Genital herpes is an infection caused by a virus that produces sores and blisters around the external sex organs. In most cases it is passed on through direct contact with secretions from the active sores of a person infected with the virus, often during sexual activity.
Herpes can be annoying, uncomfortable, and upsetting emotionally, but it is very rarely a serious health problem.
What Causes Herpes?
Herpes is an infection caused by the herpes simplex virus. This virus is one of a group of viruses that cause chickenpox, cold sores, and mononucleosis (“the kissing disease”). Two closely related virus strains, called the herpes simplex virus types 1 and 2, can affect the mouth and the genitals. Herpes simplex virus type 1 usually infects the lips, mouth, or nasal membranes. The sores, known as cold sores or fever blisters, caused by it often occur in both children and adults without having any relationship to sexual activity. The sores caused by the type 1 strain generally tend to be less severe than those caused by the type 2 strain. The type 1 strain can also infect the genitals, and it causes about one-third of genital herpes infections. Most often, however, genital herpes is caused by herpes simplex virus type 2.
Infection occurs when the herpes virus passes through a break in the skin or penetrates the moist membranes of the penis, vagina, urinary opening, cervix, or anus. Once it invades the skin, the virus starts infecting healthy cells. Sores, blisters, and swelling are caused by the body’s natural defense system as white blood cells react to the infected cells.
Although these sores (often called lesions) heal in a few days to a few weeks, some of the virus travel to nerve cells near the spine and remain inactive until some event triggers a new bout. This event may be a lapse in the body’s defenses because of infection, stress, fatigue, or other, unknown reasons. The viruses leave their resting place and travel along the nerves, back to the spot where they first entered the body, causing new blisters to pop up. Some people have only one outbreak, while others have repeated bouts. About 90% of people with herpes have recurrent infections.
During an active infection, herpes sores and blisters contain live viruses that can be spread to another place on the body or to another person. Therefore, when sores touch the skin of another person, that person can become infected. Besides the sex organs, genital herpes can affect the tongue, lining of the mouth, eyes, gums, lips, fingers, and other parts of the body. During oral sex, herpes can be passed from a cold sore around the mouth to the partner’s genitals or from the genitals to the mouth.
What are the Risk Factors of Herpes?
Virtually anyone, no matter what age, race, or sex, can become infected with herpes. Because the virus is probably transmitted most frequently through sexual contact, it often occurs in young, sexually active people who have more than one partner.
What are the Symptoms of Herpes?
Symptoms vary from person to person. Some people may have painful attacks with many sores, while others have only mild symptoms. Fortunately, most recurrent infections are milder than the first, and sores usually heal faster.
Some people infected with herpes have no symptoms at all. However, about 2-10 days after the herpes virus enters your body, you may get flu-like symptoms such as:
- Sores appearing as small, fluid-filled blisters on the genitals, buttocks or other areas
- Swollen glands
- Muscle aches
- Pain during urination
The first bout with genital herpes, known as a primary infection, usually lasts about 3 weeks. During this time the lesions break open and “weep”, then gradually shrink and dry up. Rarely are scars left behind.
If lesions recur, the warning signs are an itching or tingling feeling near the site where the virus first entered the body. This is called the “prodrome”. You may feel pain running into your buttocks or knees. A few hours later, sores will appear. In recurrent infections, there is usually no swelling in the genital area or fever, and sores heal more quickly, usually within a week or two.
How is Herpes Diagnosed?
- Clinical examination
- Testing cells from the lesions in a lab test
- Blood test
What Complications does Herpes Cause?
Although it is rare, it is possible, once you have herpes, to accidentally reinfect yourself in another place on your body. If you touch an active herpes lesion and then rub or scratch another part of your body, you can transfer the virus to a new location. This reinfection is called auto-inoculation. The eyes, mucous membranes of the mouth or genitals, and areas where there are breaks in the skin are the most susceptible. To avoid auto-inoculation, wash your hands after coming in contact with a sore and avoid touching the sores.
If you are pregnant and have a herpes infection, inform your doctor immediately. Although it is rare, newborn herpes can affect the baby in several ways:
- A primary infection causes premature birth if the mother is ill
- Newborns that contact herpes from the mother usually become infected while they are being born through the mother’s infected birth canal. As a result, the newborn baby may suffer severe skin infection, damage to the nervous system, blindness, mental retardation, or death
If you have an active infection at the time of delivery, your doctor may suggest a Caesarean birth. Caesarean birth can reduce the chance that the baby will come in contact with the virus, because delivery takes place through a “clean” surgical cut in the abdomen where the tissue is not infected with the virus. However, a baby can also be infected without passing through the vagina, especially if the amniotic sac has broken several hours before birth.
What are the Treatment Options for Herpes?
See a doctor right away if you have symptoms of genital herpes or if you think you have herpes. The sooner herpes is found, the earlier it can be treated, thus reducing the pain of first and future outbreaks.
Although no cure has yet been found for genital herpes, a prescription medicine called acyclovir is available to help control the course of the disease.
Help the sores to heal by keeping them clean and dry. Wash the sores with sores with soap and warm water and dry gently. Wear loose-fitting cotton underwear instead of those made of nylon and other synthetics.
How is Herpes Prevented?
- Limit to one sexual partner
- Avoid sexual relationships with a partner who has herpes
- Wash your hands with soap after any possible contact with lesions
Although the herpes virus can survive for a few hours away from the human body, there is no proof that the disease can be picked up from toilet seats, hot tubs, or other objects. In general, simple methods of disinfection, such as washing with detergent or bleach and water, is enough to inactivate the virus on objects.
If you have herpes, wear pyjamas that cover your sores to prevent passing it on to your partner. Using a condom does not provide reliable protection against herpes as it may not cover all lesions. The best way to avoid infecting your partner with herpes is to refrain from having sex until the sores have completely disappeared.
Obstetrics and Gynaecology (O&G)