gental, herpies
What is genital herpes?
Genital herpes is an infection caused by the herpes simplex virus
or HSV. There are two types of HSV, and both can cause genital
herpes. HSV type 1 most commonly infects the lips causing sores
known as fever blisters or cold sores, but it also can infect the
genital area and produce sores there. HSV type 2 is the usual cause
of genital herpes, but it also can infect the mouth during oral sex.
A person who has genital herpes infection can easily pass or
transmit the virus to an uninfected person during sex.
Both HSV 1 and 2 can produce sores (also called lesions) in and
around the vaginal area, on the penis, around the anal opening, and
on the buttocks or thighs. Occasionally, sores also appear on other
parts of the body where the virus has entered through broken
skin.
HSV remains in certain nerve cells of the body for life, and can
produce genital herpes symptoms off and on in some infected people.
How does someone get genital herpes?
Most people get genital herpes by having sex with someone who is
having a herpes “outbreak.” This outbreak means that HSV is active.
When active, the virus usually causes visible sores in the genital
area. The sores cast off (shed) viruses that can infect another
person. Sometimes, however, a person can have an outbreak and have
no visible sores at all. People often get genital herpes by having
sexual contact with others who don’t know they are infected or who
are having outbreaks of herpes without any sores.
A person with genital herpes also can infect a sexual partner
during oral sex. The virus is spread only rarely, if at all, by
touching objects such as a toilet seat or hot tub.
Genital Herpes Symptoms
Unfortunately, most people who have genital herpes don’t know it
because they never have any symptoms of genital herpes, or they do not recognize any
herpes symptoms they might have. When there are symptoms, they can be
different in each person. Most often, when a person becomes infected
with herpes for the first time, the symptoms will appear within two
to 10 days. These first episodes of genital herpes symptoms usually last two to
three weeks.
Early symptoms of genital herpes outbreak include:
- itching or burning feeling in the genital or anal area.
- pain in the legs, buttocks, or genital area.
- discharge of fluid from the vagina.
- feeling of pressure in the abdomen.
Within a few days, sores appear near where the virus has entered
the body, such as on the mouth, penis, or vagina. They also can
occur inside the vagina and on the cervix in women, or in the
urinary passage of women and men. Small red bumps appear first,
develop into blisters, and then become painful open sores. Over
several days, the sores become crusty and then heal without leaving
a scar. Some other genital herpes symptoms that may go with the first
episode are fever, headache, muscle aches, painful or
difficult urination, vaginal discharge, and swollen glands in the
groin area.
Will I ever have outbreaks again?
If you have been infected by HSV 1 and/or 2, you will probably
have genital herpes symptoms or outbreaks from time to time. After the
virus has finished being active, it then travels to the nerves at the end of
the spine where it stays for a while. Even after the sores are gone,
the virus stays inside the nerve cells in a still and hidden state,
which means that it’s inactive.
In most people, the virus can become active several times a year.
This is called a recurrence. But scientists do not yet know why this
happens. When it becomes active again, it travels along the nerves
to the skin, where it busies itself by making more viruses near the
site of the very first infection. That is where new sores usually
will appear.
Sometimes, the virus can become active but not cause any sores
that can be seen. At these times, small amounts of the virus may be
shed at or near places of the first infection, in fluids from the
mouth, penis, or vagina, or from barely noticeable sores. You may
not notice this shedding because it often does not cause any pain or
feel uncomfortable. Even though you might not be aware of the
shedding, you still can infect a sex partner during this time.
After the first outbreak, any future outbreaks are usually mild
and last only about a week. An infected person may know that an
outbreak is about to happen by feeling a tingling feeling or itching
in the genital area, or pain in the buttocks or down the leg. For
some people, these early herpes symptoms can be the most painful and
annoying part of an episode. Sometimes, only the tingling and
itching are present and no visible sores develop. At other times,
blisters appear that may be very small and barely noticeable, or
they may break into open sores that crust over and then
disappear.
The frequency and severity of the recurrent episodes vary
greatly. While some people have only one or two outbreaks in a
lifetime, others may have several outbreaks a year. The number and
pattern of repeat outbreaks often change over time for a person.
Scientists do not know what causes the virus to become active again.
Although some people with herpes report that their outbreaks are
brought on by another illness, stress, or having a menstrual period,
outbreaks often are not predictable. In some cases, outbreaks may be
connected to exposure to sunlight.
How does the doctor diagnose genital herpes?
Because the genital herpes sores may not be visible to the naked
eye, a doctor or other health care worker may have to do several
laboratory tests to try to prove that any other symptoms are caused
by the herpes virus. A person may still have genital herpes,
however, even if the laboratory tests don’t show the virus in the
body.
A blood test cannot show whether a person can infect another
person with the herpes virus. A blood test, however, can show if a
person has been infected at any time with HSV. There are also newer
blood tests that can tell whether a person has been infected with
HSV 1 and/or 2.
Genital Herpes Treatment
Although there is no cure for genital herpes, your doctor might
prescribe one of three medicines to treat it:
- Acyclovir (Zovirax®) treats the first and/or later episodes of
genital herpes.
- Famciclovir (Famvir®) treats later episodes of genital herpes
and helps prevent future outbreaks.
