initial sores can last five to ten days, first “weeping”, then scabbing over, then healing. In addition to blisters or open sores, a person may have swollen glands, fever, and body aches. Women tend to have more severe symptoms than men.
Genital recurrences after the first outbreak seem to be linked to stress, fatigue, lack of sleep, menstruation, and genital friction (new sexual partner after a time of no sex), although more research is definitely needed about this subject. Usually recurrences are more frequent in the first year after the initial outbreak. Some people have tingling or itching at the site of the sores before they appear, which can help them prepare for an upcoming outbreak. For some people, the recurrences are so mild that they have been mistaken for jock itch, razor burns, insect bites, ingrown hairs, and the like. Outbreaks can appear in different locations over time.
What is a Herpes test like?
Even experienced clinicians cannot reliably diagnose an initial herpes outbreak by its appearance alone. There are good viral culture tests available that can tell if herpes is present and which type (HSV I or HSV II). These tests use fluid from an open sore and are most accurate during initial outbreaks and when blisters are present.
There are several new blood tests that are very accurate for diagnosis. These tests also distinguish type (HSV I or HSV II). Speak to your medical provider about these tests if you’re interested.
How is Herpes treated?
There is no cure for herpes. However there are currently three FDA-approved antiviral medications available to treat herpes: Zovirax (acyclovir), Famvir (famciclovir) and Valtrex (valacyclovir). Using medication to treat genital herpes can help speed the healing process of an outbreak or be used as a preventative (when taken daily) to help reduce the frequency of future outbreaks.
Valtrex has also been proven effective when taken daily to reduce the risk of herpes transmission to sex partners. The most common short-term side effects of these drugs are nausea and headaches. Thus far, no long-term side effects have been found.
What should I do if I have Herpes?
In order to reduce outbreaks, keep your stress levels low, eat well, exercise regularly and get lots of rest. Learn to recognize the symptoms that occur during the period before the lesions appear. People often describe a tingling or burning feeling during this time. Taking medications in this time period before an outbreak can abort or reduce its duration. In order to avoid transmission of the virus to your sex partners, we advise discussing your herpes diagnosis with a prospective partner before you have sex. A potential partner would need to understand that it’s possible for him or her to become infected even if you’re using condoms since not all affected areas can be covered by a condom. Most good relationships can weather the news. Your partner may want to gather information and take some time to adjust to the fact that you have herpes. If you’re in a serious, long-term relationship, your partner might want to test for herpes as he or she might already be infected, but without symptoms.
How do I avoid getting Herpes?
Condoms provides some, but not complete, protection against transmission of the herpes virus. If you or your partner has herpes, abstain from sexual activities when sores are present. Communication is a wonderful tool to help you and your partner(s) make decisions about what’s right for each of you at any given time. However, be aware that herpes can be transmitted to a partner even when there isn’t a current outbreak.