|What Is Genital Herpes?
Genital herpes is a sexually transmitted disease (STD) that affects as many as 10 million Americans. It is a disease of the genital organs caused by a virus known as herpes simplex virus 2 (HSV2). The virus is closely related to type 1 herpes virus (HSV1) which causes cold sores on the mouth. Unknown until the middle of the 20th century genital herpes is now one of the most commonly transmitted STDs in America. Women are more prone to catching it than men. Types 1 and 2 can be distinguished in lab tests but the symptoms of infection are the same for both. While type 2 is generally found in the genital area it can on occasion be found in the mouth (passed via oral sex or if a person touches their infected genitals and then touches their mouth).
Conversely, type 1 can be found on the genitals by the same action. As there is still no cure for herpes, many people with the disease feel stigmatized because there is little they can do about it. They may feel angry at former sexual partners for giving them a lifelong STD over which they have little control. It can cause people to worry about how to tell new partners about their infection without jeopardizing the relationship. Women also worry about how it will affect future pregnancies.
Is My Partner Cheating On Me?
It is not unusual for one person in a mutually monogamous relationship to suddenly develop genital herpes. It does not necessarily mean that someone has cheated. It is possible that the infected person had a long-standing infection from a previous relationship that has only become active years later.
It is easier for an infected man to infect his female partner, than the other way around. As a result, HSV2 infection is much more common in women. About 1 in every 5 American women aged 14 to 49 are infected and 1 in every 9 men.
How Do I Catch Genital Herpes?
You can become infected with the herpes virus if your skin comes into contact with the genital region, lips, mouth or cheeks of an infected person. Although the virus is more contagious when the person has an actual sore, it can still be passed when no symptoms are present.
What Are The Signs Of Genital Herpes?
Symptoms usually develop between 2 and 20 days (average being 6 days) after exposure to the infection (although as mentioned above it may take months or even years for the first sign to appear).
The principle symptom is the appearance of one or several small, painful itchy blisters around the vulva (but could also appear internally on the cervix or externally on the thighs and buttocks). The blisters are moist and grayish in color with red edges. The blisters soon rupture and ooze a yellow type of pus. They scab over and heal in about 3 weeks. There may also be:
• Pain on urination due to inflammation of the urethra.
• Vaginal discharge due to irritation of the cervix.
• Low fever and general feeling of unwellness. This is associated with a first-time infection when the person has not yet developed antibodies.
Note: Not all women infected with HSV2 have symptoms of a primary outbreak. As many as 3 in every 5 women infected are unaware of their infection. This may be because the sores appear internally on the cervix and go unnoticed. Or the blisters are so mild they are mistaken for chaffing due to clothing. Painful urination can be put down to a urinary tract infection.
After the initial outbreak some people never have symptoms again (but this does not mean they are cured). For others, they have periodic outbreaks - usually more so in the first year after infection. Sores tend to recur in the same spot. Gradually outbreaks become milder and shorter, probably because the person builds up antibodies. Women may notice that outbreaks are more common around the time of menstruation as well as during ovulation and pregnancy (due to higher hormone levels) as well as during times of stress, if they are also infected with gonorrhea, in excess heat or when feeling generally run down. Usually there is a so-called prodromal period, a timeframe anywhere between 30 minutes and 2 days before sores appear but where the person becomes aware that an outbreak will occur (the site becomes itchy, burns or stings). If your initial infection was symptom-free you may remain symptom free for life. Often however, these are the sorts of cases that suddenly experience an outbreak later in life without ever having had (or noticed) a primary outbreak.
How Is It Diagnosed?
Genital herpes is often missed because the sores resemble those of other STDs, namely syphilis and chancroid. For this reason, it is important for a doctor to suspect herpes in all cases of genital sores. To test for the virus a sample of fluid is taken from a sore and placed on a slide for study under a microscope. The sample may also be cultured for 2 to 3 days to confirm the diagnosis. This method is most effective in the early stage of an outbreak when sores are still active. If the sores were healing by the time the culture was done, it can result in a false negative result. For this reason, you should seek a diagnosis as soon as a sore appears.
