Genital Herpes

What is Genital Herpes?

Genital Herpes is a common sexually transmitted infection, caused by the Herpes Simplex Virus. Genital Herpes spreads by skin-to-skin contact with an infected person.

Although there is no cure for Genital Herpes, many cases become dormant for long periods of time, and medications can alleviate symptoms and help reduce the risk of spreading the virus to another person.

Different types of Herpes

Genital Herpes is caused by one of two Herpes viruses. Herpes Simplex Virus 1 (HSV-1) and Herpes Simplex Virus 2 (HSV-2).

Herpes Simplex Virus 1

Herpes Simplex Virus 1 (HSV-1) is a highly contagious virus that is spread through close personal contact, such as kissing or sharing utensils. This virus type commonly causes blisters or sores around the month, known as cold sores or fever blisters.

HSV-1 can spread to the genital area through oral sex with someone who has an active infection.

Although there is no cure for HSV-1, there are antiviral medications that reduce the severity and frequency of outbreaks.

Herpes Simplex Virus 2

According to the CDC, This is the most common virus type that causes Genital Herpes. This virus type causes small bumps or sores around the penis, vagina, mouth, or rectum.

HSV-2 is spread through sexual contact with an infected person. It can also spread from mother to child during childbirth.

Antiviral medications are also used to help control the severity and frequency of active infections.

Genital Herpes vs. Oral Herpes

Herpes Simplex Virus 1 (HSV-1) and Herpes Simplex Virus (HSV-2) are both part of the Herpes Virus family and cause similar symptoms. However, HSV-1 is the most common cause of Oral Herpes, and HSV-2 is the most common cause of Genital Herpes.

Oral Herpes (HSV-1)

Oral Herpes is a highly contagious virus that spreads through kissing, sharing drinks, sharing utensils, and oral sex with an infected person. Oral Herpes is often referred to as having cold sores, or fever blisters.

Stress and illness can trigger a flare up of HSV-1 and while there is no cure for oral herpes, there are medications that help with symptoms and transmission.

Genital Herpes (HSV-2)

Genital Herpes is a highly contagious STI that spreads through skin-to-skin contact during vaginal, anal, or oral sex. The HSV-2 virus that is responsible for genital herpes remains dormant in the body and may flare up and cause an active infection at any time. Like HSV-1, stress and illness can trigger a flare-up and while there is no cure for genital herpes, there are antiviral medications that help with symptoms.

What causes Genital Herpes?

You get Genital Herpes with skin-to-skin contact with someone who has an active infection. You can also contract Genital Herpes by receiving oral sex from someone who has Oral Herpes (“cold sores”).

How common is Genital Herpes?

Genital herpes is a very common STI, says the CDC.

1 in every 6 people between the ages of 14 and 49 years of age have genital herpes, according to John Hopkins University.

Every year, over half a million new cases of Genital Herpes are reported to the CDC.

When is Genital Herpes contagious?

The Herpes Simplex Virus that causes Genital Herpes is the most contagious when sores or blisters are present, reports reports the CDC. However, the virus can still spread when few or no symptoms are present.

Because Genital Herpes can spread even when no symptoms are present, practicing safe sex techniques is important. Condoms provide a sufficient barrier to protect against Genital Herpes.

How Does Genital Herpes spread?

Genital Herpes spreads with skin-to-skin contact with someone who is infected. Skin-to-skin contact includes:

• Vaginal sex
• Oral sex
• Anal sex

Who can get Genital Herpes?

Both men and women can contract Genital Herpes from a sexual partner. People who have sexual contact without barrier protection (such as a condom, or dental dam), and people who have multiple sexual partners are at higher risk for contracting this virus.

Symptoms of genital herpes

Genital herpes symptoms can vary in severity from person to person, and are slightly different between men and women. For some people, symptoms may be so mild that they don’t realize they have Genital Herpes. According to the CDC, 87.4% of infected 14 to 49 year olds never receive a clinical diagnosis.

Some people report a burning or tingling sensation just before the blisters start forming during an outbreak.

Symptoms of Genital Herpes in women

According to the Mayo Clinic, the symptoms of genital herpes in women include:

• Pain or itching around the genitals, including the labia majora and labia minora
• Small bumps or blisters around the labia majora, labia minora, or rectum
• Painful sores or ulcers that form when the blisters rupture
• Oozing or bleeding from blisters
• Scabs that form as the sores and ulcers heal
• Pain or difficulty with urination
• Unusual vaginal discharge

It is also possible to experience bumps, sores, and blisters on the buttocks and upper or inner thighs.

