|
|
- What is
genital herpes?
- How do people get genital herpes?
- How will genital herpes affect my relationships?
- What are the symptoms?
- What is “tingling”?
- Can I spread Herpes even when
I am not having an outbreak?
- How long does it take for
sores to appear after infection?
- Do the symptoms return?
- What can I do to reduce the risk of transmission?
- Is there a cure?
- How do I know if I have genital herpes?
- Where do I go to get tested?
- What are the complications of genital herpes?
- What is the impact of herpes on pregnancy?
- How can herpes be prevented?
Genital herpes is a common infection generally transmitted through sexual contact. It is caused by one of two members of the herpes virus family, which also includes the viruses causing chickenpox, shingles, and glandular fever.
Genital herpes is usually caused by infection with herpes simplex virus type 2 (HSV-2). Genital herpes can also be caused by HSV-1, the virus which more usually causes facial herpes, including cold sores on the lips.
Genital herpes, for most people, is an occasionally recurrent, sometimes painful condition for which effective treatment is available. Generally, it is not life-threatening and has no long-term repercussions on one's general physical health. Anyone who is sexually active is at risk of catching genital herpes, regardless of their gender, race or social class.
Genital herpes can be transmitted through direct contact with an infected blister or sore, usually through sexual contact. It can also be transmitted when there are no symptoms present.
HSV-2 infection is usually passed on during vaginal or anal sex. HSV-1 is usually transmitted to the genital area by oral sex (mouth to genital contact).
If you have only just been diagnosed as having genital herpes and are in a monogamous relationship, this does not necessarily mean that your partner has been unfaithful to you, or sexually promiscuous in the past.
It is possible for a person to carry the virus without knowing that they have it, since up to 80% of people who are infected with HSV-2 show no signs of the infection. So it is very easy for a person to unwittingly transmit the infection to their partner.
The symptoms of the infection vary greatly between individuals. It might be totally unnoticeable in one person, but cause severe blistering in their partner.
Since the genital herpes virus can be transmitted through oral sex as well as vaginal sex, it is also possible to have caught the virus from a cold sore on your partner's mouth or face. It is possible to pass the virus on even if they did not have a cold sore present at the time of contact.
Alternatively, you may have contracted the virus from a previous sexual partner, perhaps even several years ago. The virus can remain inactive in the body for long periods, so this may be the first time it has caused symptoms. Or, previous symptoms may have been so slight that the herpes condition went unnoticed or was dismissed
(eq. a mild rash, itching or tingling).
Because of the stigma wrongly attached to genital herpes, it has probably taken a great deal of courage for you to tell your partner that you have the infection. If you have not already told your partner and need advice on how to do this please click here.
You may find that the honesty and trust brought about by discussing genital herpes strengthens your relationship and brings you closer together. Support and understanding can help to overcome much of the anxiety that you may be feeling about genital herpes.
A good long-term relationship must be based always on honesty and trust. While some people may experience an unsupportive response, most have found their partners are both supportive and understanding.
Herpes symptoms can be broken down into two main classifications: None and Some. Amazingly, some seventy five percent of those infected with HSV will never experience an outbreak, or otherwise be affected so mildly as to not even notice, or, perhaps, to misinterpret what it is that they do feel.
For those in the "Some" category, different people will experience different things. The first signs of the infection generally occur within two to twenty days of exposure, though the virus can hide out for longer, sometimes years. Very often the initial symptoms will be somewhat flu-like including swollen glands, sore throat, muscle aches (especially in the lower back for new cases of genital herpes), neuralgia (the nerves of the lower back or legs actually hurt), pronounced lethargy, and/or fever.
If those weren't enough there comes the outbreak itself. Many experience what can only be called a "tingling" or faint itch just before an outbreak, called a
prodrome and now being understood as a premonitory symptom), at the site of the approaching outbreak. Within a few hours the skin reddens and a small bump or bumps may form. For many people that may be it, the redness or
bumps will fade away over the course of a week or more and, when all gone, the outbreak is over. For others the redness rapidly turns into clusters of tiny pimples, or, in some, the lesions are said to resemble tiny cuts in the skin. In either case the lesions may be quite painful, especially during the host's first, or primary, outbreak. The tiny pimples are filled with a clear liquid, and quickly break open, releasing the liquid, which contains untold numbers of new viruses. Care should be taken not to transfer those viruses to other parts of one's body, or to other people. The broken lesions, if left to themselves, crust over in a day or two and begin healing. Tight clothing or other friction or excessive moisture can prolong the healing process. Eventually, the sores do heal, rarely leaving a scar. Until the pink skin at the site of the outbreak returns to normal color, one should assume that viruses are still present and appropriate
hygienic precautions observed. Soap and water after touching the affected area is usually sufficient to kill any virus on the surface. A primary outbreak can take two weeks or longer to heal completely, while most subsequent outbreaks run their course in from seven to eleven days.