PCR Test: Polymerase chain reaction (PCR) is a DNA test that can be performed on a sample of fluid taken from a sore. It is highly accurate and is much quicker than growing a culture.
Blood Tests: These are not accurate if they are performed after an initial attack (rather than during) because the results will be unclear.
How Is It Treated?
Currently there is no permanent cure for genital herpes. Antiviral medications Zovirax, Famvir and Vlatrex can suppress symptoms, help sores heal more quickly and suppress recurrences. Acyclovir ointment can be applied to sores to help them heal but they do not stop them developing. Antiviral medications should be taken as soon as you start to feel burning, tingling or itching at the site of infection. For those who have frequent outbreaks (more than 6 a year), daily suppressive therapy (that is, daily use of antiviral medication) can suppress outbreaks and reduce the likelihood of transmission to partners.
Living With Genital Herpes
Natural remedies for an outbreak of herpes include applying cool dressings to the sores, such as ice or wet tea bags. Take a cool sitz bath with baking soda to relieve itching and oral analgesics such as aspirin and codeine to relieve pain. Also:
• Apply a compress with cloves, infused with peppermint oil and cloves oil.
• Wash your hands regularly during an outbreak to avoid spreading the virus to other parts of the body.
• Wear loose clothing to promote healing and take regular baths to keep the area clean.
• Take a daily kelp capsule and one tablespoon of sunflower seed oil to prevent recurrences.
Can It Be Prevented?
1. The best way to prevent the disease is to avoid sexual contact with people who have active herpes sores.
2. Ideally limit sexual activity to mutually monogamous relationships.
3. Follow STD prevention advice in regards to safer sex practice.
4. Always use a condom or female condom if you are not in a monogamous relationship.
5. Undergo annual STD testing at an STD clinic or doctor's office.
6. If you are infected avoid having sex when you have active lesions and at other times use a condom when having sexual intercourse with an uninfected partner. If both partners are infected, these precautions are not necessary.
7. The FDA recently approved Valtrex, a medication which is taken daily, for herpes prevention. It can reduce the risk of passing on the virus to an uninfected partner by 50 percent.
8. Be aware of the symptoms of STDs - herpes and others.
9. Read recommended health screenings for women for overall health.
Genital Herpes And Pregnancy
Pregnant women who have an active infection at the time of childbirth may pass the infection to their baby (when the baby passes through the birth canal). For this reason, a cesarean section may be recommended. However, if the infection has already spread through the placenta before labor or if the membranes rupture more than two hours before birth, a c-section is pointless. The risk of passing an infection to the baby is highest if the mother first becomes infected with herpes while pregnant (50 percent risk). The risk is much lower in recurrent outbreaks (5 percent). In the United States it is relatively rare for an infant to become infected with genital herpes - it occurs no more than in 1 in 3,000 births, possibly as few as 1 in 20,000. However, if it does occur it can cause blindness, brain damage and even death of the baby. An infant usually shows signs of an infection within 4 to 7 days after birth, although in severe cases it may be evident immediately.
What Complications Can Genital Herpes Cause?
A herpes infection is more uncomfortable (and embarrassing) than dangerous. There are some important notes however:
1. Infected women may be more prone to developing cervical cancer. An annual pap smear test is recommended.
2. The infection is associated with precancer of the vulva, read about vulva cancer.
3. Pregnant women, particularly those first infected in pregnancy, need careful monitoring.
4. Women with a weakened immune system (due to HIV or other problems) are more at risk of the virus spreading to other parts of the body such as the eyes, liver and lungs.
Non-commercial website which offers advice on living with herpes, health tips and dating advice. It even lists dating websites for people with herpes.
Herpes Viruses Association (HVA) UK
Provides latest information on the disease, an FAQ section, publications and membership service.