Genital Herpes

What is genital herpes?

Genital herpes is a common disease caused by a virus. The virus is called the herpes simplex virus, or HSV. It causes painful blisters that break open and form sores in the genital area.

There are 2 types of HSV, type 1 and type 2. HSV-1 is usually seen on the lips and mouth. HSV-2 is usually seen in the genital area. However, you can get HSV-1 in the genital area and HSV-2 on the lips or mouth.

How does it occur?

You can become infected with the virus by contact with broken blisters or sores on the genitals, mouth, or rectal area of an infected person. The infection can be passed from person to person during sex. You may spread it from one part of your body to another if the virus gets on your hands.

Once you are infected, the virus stays in your body for the rest of your life. Usually the virus is inactive, which means it is staying in certain cells in the body and not causing symptoms. However, the virus may become active and cause sores again. The sores may come back often. Outbreaks of sores may occur with physical stress, such as wearing tight clothing, having sex without enough lubrication, or having other illnesses. Emotional stress or menstruation may also cause an outbreak. Most people with herpes have recurrent infections.

Herpes is very contagious when you have sores. It may also be possible for the virus to spread even if you have no symptoms, or for up to 3 months after the sores have healed.

What are the symptoms?

Symptoms usually occur within 2 weeks after the virus first enters your body. They may include:

• painful sores (blisters) on the genitals (for example, a man's penis or the area around a woman's vagina), thighs, or buttocks
• vaginal discharge
• pain when you urinate or have intercourse
• trouble urinating
• sudden itching in the genital or anal area
• general discomfort, such as tiredness and muscle aches
• fever (usually only with the first outbreak of blisters)
• tender, enlarged lymph nodes in the groin

The sores appear first as tiny clear blisters. Usually they occur in groups of several blisters, but sometimes there may be just a single blister. The blisters usually quickly lose their thin tops. Then they look like small (1/8 inch to 1/4 inch wide), pink or red shallow sores. The blisters may be painful and oozing. They may become covered with a yellowish dried crust.

The symptoms of herpes are usually most severe during the first outbreak. Some people infected with herpes have no symptoms.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and examine you. Cells or liquid from one of the sores will be tested in the lab for the virus. Blood tests may be done to see if you had a previous herpes infection.

How is it treated?

Genital herpes cannot be cured. The virus will always stay in your body. However, your healthcare provider may prescribe antiviral medicine such as acyclovir, famciclovir, or valacyclovir to relieve the symptoms more quickly. Even though you are taking the medicine, the infection will still be very contagious as long as you have sores, but the medicine will shorten the amount of time you are contagious. If you are pregnant, discuss the use of these medicines with your provider.

Pain medicine such as acetaminophen or ibuprofen can help relieve pain and fever. Sitting in a bathtub of warm water 2 or 3 times a day may also help soothe the pain.

A herpes infection for the first time during the first 3 months of pregnancy could cause a miscarriage or problems with the baby. If you get a herpes infection for the first time in the second trimester of pregnancy, it can cause premature labor and delivery. If a pregnant woman has an active herpes infection at the time her baby is born, she could pass the disease to her baby. If you are pregnant and have had herpes, tell your provider so steps can be taken to avoid infecting the baby. Antiviral medicine is a safe medical treatment for infected pregnant women. It can help prevent an active infection that could be passed to your child during birth. Antiviral medicine does not decrease the risk of passing the infection when you already have sores at the time of delivery. If you have an active herpes infection when you go into labor, your provider may suggest a cesarean delivery (C-section) to avoid infecting the baby. Breast-feeding is safe as long as there are no sores on or around the breast.

How long will the effects last?

The sores usually start to heal after about 5 days. They generally disappear in 1 to 3 weeks. Sometimes they may last for as long as 6 weeks, especially when a woman also has a bacterial or yeast infection of the vagina. The sores rarely leave scars.

About half of herpes-infected people have repeat outbreaks of sores. These recurrences tend to be milder than the first bout of herpes and the sores heal more quickly.

How can I take care of myself while I have an active infection?

• Follow the full treatment prescribed by your healthcare provider.
• Take all the medicine as prescribed by your healthcare provider.
• Wipe yourself from front to back after using the toilet.
• Wear loose clothing, preferably cotton, to allow circulation of air. It also helps avoid pressure on the skin, which may cause more blisters.
• Take aspirin, acetaminophen, or ibuprofen to reduce pain and fever.
• Avoid sharing towels or clothing.
• Avoid using douches, perfumed soaps, sprays, feminine hygiene deodorants, or other chemicals in the genital area.
• Avoid a lot of sunlight and heat, which may cause more blisters.
• Avoid sexual contact with others.

Although genital herpes itself is not usually a serious disease, having it may lead to depression and other emotional problems. Don't let herpes lower your self-esteem. It is also helpful to learn how to recognize and avoid stress because stress may allow the virus to reactivate.

There are many herpes counseling groups that give support and help to herpes patients. You can get more information by calling the National Sexually Transmitted Disease Hotline at 800-227-8922.

What can I do to help prevent recurrences of herpes infection?

You may have fewer recurrences if:

• You take all the medicine prescribed by your healthcare provider. Daily doses of acyclovir or another antiviral medicine may lessen the frequency of recurrent outbreaks of herpes sores and might prevent recurrences completely.
• You follow your healthcare provider's instructions for follow-up visits and tests.
• You tell your sexual partner or partners about the infection so they can be checked and treated, if necessary.
• You avoid conditions that might cause the infection to recur, such as high stress or vaginal infections.

How can I help prevent infection with genital herpes?

• Practice safe sex. Always use latex or polyurethane condoms during any sexual contact because it is not possible always to know or predict when the virus can be shed or passed to someone else. This includes oral-genital and anal-genital sex. In addition, you are less likely to get a sexually transmitted disease if you have just one sexual partner who has no other partners.
• Ask your partner(s) if they have had herpes because herpes may be spread from areas not protected by condoms; for example, the groin, thigh, and abdomen. Avoid sexual contact if your partner has any sores.
• Avoid oral-genital and oral-anal sex with someone who has fever blisters (cold sores) in the mouth. Cold sores are caused by a related virus that can infect the genitals.