Genital Herpes
- What Is Genital Herpes?
- How Does One Get Genital Herpes?
- What Is An Outbreak?
- What Are The Symptoms Of Genital Herpes?
- How Is One Screened for Herpes?
- Who Should Be Screened With Serologies?
- How Does One Decrease Transmission Of The Disease?
- Herpes and Pregnancy
- Herpes and HIV
- How Is Herpes Treated?
What Is Genital Herpes?
Genital herpes is a sexually transmitted disease (STD) caused by the herpes simplex viruses type 1 (HSV-1) and type 2 (HSV-2). Most genital herpes is caused by HSV-2. The disease may cause skin blisters and sores in the genital skin area, but often causes no visible symptoms. It is possible to get genital herpes through sexual contact with an infected person even if he or she does not have any symptoms.
It is estimated that 25 percent of American adults have genital herpes, and only 20 percent know it.
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How Does One Get Genital Herpes?
HSV-1 and HSV-2 can be found in and released from the sores that the viruses cause, but they also are released between outbreaks from skin that does not appear to be broken or to have a sore. Generally, a person can only get HSV-2 infection during sexual contact with someone who has a genital HSV-2 infection.
HSV-1 can cause genital herpes, but more commonly causes infections of the mouth and lips, so called “fever blisters.” HSV-1 infection of the genitals can be caused by oral-genital or genital-genital contact with a person who has HSV-1 infection.
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What Is An Outbreak?
Once you have been infected with the herpes virus, the virus enters the body, travels to the bundle of nerves at the base of the spine, and lies dormant (inactive). Once the virus becomes active, it travels along nerve paths back to the surface of the skin, where it may cause an outbreak. Because the nerves in the buttocks, genital area, and upper thighs are connected, an outbreak can occur in any of the following areas: the anus, buttocks, penis, scrotum or testicles, thighs, vagina or vulva.
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What Are The Symptoms Of Genital Herpes?
- Itching, burning or tingling in or around the genital area
- Aches or pains in or around the genital area
- A rash, bumps, blisters, cuts or sores in or around the genital area
- Vaginal or penile discharge (often mistaken as a yeast infection in women)
- Burning and/or pain when urinating
- Flu-like symptoms such as headache, fever and swollen glands
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How Is One Screened for Herpes?
Herpes is diagnosed using two methods. If an active lesion exists, it can be sent for a culture. A type-specific blood test, also known as a serology, can be performed to see if you have been exposed to HSV-1 or HSV-2. However, if your serology is positive, it does not necessarily mean you have active herpes; it may simply indicate that you have been exposed to HSV. The herpes serology test may be especially useful for diagnosing genital lesions or symptoms in patients who have a normal culture test, or who have symptoms suggestive of herpes without any lesions with which to perform a culture test. It typically takes at least six weeks after a person has been infected for their serology to turn positive.
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Who Should Be Screened With Serologies?
Although no specific guidelines exist yet, the following patients should generally be screened:
- Patients at risk for sexually transmitted diseases (STDs), including HIV (including patients with a current STD, recent STD and/or high risk behaviors)
- All HIV-positive patients
- Patients partnered with HSV-2 infected people
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How Does One Decrease Transmission Of The Disease?
All patients with genital HSV infection should inform their current sexual partners and future partners of their infection before engaging in a sexual relationship. Keep in mind that a person with HSV may shed the virus and transmit HSV to a person even when he or she is not experiencing symptoms, which is known as asymptomatic viral shedding. It is more frequent with genital HSV-2 than HSV-1 and is most common in the first 12 months after acquiring HSV-2. Using latex condoms to cover affected areas has been shown to decrease transmission of HSV-2 to an uninfected person. However, it will not prevent transmission from exposed areas that may transmit the disease by skin-to-skin contact. There also appears to be evidence that taking suppressive antiviral medications, such as acyclovir and valacyclovir, may also reduce the rate of transmission. If your partner has HSV-2, your chance of becoming HSV-2 positive is 18 percent annually for women and 5 percent annually for men. Please note that being HSV-2 positive does not predict that you will develop symptoms of herpes.
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Herpes and Pregnancy
HSV can cause neonatal complications in pregnant women. Because of this, pregnant women without HSV-2 should avoid intercourse with men who have genital herpes, particularly during the third trimester of pregnancy. Pregnant women should also avoid genital exposure to oral HSV (such as cunnilingus with a partner with oral herpes).
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Herpes and HIV
Individuals with HSV-2 have a significantly higher risk of acquiring HIV and should especially protect themselves against HIV exposure.
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How Is Herpes Treated?
There is no cure for genital herpes. However, effective antiviral medications such as acyclovir, valacyclovir (Valtrex) and famciclovir (Famvir) treat symptoms of genital herpes. The earlier these medications are used, the more effective they are. Notify your physician immediately if you experience any symptoms of genital herpes.
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