Definition | Causes | Risk Factors | Symptoms | Diagnosis | Treatment | Prevention

Definition

Genital herpes is an infection. It causes small, painful, fluid-filled blisters. These blisters break open and leave an indented sore or ulcer. The blisters can be found on the genitals, buttocks, or thighs. However, they can also spread to other parts of the body (eg, mouth, face, or eyes).

Genital Herpes

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Causes

Genital herpes is usually caused by the herpes simplex 2 virus. It can also be caused by the herpes simplex 1 virus that causes cold sores. The virus enters the body through a break in the skin or through mucous membranes. After the first outbreak, the virus migrates to nerve endings at the base of the spine. It will remain there until the next outbreak.

The virus is spread through:

  • Sexual contact, including intercourse, oral sex, and anal sex
  • Fluid from herpes blisters that gets on other parts of the body
  • An infected mother passing it on to her child during pregnancy or childbirth

The virus is most contagious when blisters are present. It is also contagious during the shedding stage. This is the stage before blisters or sores are visible. The virus may also spread when there are no visible skin sores. While type 1 herpes is most commonly found around the mouth, it can also cause genital infection, just like herpes type 2.

Risk Factors

The strongest risk factor is having unprotected sex with an infected partner. Studies suggest that about 20% of people become infected with genital herpes during their lives. The infection does not always cause symptoms.

Once herpes simplex is in the body, other factors can trigger the blisters to form. These can include:

  • Fever
  • Illness or infection
  • Weakened immune system
  • Menstruation
  • Long periods of exposure to sunlight

Often, the cause of an outbreak is unknown.

Symptoms

Symptoms depend on whether or not this is your first episode. The virus remains dormant between outbreaks. During this time, you may not have visible symptoms. You may still be shedding the virus. This means the virus can be spread during sex.

The number of outbreaks varies and may decrease over time.

Primary Infection

This is when you are first exposed to the virus. You may not have any symptoms, or you may feel like you have the flu. This can include fever and muscle aches. The blisters may be in the genital area or other areas, like the mouth, lips, or tongue. The size and number of ulcers are usually larger during this first time. It may take about two weeks for the primary infection to resolve. Severe infections can last more than a month.

Recurrent Infection

This happens when the virus reactivates in your body. How severe the virus is, how long it lasts, and how much is shed all vary. In most cases, these infections are shorter. They may last about 3-7 days. Men are more likely to have recurrent infections. These infections often have smaller and fewer ulcers. Symptoms are usually around the blister or ulcer area. Remember that you can still spread the virus even if you do not have any symptoms.

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done. If you have visible blisters and ulcers, the doctor will examine these. Lesions inside the urinary tract, vagina, or cervix may not be easily seen. To help with the diagnosis, your doctor may:

  • Open a blister to take a sample of it
  • Have blood tests done—You doctor will do tests to find out if you have herpes simplex type 1 virus or herpes simplex type 2 virus.

If you are diagnosed with genital herpes, you may be tested for other sexually transmitted disease , including HIV.

Treatment

Getting treatment as soon as possible is important because it decreases the chance that you will infect others and helps you recover faster from an outbreak. It is important to keep in mind, though, that the virus remains in your body. There aren't any treatments that can kill the virus. But, there are medicines to decrease the chance that you will have an outbreak.

Medications

Antiviral medicines are used to treat genital herpes. Examples of these medicines include:

  • Acyclovir (Zovirax)
  • Valacyclovir (Valtrex)
  • Famciclovir (Famvir)

These medicines are used to treat people with either a primary infection or a recurrent infection. If you have a recurrent infection, the medicine is most effective when it is taken as soon a possible (eg, as soon as you notice symptoms).

If you have recurrent infections, your doctor may have you take antiviral medicine every day to prevent an outbreak. This is called suppressive therapy.

Counseling

Learning about genital herpes and ways to prevent spreading it to sex partners is important. Your doctor will provide you with information about the virus.

Other Treatments

Your doctor may recommend that you:

  • Take over-the-counter pain medicine
  • Apply cool cloths on blisters or sores
  • Take lukewarm baths
  • Wear loose-fitting clothing
  • Keep blisters or sores dry when not bathing
  • Take antibiotics if you have a bacterial infection of the blisters

Treatment for Sexual Partners

It is important that your sexual partner be tested for genital herpes and receive counseling. If your partner does have the virus, he or she should also receive treatment.

Prevention

Prevention strategies include:

  • Using latex condoms
  • Avoiding oral sex if your partner has herpes blisters on the mouth or genital area
  • Avoiding touching blisters to prevent spreading to other parts of the body

If you are pregnant and have herpes, tell your doctor. Medicine given to newborns right after birth can decrease the chance of infection.