Genital Herpes
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
Causes
Genital herpes is usually caused by the herpes simplex 2 virus. It can also be caused by the herpes 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. Most infected people have an outbreak at least once per year. The number of outbreaks 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 takes at least 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 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 don't have any symptoms.
Diagnosis
The doctor will ask about your symptoms and medical history. A physical exam will be done. The blisters and ulcers will be looked at. 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
Treatment
Treatments to ease pain include:
- Over-the-counter pain medicine
- Antiviral creams and ointments
- Cool cloths placed on blisters or sores
- Lukewarm baths
- Loose-fitting clothing
Treatments to speed healing include:
- Taking oral antiviral medicines
- Keeping blisters or sores dry when not bathing
Treatments for bacterial infection of the blisters or sores include:
- Antibiotic medicines
Prevention
To prevent the spread of the herpes simplex virus:
- Use condoms to help prevent the spread of genital herpes.
- Avoid oral sex if your partner has herpes blisters on the mouth or genital area.
- Avoid touching blisters to prevent spreading to other parts of the body.
- Ask your doctor about medicine that may reduce the chance of spreading the virus. (eg, valacyclovir)
- If you are pregnant and have herpes, tell your doctor. Medicine given to newborns immediately after birth can decrease the chance of infection. If you have herpes blisters during delivery, you may need a Cesarean section.
Resources:
The American College of Obstetrics and Gynecology
American Social Health Association
International Herpes Alliance
Canadian Resources:
Health Canada
Sex Information and Education Council of Canada
References:
Berkow R. The Merck Manual of Medical Information. New York, NY: Pocket; 2000.
Contraception and STDs. Mayo Foundation for Medical Education and Research website. Available at: http://mayoresearch.mayo.edu/mayo/research/ndc_education/upload/mos...ontraception.pdf. Published 2003. Accessed June 24, 2008.
Corey L, Bodsworth N, Mindel A, Patel R, Schacker T, Stanberry L. An update on short-course episodic and prevention therapies for herpes genitalis. Herpes. 2007 Jun;14:Suppl 1:5A-11A.
Centers for Disease Control and Prevention Seroprevalence of herpes simplex virus type 2 among persons aged 14-49 years--United States, 2005-2008. MMWR Morb Mortal Wkly Rep. 2010 Apr 23;59(15):456-9. Available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5915a3.htm. Accessed July 26, 2010.
Herpes genitalis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated June 2008. Accessed June 24, 2008.
Herpes simplex. American Academy of Dermatology website. Available at: http://www.aad.org. Published 2005. Accessed June 24, 2008.
Last reviewed July 2010 by Lawrence Frisch, MD, MPH
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.