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Genital Herpes

What is genital herpes?

Genital herpes is caused by the herpes simplex virus (abbreviated as HSV).  It is very common--about 1 in 4 women and 1 in 8 men have genital herpes. There are two types of the virus:

  • HSV I or Type I is usually associated with sores around the lips or mouth ("cold sores" or "fever blisters"). Type I can be transmitted to the genitals by oral-genital sex.
  • HSV II or Type II is usually associated with genital sores or lesions. Type II can be transmitted from genital sores to a partner's mouth and/or throat. 

What are the symptoms of genital herpes?

The symptoms of genital herpes vary greatly from person to person.  Many people do not know that they have it. 

Initial symptoms

For some people, initial or primary infection occurs two to ten days after exposure.  Lesions start as sensitive or itchy areas that develop into blisters, then break open to form painful, shallow ulcers, and finally heal by scabbing and drying.  In women, the sores appear around the vagina, labia, rectum, and occasionally the groin and inner thigh.  Often an increase in vaginal discharge is noted.  In men, lesions can be on the penis, scrotum, rectum, buttocks, or inner thighs.

During the first or primary episode, people may experience fever, headache, body aches, enlarged lymph glands in the groin area, and painful urination.  Generally, the first episode is more severe than later outbreaks, and sores may take two to three weeks to heal.

Some people have minor symptoms such as itching, slight burning or discharge and do not recognize these as signs of herpes.  Others have no symptoms at all.

Regardless of whether a person has symptoms or not, they are able to transmit the virus to sexual partners.  If you have tested positive for herpes, you should inform you partner(s) of your diagnosis, and that there is a small risk of transmission even when sores or other symptoms are not present.

Recurring symptoms or "outbreaks"

Many people have recurring outbreaks of genital herpes throughout their lives, although these are typically less severe than their first outbreak.  Current literature suggests that 30-70% of people with genital herpes will experience at least one recurrence.  Outbreaks may occur as seldom as once a year, or as often as twice a month.

Signals of an outbreak may be the onset of a tingling sensation or hypersensitivity of the skin in the thigh or buttock area a day or two before the sores/blisters appear.  Some people feel herpes outbreaks recur when they are especially fatigued and "run down."

How does somebody get genital herpes?

The herpes virus enters through a cut or break in the skin during skin-to-skin contact or is easily absorbed by the thinner skin or mucous membranes of the genitals or mouth.  No matter the biological sex of your partners, you may be at risk for genital herpes.

Although it is theoretically possible to get herpes from inanimate objects (towels, underwear, etc. used by someone who has herpes), it is very unlikely

How can I find out if I have genital herpes?

You'll need to schedule an appointment with Hall Health or another medical provider.  At your appointment, you'll be asked about your symptoms and your provider will do a genital examination.  If the typical blisters or ulcers are found during this examination,  the diagnosis can be made.  If the sores found are not typical, a blood test for herpes may be done, or your doctor may take a sample of fluid from the blisters for testing.

The most common blood test for herpes, the Western Blot, looks for the presence of antibodies--special proteins your body produces to fight infection. Since your body may not produce enough antibodies to be detectable for up to three months, your health care provider may recommend waiting before being tested.

What treatments are available?

To date, there is no medical treatment or medication that will cure genital herpes.  There are, however, antiviral medications that can shorten the time you have symptoms and, in some cases, make it less likely for you to spread the virus to others.

Acyclovir (Zovirax), valacyclovir (Valtrex), and famciclovir (Famvir) are the three drugs now being used to reduce the intensity and duration of symptoms. As with any medication, there may be mild side effects which you should discuss with your primary care provider. For people with frequent episodes of symptoms, these drugs may also be prescribed to be taken as a preventive measure to suppress outbreaks.

How can I minimize discomfort while having an outbreak?

  • Try sitting in warm water several times a day.  This will increase your circulation and gently cleanse the area.
  • Avoid soaping the genital area as this can cause irritation.  Gently dry with a towel.  The use of a hair dryer on a warm setting will help get the remaining moisture out of the skin, thus promoting faster healing of sores.
  • Wear cotton underwear and loose fitting clothing.
  • If you have discomfort when urinating, try urinating into the water while sitting in the tub.  Another option is to pour warm water over the genital area as you urinate.  Increasing your fluid intake will dilute your urine, making it less painful when it comes into contact with open lesions.

What complications are associated with herpes?

Although genital herpes itself usually does not cause major complications, it can cause problems if precautions are not taken.

  • Herpes keratitis (an eye infection) is a potentially serious disease that can be caused by the transfer of the virus from any herpes sore to the eyes via your fingers. Prevention: Always wash your hands with soap and water after any genital contact when lesions are present.  If you wear contact lenses, always wash your hands before handling them. Do not lubricate the lenses with saliva, especially during an outbreak of oral herpes.
  • Pregnancy and infants:  Women who become pregnant should always let their health care provider know that they have a history of genital herpes.  Babies born through an infected vaginal canal may contract a life-threatening form of herpes. This can be prevented through careful surveillance during the last month of pregnancy with the option of Cesarean section if active lesions are present at the time of birth.  Remember that newborn babies up to 4 months old are more susceptible to herpes, so pay careful attention to hand washing and avoid kissing infants if you have oral lesions.

How can I protect myself and others?

  1. Learn about herpes and practice honest and open communication with your sexual partner(s).  This may be hard, but it is the most loving and honest method to prevent the spread of the virus.
  2. Refrain from skin-to-skin contact near any lesions until they are completely healed over.  In the initial outbreak only, women may continue to shed the virus from the cervix for 6 months or longer after visible genital lesions have healed.  It is not clear if men who are not having symptoms shed the herpes virus.  If cold sores are present on the mouth or lips, refrain from oral-genital contact until they have completely healed.  Canker sores that appear occasionally on the gums or inside of the mouth are not herpes and are not transmitted from person-to-person.
  3. Condoms reduce the risk of spread and help prevent transmission of other STDs.
  4. Abstinence should start as soon as you feel any itching or tingling or numbness in the area.  Remember, you can be intimate and affectionate without having vaginal or anal intercourse.
  5. There have been no proven cases of herpes acquired from towels or toilet seats.  However, to be safe during an outbreak, do not allow anyone else to use your towels or washcloths.

Getting help

Phone

Herpes Resource Center, 9am to 6pm Eastern Time, (919) 361-8488

If you have any questions and are a UW student or established Hall Health patient, you may call one of our Consulting Nurses for further information. consulting nurse service for further information. 

Online resources

The American Sexual Health Association's Herpes Resource Center

Hall Health's article on how to tell your partner you have an STD

Books

Ebel, Charles. Managing Herpes—How  to Live and Love with a Chronic STD.

Sacks, Steven. The Truth About Herpes.

 

Authored by: Hall Health Center Women's Health Clinic staff

Reviewed by: Hall Health Center Women's Health Clinic staff, January 2014