Genital Herpes Infection

What is it?

Herpes simplex is caused by a virus similar to that which causes chickenpox. Herpes simplex is of two types: Herpes simplex 1 (HSV 1) and Herpes Simplex 2 (HSV 2). Herpes Simplex 1 causes 85-90% of the infection around the lips, nose, and mouth such as "fever blisters", "cold sores", or canker sores. Herpes Simplex 2 is responsible for 85-90% of genital infections which present as sores or blisters in the genital area or buttocks that are often painful. It is possible to get HSV 1 in the genital area or HSV 2 in the oral area.

How did I get it?

Genital herpes infections are almost always spread sexually, either by intercourse or oral-genital contact. Condoms will help prevent transfer of the virus from one person to another. Once the initial, or primary infection has cleared, the herpes virus frequently will move into the nerve bundles (sacral ganglions in the lower back) and become dormant. The virus can come out and cause recurrent (secondary) infections in the future. These secondary infections are usually milder and shorter. Sometimes they are brought on by stress such as colds, other illnesses, emotional upset, or even menstrual periods.

What are the symptoms?

Genital herpes infections begin as tingling, burning, or itching around the outside genital area (labia in women, penis in men), followed by small bumps. These bumps then become small, clear blisters which break and become painful ulcerations. With the first herpes infection, you may experience headache, backache, pain or tingling in the legs. You may feel tired and feel like you have the flu. Symptoms can last seven to 21 days. It is possible for some people to carry the virus and transmit infection from the penis, cervix, or other genital tissues without having symptoms.

What is the treatment?

To date, there is no permanent cure for herpes. There are some treatments that can shorten the normal course of the outbreaks, reduce the number of recurrences, or alleviate some of the discomfort. Acyclovir is available as an ointment or in pill form to reduce pain and shorten healing time. The oral form seems to be more effective and has also been approved for use on a daily basis to prevent or reduce the number of recurrences. A drying agent such as Burrow's solution can be soothing and is available without a prescription. Other supportive measures include keeping the area clean and dry, using a topical anesthetic ointment or cream, using wet tea bags or medications containing camphor, and alternating hot and cold compresses. All of these measures may make the infection more tolerable, but do not permanently cure it.

Are there long-term effects?

At one time it was thought that Herpes simplex was associated with an increased rate of cervical cancer. At this time, research studies have not been able to support a relationship between herpes and cervical cancer.

During late pregnancy, there is a risk of herpes infection spreading to newborn infants (usually at the time of delivery). This type of infection in babies can be very serious. A woman with an active herpes infection in the last few weeks of pregnancy may have to have her baby by Cesarean section to prevent exposing the infant to the virus. If you should become pregnant, inform your practitioner of your history of Herpes infections.

Preventative Measures

As sexual preferences and practices vary, so do approaches to prevention. The most important point is to avoid direct physical contact with an involved area of skin (or mucous membranes) when an outbreak in noticed. To prevent recurrences, practice good nutrition and maintain good physical and mental health. Wash your hands after contact with lesions whether they are oral or genital to avoid spread. Fatigue and stess may leave you more vulnerable to recurrences. Using condoms, dental dams, and spermicides can help reduce risk of transmission between outbreaks.

What does having Herpes mean to my partner?

An estimated 30 million Americans have genital herpes and 50 million have oral herpes. But herpes does not mean the same to everyone. Both the physical and emotional consequences of herpes vary greatly from person to person. It would be best to talk with your partner about concerns and share your feelings honestly. Self help groups are also available to provide information and support.