Symptoms of Genital Herpes In men

According to the Mayo Clinic, the symptoms of Genital Herpes in men include:

• Pain or itching around the genitals, including the penis and scrotum
• Small bumps or blisters on the penis, scrotum, or rectum
• Painful sores or ulcers that form when the blisters rupture
• Oozing or bleeding from blisters
• Scabs that form as the sores and ulcers heal
• Pain or difficulty with urination
• Discharge from the urethra

It is also possible to experience bumps, sores, and blisters on the buttocks and upper or inner thighs.

The first Genital Herpes infection

During the first Genital Herpes infection, a person may also experience symptoms similar to the flu, such as:

• Fever
• Headache
• Body aches
• Chills
• Swollen lymph nodes around the groin area

According to the CDC, the initial infection of Genital Herpes is often associated with a longer and more severe duration of symptoms.

What can trigger a Genital Herpes outbreak?

After you are infected with HSV-2, the virus lives dormant in the body for life—causing outbreaks to occur. According to the American College of Obstetricians and Gynecologists, an outbreak of genital herpes can be triggered by:

• Illness
• Stress
• Hormone changes

It is important to note that genital herpes is contagious to your sexual partners during every outbreak and until all sores or blisters are fully healed.

How long do the sores or blisters from a Genital Herpes outbreak last?

According to the CDC, the sores or blisters caused by genital herpes last about 2 to 4 weeks. Subsequent outbreaks are typically shorter—healing in an average of 3 to 7 days in most cases, according to the American College of Obstetrics and Gynecologists.

How can I ease my symptoms during an outbreak of Genital Herpes?

Sores and blisters caused by genital herpes can be very painful. The American Academy of Dermatology recommends these self-care tips for easing symptoms during an outbreak:

• Keep the affected area clean and dry
• Wear loose-fitting, cotton underwear
• Apply a cold compress to the affected area
• Soak in an Epsom salts bath for 10 to 20 minutes
• Take over-the-counter pain-relieving medications like Acetaminophen

There are also certain antiviral medications that are available by prescription, that can ease the severity and duration of symptoms.

Complications of genital herpes (HSV-2)

Occasionally, genital herpes can lead to a more serious condition. This is more likely to happen in people with suppressed immune systems (such as those with other chronic illnesses).

In some rare cases, genital herpes can lead to a complication called herpes meningoencephalitis. This is an inflammation of the lining of the brain. According to Johns Hopkins, symptoms of herpes meningoencephalitis include:

• Headache
• Fever
• Changes in consciousness
• Confusion
• Neck stiffness
• Sensitivity to light
• Seizures
• Changes in mood, personality, or behaviors

Genital herpes and pregnancy

According to Boston Children’s Hospital, around 1 in 3,500 babies in the United States are born with neonatal herpes simplex. Newborns who are diagnosed with a herpes infection soon after birth typically contracted the virus in the birth canal. For this reason, it is recommended that women with genital herpes schedule a cesarean birth.

The herpes simplex virus poses a serious risk of complications in a newborn. Boston Children’s Hospital outlines some of these complications as:

• Localized skin infections
• Encephalitis (inflammation of the brain)
• Disseminated herpes infections (a herpes infection that spreads inside the body and can cause organ damage)

Women who experience their first genital herpes infection during the third trimester of pregnancy have the highest risk of spreading the herpes simplex virus to their newborns according to Boston Children’s Hospital.

Since many genital herpes infections go unnoticed, it is important for a woman who is pregnant or plans to become pregnant, to get tested for STIs including HSV-2 which causes genital herpes.

Diagnosing and testing for genital herpes

Because many people have no symptoms, getting diagnosed with genital herpes can be a challenge. The most common test for a genital herpes diagnosis is a swab test or blood test.

How is genital herpes diagnosed?

There are a few options to diagnose genital herpes. Your healthcare provider will determine which option is the best for your specific circumstances.

Swab testing

During a swab test, a healthcare provider will use a cotton-tipped swab to collect fluid from any blisters or sores at the affected site. This swab is then sent to a laboratory for testing.

Blood tests

For patients who have no active sores or blisters, a blood test is an available option. For a blood test, your healthcare provider will collect a sample of blood, using a venipuncture method, and then send the same to the laboratory for testing.

The CDC notes that blood tests have a higher chance of yielding a falsely negative result, because they may be performed too early to detect the virus.

Physical examination

ManySome medical providers may choose to start treatment for genital herpes based only on physical assessment. A medical provider will consider physical symptoms and sexual history during the assessment.

What to do after testing positive for genital herpes

After testing positive for genital herpes, you should talk to your healthcare provider about treatment options. There are several approved antiviral medications that can lessen the severity and duration of your symptoms, as well as lower your chances of spreading the virus.