- Valacyclovir (Valtrex®) treats later episodes of genital
herpes.
During an active herpes episode, whether the first episode or a
repeat one, you should follow a few simple steps to speed healing
and avoid spreading the infection to other places on the body or to
other people:
- Keep the infected area clean and dry to prevent other
infections from developing.
- Try to avoid touching the sores.
- Wash your hands after contact with the sores.
- Avoid sexual contact from the time you first feel any genital
herpes symptoms until the sores are completely healed, that is, the
scab has fallen off and new skin has formed where the sore was.
Can genital herpes cause any other problems?
Usually, genital herpes infections do not cause major problems in
healthy adults. In some people whose immune systems do not work
properly, genital herpes episodes can last a long time and be
unusually severe. (The body’s immune system fights off foreign
invaders such as viruses.)
If a woman has her first episode of genital herpes while she is
pregnant, she can pass the virus to her unborn child and may deliver
a premature baby. Half of the babies infected with herpes either die
or suffer from damage to their nerves. A baby born with herpes can
develop serious problems that may affect the brain, the skin, or the
eyes. If babies born with herpes are treated immediately with
acyclovir, their chances of being healthy are increased. Therefore,
if you are pregnant and infected with genital herpes, you should
stay in close touch with your doctor before, during, and after your
baby is born.
If a pregnant woman has an outbreak and it is not the first one,
her baby’s risk of being infected during delivery is very low.
If a woman is having an outbreak during labor and delivery and
there are herpes lesions in or near the birth canal, the doctor will
do a cesarean section to protect the baby. Most women with genital
herpes, however, do not have signs of active infection with the
virus during this time, and can have a normal delivery.
Is genital herpes worse in a person with AIDS?
Genital herpes, like other genital diseases that produce sores,
increases a person’s risk of getting HIV, the virus that causes
AIDS. Also, prior to better treatments for AIDS, persons with HIV
(because of lower protection from their immune systems) had severe
herpes outbreaks, which may have helped them pass both genital
herpes and HIV infections to others.
How can I protect myself or my sexual partner?
If you have early signs of a herpes outbreak or visible sores,
you should not have sexual intercourse or oral sex until the signs
are gone and/or the sores have healed completely. Between outbreaks,
using condoms during sexual intercourse may offer some protection
from the virus.
Is any research going on?
The National Institute of Allergy and Infectious Diseases (NIAID)
supports research on genital herpes and on herpes simplex virus,
HSV-1 and HSV-2, the viruses that cause it. Studies are currently
under way to develop better treatments for the 67 million people who
suffer from genital herpes. While some scientists are carrying out
clinical trials to determine the best way to use existing drugs,
others are studying the biology of herpes simplex virus. NIAID
intramural scientists have identified certain genes and enzymes that
the virus needs to survive. They are hopeful that drugs aimed at
disrupting these viral targets might lead to the design of more
effective therapies.
Meanwhile, other researchers are devising methods to control the
virus' spread. Two important means of preventing HSV infection are
vaccines and topical microbicides. Several different vaccines are in
various stages of development. These include vaccines made from
proteins on the HSV cell surface, peptides or chains of amino acids
that present important targets to the immune system, and the DNA of
the virus itself. Topical microbicides, preparations containing
microbe-killing compounds, are also in various stages of development
and testing. These include gels, creams, or lotions that a woman
could insert into the vagina prior to intercourse to prevent
infection in both herself and her partner.
Where can I get help if I'm upset about having herpes or I have
an infected partner?
Genital herpes outbreaks can be distressing, inconvenient, and
sometimes painful. Concern about transmitting the disease to others
and disruption of sexual relations during outbreaks can affect
personal relationships. If you or your partner has genital herpes,
you can learn to cope with and treat the disease effectively by
getting proper counseling and medicine, and by using preventive
measures as mentioned above.
Keeping on Top of Your Condition
Keeping in tune with your disease or condition not only makes treatment less intimidating but also increases its chance of success, and has been shown to lower a patients risk of complications. As well, as an informed patient, you are better able to discuss your condition and treatment options with your physician.
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More Information on Genital Herpes
National Institute of Allergy and Infectious Diseases
National
Institutes of Health
31 Center Drive, MSC 2520
Bethesda, MD
20892-2520
http://www.niaid.nih.gov/
National Library of Medicine
MEDLINEplus
8600 Rockville
Pike
Bethesda, MD 20894
1-800-338-7657
http://medlineplus.gov/
Centers for Disease Control and Prevention
1600 Clifton
Road
Atlanta, GA 30333
1-888-232-3228
http://www.cdc.gov/
National Herpes Resource Center and Hotline
American Social
Health Association
P.O. Box 13827
Research Triangle Park, NC
27709-9940
919-361-8488 (9 a.m. to 7 p.m. Eastern Time, Monday
through Friday)
http://www.ashastd.org/hrc/index.html
National STD and AIDS Hotline
1-800-227-8922 or 1-800-342-2437
(24 hours a day, 7 days a week)
The American College of Obstetricians and Gynecologists
409
12th Street, S.W.
P.O. Box 96920
Washington, DC
20090-6920
202-863-2518
http://www.acog.org/
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