Genital herpes is a highly contagious sexually transmitted disease (STD). The cause is a strain of the herpes simplex virus (HSV). This virus enters your body through small breaks in your skin or mucous membranes.
The illness is characterized by pain, itching and sores in your genital areas. Sexual intercourse is usually the primary way that genital HSV spreads. It's almost impossible to get the infection through contact with toilets, towels or other objects used by an infected person. The virus dies within hours outside the body.
HSV affects both men and women. There is no cure for this recurrent infection, which often causes embarrassment and emotional distress. Having genital herpes is no reason to avoid sex or give up on relationships. If you or your partner is infected, you can manage the spread of HSV by taking steps to protect yourself and your partner. Open communication with your partner or potential partner is important.
Signs and symptoms of genital herpes include:
- Pain or itching in the skin around your genital area
- Water blisters (vesicles) or open sores (ulcers)
The initial symptom of genital herpes is pain or itching. This stage begins 2 to 7 days after exposure to the virus. Anywhere from a few hours to several days after the first stage, sores begin to appear.
In women, sores can erupt in the vaginal area, external genitals, buttocks, anus or inside the cervix. In men, sores can be on the penis, scrotum, buttocks, anus, thighs, or inside the channel between the bladder and the penis (urethra).
While the ulcers are present, it may be painful to urinate. The ulcers begin as small, tender, red bumps and become watery blisters within a few days. They then rupture, becoming ulcers that ooze or bleed. After 3 to 4 days, scabs form and the ulcers heal. You may experience pain and tenderness in your genital area until the infection clears. During an outbreak, you may experience flulike signs and symptoms including headache and fever, as well as swollen lymph nodes in your groin.
Genital herpes has a unique cycle. The signs and symptoms may recur for years. Some people experience an episode every month. For most people, however, the outbreaks are less frequent. Various factors may trigger later outbreaks, including:
- Stress
- Menstruation
- Fatigue
- Illness
- Skin irritation
- Surgery
- Vigorous sexual intercourse
In some cases, the infection can be active and be spread even when lesions aren't present (known as asymptomatic viral shedding). However, this is uncommon.
There are two types of herpes simplex virus infections. HSV type 1 (HSV-1) is the type that causes cold sores or fever blisters around your mouth. HSV type 2 (HSV-2) is the type that causes genital herpes. The virus spreads through sexual contact and skin-to-skin contact. HSV-2 is highly contagious if you have an open sore, but it's also possible to spread the virus even when you don't have an active sore. This process of infection is called asymptomatic viral shedding. HSV-2 is extremely common. The Centers for Disease Control and Prevention estimates that 45 million Americans over the age of 12 have an HSV-2 infection, although in most people the infection is inactive or "silent" and causes no symptoms.
If you suspect you have genital herpes, see your doctor. Your doctor can diagnose herpes by taking a tissue scraping or culture of the water blisters or early ulcers for examination in the laboratory. Because at least one other STD is often present in addition to herpes, your doctor will examine you for other STDs.
In adults, genital herpes generally doesn't cause any other serious permanent complications besides the sores. A mother with open sores can spread the infection to her newborn as the infant passes through the birth canal. Genital herpes may result in brain damage, blindness or death for the newborn. This infection is more common in infants of mothers who are having their first outbreak of active herpes infection at the time of delivery.
There is no cure for genital herpes. However, the oral prescription medications acyclovir (Zovirax), famciclovir (Famvir) and Valacyclovir (Valtrex) can help heal the sores sooner and may limit relapses. In some cases, doctors may advise these medications after the first outbreak. In other cases, doctors may wait until after subsequent outbreaks.
The suggestions for preventing genital herpes are the same as those for preventing other STDs. The key is to avoid spreading HSV, which is highly contagious while lesions are present. Having genital herpes can increase the risk of transmitting or contracting other STDs, including the AIDS virus.
The surest way to prevent infection is to abstain from sexual intercourse or to have intercourse with only one person who is infection-free. Short of that, you can:
- Use a latex condom during each sexual contact.
- Save sexual intercourse for times when you have no signs or symptoms.
- Limit your sex partners.
If you have an active infection:
- Avoid sex.
- Keep sores clean and dry.
- Avoid touching sores, and wash hands after contact with sores.
Remember that the virus can spread even when no symptoms are present. Wait until all sores are completely healed before resuming sexual activity and always use protection with latex condoms.
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July 25, 2001 —
