Genital herpes is a recurrent, life-long viral infection. Two types of HSV are known: HSV-1 and HSV-2. Most cases of recurrent genital herpes are caused by HSV-2. At least 50 million persons in the United States have a genital HSV infection.
Most persons infected with HSV-2 have not been diagnosed. Many such persons have mild or unrecognized infections but shed virus intermittently in the genital tract. Most genital herpes infections are transmitted by persons unaware that they have the infection or who are asymptomatic when transmission occurs.
The first attack of HSV (the initial infection) usually occurs within two days to three weeks after sexual contact with a contagious person. Flu-like symptoms (swollen glands, fever, headache, joint pain, and tiredness) are often present. Next, fluid-filled sores appear in the area of exposure. They may itch, burn, or be quite painful. Sometimes urination is painful and there may be a discharge from the penis or vagina. Within two to three weeks, the sores crust over, form scabs, and heal completely.
Not everyone has these symptoms. In some people, the first infection may be so mild that it is not noticed. After the initial infection, the sores may return, usually in the same place. In most cases they are fewer in number, less severe, and take a shorter time to heal (average 10 days).
Some people with HSV have symptoms just before they get the sores. These warning symptoms may include itching, tingling, burning, or numbness where the sore appears. This can happen two hours to two days before the sore starts to form.
It is not known what causes HSV to return, but some things may affect it. Lack of sleep, emotional stress, poor nutrition, fever, menstruation, sexual intercourse, overexposure to sun, wind, or cold, or having a respiratory tract infection may cause herpes to return. Also wearing tight clothing, such as jeans, may cause genital herpes to return from excess rubbing in the area. In many cases outbreaks appear without any known cause.
Clinical diagnosis of genital herpes is difficult especially in the absence of typical blisters or sores. If ulcers or lesions are present, a cell culture can be done to confirm the diagnosis. The test is most accurate within the first 2-3 days of the symptoms appearing.
At present, herpes can be treated, but not cured. Antiviral drugs partially control the symptoms and signs of herpes episodes. Suggestions to help reduce pain: Take warm tub baths with Epsom salts or baking soda. Keep infected area dry, as moisture may slow healing. Wear loose fitting clothing to help prevent rubbing. Hold a warm cloth or an ice pack on the affected area for a few minutes several times a day. Aspirin and similar medicines will help relieve pain and fever.
The sex partners of people with HSV-2 are likely to benefit from evaluation and counseling.
Symptomatic partners should be evaluated immediately.
Always use condoms, but avoid intercourse completely (including oral and rectal sex) when lesions or blisters are present. There is evidence to conclude condoms prevent HIV transmission in males and females, and that they could reduce the risk of Gonorrhea for men. Additional studies are needed to determine effectiveness for other STDs, including Herpes.
The more sexual partners you have, the greater your chance of getting a sexually transmitted infection.
Do not have intercourse with anyone who has an infection or is being treated for an infection. Also, talk with a new partner before having sex about any previous infections that they have had.
Do not use feminine sprays or douches. They can change the normal balance of bacteria in the vagina and increase your chances of getting a vaginal infection.
- Women with genital herpes may be more likely to develop cancer of the cervix than those who have not had the infection. The Pap smear can detect changes in the cervix at very early stages. A woman needs to have a Pap smear every year and possibly more often if she has herpes.
- If a pregnant woman or her sexual partner has, or has had genital herpes, she should tell her doctor. The doctor can check for the presence of an active herpes infection during pregnancy and plan the best care for herself and her infant.
- Herpes during pregnancy may result in stillbirth, or infection of the newborn as it passes through the birth canal. An infected newborn may have sores on the skin or damage to internal organs or the nervous system, which may cause mental retardation or death.
National Herpes Hotline, (919) 361-8488, Monday through Friday 9:00 a.m. - 7:00 p.m.
American Social Health Association Herpes Resource Center
P.O. Box 13827
Research Triangle Park, NC 27709-9940
Sexual Health Communications, (888) 238-4238, Monday - Friday
9:00 a.m. - 5:00 p.m. E.S.T.