You should also have open and honest communication with your sexual partners about your diagnosis, so they can seek testing and treatment options for themselves.

Treatment options for genital herpes

Currently, there are 3 antiviral medications that are FDA approved for the treatment of genital herpes. These medications are:

• Acyclovir
• Valacyclovir
• Famciclovir

Each of these antiviral medications is available in a pill or capsule form that is taken orally. Although these medications are clinically proven to treat an outbreak of genital herpes, they do not cure the virus.

According to the Mayo Clinic, the benefits of taking antiviral medications as a treatment for genital herpes are:

• Healing sores and blisters faster
• Lower the frequency of recurrent outbreaks
• Lessen the severity and duration of symptoms in recurrent outbreaks
• Reduce the chance of passing herpes to a sexual partner

The CDC notes that the use of topical antiviral creams is not effective, so they are generally discouraged.

Suppressive therapy for genital herpes

According to the FDA, tThe following antiviral medications can be prescribed on a long-term basis in some cases:

• Acyclovir
• Valacyclovir
• Famciclovir

Taking antiviral medications on a long-term basis is known as suppressive therapy. Only a healthcare provider can determine if suppressive therapy for genital herpes is right for you.

Treatment for first-time genital herpes

According to the CDC, recurrent outbreaks of genital herpes can become more severe if the initial outbreak is not treated appropriately. This is true even for people who initially have a mild case. Because of this, it is important to get properly tested and treated if you think you may have genital herpes.

Since many cases of genital herpes have no symptoms, it is important to get tested regularly if you are sexually active, especially if you have multiple partners.

Self-treating genital herpes

There are steps you can take to help make yourself more comfortable during a genital herpes outbreak, however, these steps should not replace having a medical evaluation.

The American Academy of Dermatology recommends these self-care tips for easing symptoms during an outbreak:

• Keep the affected area clean and dry
• Wear loose-fitting, cotton underwear
• Apply a cold compress to the affected area
• Soak in an Epsom salts bath for 10 to 20 minutes
• Take over-the-counter pain-relieving medications like Acetaminophen

It is important to note that the use of antiviral medication is the only clinically proven way to heal an outbreak faster according to the FDA..

Can genital herpes be medication-resistant?

According to published studies, the virus responsible for genital herpes (HSV-2) is reported resistant to antiviral drugs primarily in immunocompromised patients and people who take antiviral medications for long periods of time.

In the event of an antiviral-resistant case of genital herpes, your healthcare provider will evaluate if the use of other antiviral medications is appropriate.

Is there a cure for genital herpes?

Currently, there is no cure for genital herpes. Once infected, the virus lives dormant in the human body, and may “flare up”. The timing of these recurrent outbreaks is unpredictable and may correspond with life events such as:

• Elevated stress
• Hormone changes
• Illness

For women, the hormone changes associated with menstrual cycles or pregnancy may trigger outbreaks.

It is important to note that most people infected with genital herpes lead full and productive lives and manage their STI well.

What happens if I don’t get treatment for my genital herpes?

Genital herpes is a life-long viral infection that can, at times, disrupt your daily life. According to the CDC, lLeaving a genital herpes infection untreated raises your risk of:

• Recurring outbreaks that may become increasingly more severe
• Spreading the HSV-2 virus to other people easier

Additionally, pregnant women who have active genital herpes outbreaks are at risk for passing the herpes virus to their infant, which has the potential to become a life-threatening emergency for the infant.

Preventing genital herpes

Because genital herpes is a painful virus that has no cure, it is important to take steps to prevent getting exposed to it.

How can I prevent genital herpes?

As noted by the CDC, the surest way to prevent a genital herpes infection is to not have sex, or have only monogamous sex with a partner who has only had sex with you. However, there are other ways you can reduce your risk:

• Ensure the proper use of condoms or dental dams every time you engage in sexual activity
• Have open and honest communication with your sexual partner about their sexual history and recent STI testing

It is important to note that washing or douching is not sufficient in preventing genital herpes.

Since many cases of genital herpes are asymptomatic, it is important to use proper protection and get tested regularly if you are sexually active.

Do condoms help prevent the spread of genital herpes?

Condoms do help prevent the spread of genital herpes. However, you can still contract herpes in the areas that a condom does not cover, such as:

• Pubic area
• Scrotum
• Buttocks
• Inner thigh
• Labia Majora
• Rectum
• Mouth

Because condoms are not 100% perfect, it is important to talk to your sexual partners about their sexual health and recent STI testing.

Is there a vaccine for genital herpes?

Currently, there is research being done on vaccines for HSV-2, the virus that causes genital herpes. This vaccine is still in development and is not available to the public.