A person's very first outbreak, called a Primary outbreak, will usually be the most severe one experienced, owing to the fact that one's immune system is totally unprepared to deal with the new invader.
Many people who are newly infected will
hear a common description of “tingling” in connection with outbreaks.
Tingling has been described best as a sensation similar to that of a rub
burn, scraping of the skin or a feeling that the muscle has gone to sleep.
“Tingling” sensations associated with Genital Herpes have been most common
in the calf, thigh, buttocks or lower back. “Tingling” sensations associated
with Oral Herpes have been most common in the neck, jaw-line or muscles
surrounding the mouth.
In most “textbook” cases, primary herpes
usually begins from two to three weeks after the virus enters the body. In
some cases it has taken only a couple of days, while in others it can take
much longer.
|
|
Yes. The genital herpes virus can still
be spread through the skin although there are no visible signs of an
outbreak. This is called asymptomatic viral shedding. Up to 70% of people
catch genital herpes from an infected partner who has no signs or symptoms.
And since the symptoms are not always obvious, nine out of ten people who
have genital herpes don’t even know they’re having an outbreak.
|
The symptoms of genital herpes may reappear from time to time. This is because once the viral infection is acquired, it stays permanently in the body. Most of the time the virus remains inactive, but every so often it may reactivate and cause another outbreak.
Each individual is different - some people never have a recurrence. Others may have recurrences several times a year. However, recurrent outbreaks are usually shorter and less severe than the first episode.
Certain events or situations can trigger recurrences, and you may be able to avoid or reduce the trigger factors, which may include stress at work or home, fatigue, ill health, loss of sleep, friction due to sexual intercourse, and menstruation in women.
|
If you take the necessary precautions, the chances of transmitting the virus to your partner are small. Genital herpes does not necessarily mean complete abstinence from sex or a reduced enjoyment of sex.
The risk of transmitting the virus may possibly be reduced if you use condoms. The continued use of condoms in a long-term relationship is a personal decision that only the couple can make. Most find that as the importance of the HSV infection in their relationship is seen in perspective, that condom use can become less relevant if this is the only reason condoms are being used.
However, at all costs couples should try to avoid sexual intercourse during an active episode of herpes, because this is when the virus is most likely to be transmitted. This period includes the time from when your partner first has warning signs of an outbreak, such as tingling or burning in the genitals, until the last of the sores has healed. Also, sexual activity prolongs the healing of the episode.
Transmission risk is increased if there are any breaks in the skin, for example, if you have thrush or small abrasions from sexual intercourse, often due to insufficient lubrication. It can be helpful to use a lubricant specifically for sexual intercourse and avoid sex if you have thrush. Sexual lubrication is helpful right at the start of sexual activity.
Sores in other areas, such as the buttocks and thighs, can be just as contagious as those in the genital area, and care should be taken to avoid direct contact with such sores during sex.
At other times, there is still a small risk of transmitting the infection, even if your partner is showing no signs of genital herpes. If you or your partner has a cold sore, it is advisable to avoid oral sex as this can spread the virus to the genitals.
You cannot catch genital herpes by sharing cups, towels or bath water, or from toilet seats. Even during an outbreak, it is only skin to skin contact with the parts of your partner's body which have the sores which you need to avoid. You can still cuddle, share a bed, or kiss.
|
There is no cure for herpes. Once an individual is infected with herpes, he or she carries the virus in his or her body for life. Certain antiviral drugs and creams
may be used to decrease the severity of the symptoms, the duration of an outbreak, and the frequency of recurring outbreaks. Infected individuals can also avoid some of the known causes of outbreaks to prevent recurring outbreaks
However, total cure is not out of the question and has been observed many
times by our patients. The sooner a treatment can begin after infection
the greater the chance of overcoming the virus, so whatever treatment you
decide on begin it soon and stick to it for a time.
|
The usual symptoms of genital herpes begin with feeling generally unwell. You may have fever, headache, and general joint and muscle aches, as well as irritation in the genitals. This may last for several days, during or after which reddened areas may appear on the genitals. These may develop into painful blisters, which then burst, leaving sores which gradually heal, usually without scarring.
Signs of infection vary greatly between individuals and it is possible for you to show only mild symptoms that are not so easily recognizable as being genital herpes. These may include itching in the genital area, small cracks in the skin around the genitals, or reddened patches of skin in the genital area, thighs or buttocks, or you may have no symptoms at all.
Consult your doctor if you think you might be showing signs of the infection. Until recently, diagnosis could only be made by clinical symptoms and swabs to detect the virus during an active episode. However, blood tests are becoming commercially available that can distinguish between HSV-1 and HSV-2 antibodies.
The time taken to develop antibodies after initial infection is normally 8 to 12 weeks. It is also important to know that false positives and false negatives can occur with these tests.
Blood tests cannot definitively diagnose herpes, they can only tell you whether or not you are infected with HSV-1 and/or HSV-2, but cannot identify the site of infection. A swab taken from a genital site test is also required. If this tests positive, that is, the virus is detected, the diagnosis of genital herpes is confirmed
|
Depending on the size of the city you live in, and your financial situation, there are various options for consultation and diagnosis. There's the family doctor, of course, and the emergency room at the nearest hospital, but those options can be expensive. Many cities of even moderate size have walk-in clinics which are less expensive than the emergency room and don't make you wait as long. There may even be a "free" clinic which can offer consultation and testing for a nominal or zero fee. Some Planned Parenthoods also provide testing, often at a very low price, and they're not just for women. Look in the yellow pages under "Clinics", "Physicians", "Social Service Organizations", or even "Sports Medicine". Call ahead to see if they routinely deal with STIs. In some cities there are clinics which specialize in STIs, offering convenient testing at reasonable prices.
When all else fails there is the National Herpes Hotline, wherein support and referral info can be obtained for the price of a phone call during normal business hours.
The number can be found at: http://www.ashastd.org/hotlines/herphotline.html
|
Genital herpes can cause recurrent painful genital sores in many adults, and herpes infection can be severe in people with suppressed immune systems. Regardless of severity of symptoms, genital herpes frequently causes psychological distress in people who know they are infected.
In addition, genital HSV can cause potentially fatal infections in babies. It is important that women avoid contracting herpes during pregnancy because a first episode during pregnancy causes a greater risk of transmission to the baby. If a woman has active genital herpes at delivery, a cesarean delivery is usually performed. Fortunately, infection of a baby from a woman with herpes infection is rare.
Herpes may play a role in the spread of HIV, the virus that causes AIDS. Herpes can make people more susceptible to HIV infection, and it can make HIV-infected individuals more infectious.
Another complication is that the blisters can become infected by bacteria. You should suspect this has happened if the pain and redness suddenly become worse or go away and then return.
Herpes can be passed from mother to baby. The chance of giving herpes to the baby is highest if the initial infection occurs near the time of delivery. The virus can be transmitted to the baby in
utter or during passage through an infected birth canal. First-time infection during pregnancy leads to an increased risk of miscarriage, decreased fetal growth, and preterm labor. About 30-50% of infants who are born vaginally to a mother with first-time infection become infected with the herpes virus. Of babies born to women experiencing recurrent herpes at the time of birth, 1-4% become infected with the virus.
If a woman is having an active outbreak of genital herpes at the time of delivery, the baby will usually be delivered by cesarean section to prevent transmission of herpes.
Of infants infected with herpes at birth, 30-60% die within the first month. Survivors may have long-term complications such as mental retardation and seizures. To prevent transmission of herpes to their babies, pregnant women should discuss any past history of herpes with their health care providers and take adequate measures to prevent infection during pregnancy. The risk of herpes can be reduced during pregnancy by:
• Avoiding sexual intercourse (vaginal, anal, and oral) during the last three months of pregnancy if your partner is known to have or suspected of having genital herpes.
• Avoiding receptive oral sex during the last three months of pregnancy if your partner is known to have or suspected of having herpes sores on the mouth, tongue, gum, or lips.
|
The surest way to avoid transmission of sexually transmitted diseases, including genital herpes, is to abstain from sexual contact, or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.
Genital ulcer diseases can occur in both male and female genital areas that are covered or protected by a latex condom, as well as in areas that are not covered. Correct and consistent use of latex condoms can reduce the risk of genital herpes only when the infected area or site of potential exposure is protected. Since a condom may not cover all infected areas, even correct and consistent use of latex condoms cannot guarantee protection from genital herpes.
Persons with herpes should abstain from sexual activity with uninfected partners when lesions or other symptoms of herpes are present. It is important to know that even if a person does not have any symptoms he or she can still infect sex partners. Sex partners of infected persons should be advised that they may become infected. Sex partners can seek testing to determine if they are infected with HSV. A positive HSV-2 blood test most likely indicates a genital herpes infection.
|
