Genital Herpes
Essential facts
Genital herpes is caused by herpes simplex virus,
type I or type II. Both types can infect the mouth (producing cold sores)
or the genital area (genital herpes).
Symptoms
When a person is infected with the herpes virus, it may
pass unnoticed. This is called subclinical infection. Therefore many
people with genital herpes are not aware they have the infection.
When symptoms occur, they appear from time to time in episodes
(also called outbreaks or attacks). After contracting the
herpes virus, a person may experience an episode within a few days, but it
may take much longer (sometimes years) before symptoms are noticed. Often,
the person never develops recognisable herpes symptoms.
In the first episode, general flu-like symptoms may
occur — feeling unwell, fever, headaches, or pains in the back and legs.
These symptoms do not usually occur with later outbreaks.
Most genital herpes outbreaks cause symptoms similar to
the cold sores that many people experience on or around their lips. But
with genital herpes, the "cold sores" usually appear on or near
the genitals or anus. Sometimes they appear on the buttocks or thighs.
Outbreaks may produce small blisters, which break open
to form shallow painful sores. These develop a scab after 1-2 weeks and
then heal. Sometimes the first outbreak causes considerable pain and
distress; future episodes are usually less severe.
Although herpes sores heal, the virus remains in the
body and may produce more sores later. These are called recurrent
outbreaks.
Recurrent Outbreaks
These usually occur on or near the same part of the body
as the first attack, but are often shorter and not as painful. They may be
triggered by general illness, stress, menstruation or sexual activity, but
often no trigger can be identified.
In most cases, recurrent outbreaks become less frequent
with time and may eventually stop altogether.
Recurrent attacks are caused by reactivation of virus
already present in the body — not by being re-infected.
Transmission
The virus is spread by skin-to-skin contact. Cold sores
on the mouth are a potential source of genital infection during
mouth-to-genital contact (oral sex).
Because recurrent herpes may cause few symptoms or pass
unnoticed, it is possible to pass on the virus even when there are no
visible blisters or sores.
Once you have a herpes infection, you probably cannot be
infected again by the same strain of herpes virus.
Diagnosis
Herpes is diagnosed by taking a sample from an infected
area during an outbreak. The herpes virus will usually grow from a swab
taken from a ruptured blister. The test will identify the strain (type 1
or type 2) of the herpes virus. Type 1 genital herpes tends to cause fewer
recurrences than type 2.
Blood tests may assist diagnosis in some cases, but the
results can be difficult to interpret. A blood test can only tell that you
have been infected with the herpes virus in the past. It cannot
tell you:
- which part of your body is infected (i.e. whether you
are carrying the virus on your lips or genitals)
- whether you will develop any symptoms of genital
herpes
- if symptoms you have experienced are due to herpes
Your doctor can advise if a blood test would be helpful.
Treatment
Iodine paint (Betadine) will dry out the blisters
and help prevent secondary infection. Salt baths may help ease discomfort,
and passing urine in a warm bath may help if urination is painful. Aspirin
or paracetamol will help relieve pain.
Anti-viral medication may be prescribed by a doctor. It
will reduce the severity of an outbreak if taken early in infection
(preferably within three days of symptoms appearing).
If outbreaks are frequent, medication can be taken
continuously. It does not get rid of the virus from the body, but it
prevents most outbreaks.
Antiviral drugs include aciclovir (Zovirax),
famciclovir (Famvir) and valaciclovir (Valtrex).
Preventing transmission
Transmission of herpes to another person is most likely
to occur when you have oral, genital or anal sex a few days before, or
during, an outbreak.
It is possible to transmit infection even if there are
no obvious blisters, sores or other symptoms.
When condoms are used properly, they stop transmission
of the virus across the skin that they cover. If you do not have any
blisters or sores, it is an individual decision whether to use condoms
when having sex. Many factors may influence the decision, so you may wish
to discuss this with a doctor or health adviser.
Herpes and pregnancy
In pregnant women, herpes infection may be transmitted
to the baby at delivery, causing serious illness. This is not common, but
the obstetrician should be told of past genital herpes infections so the
risk of this complication can be minimised.
Coping with herpes
Much anxiety and fear is caused by genital herpes,
and many people are alarmed by the diagnosis. Genital herpes blisters are
simply cold sores in the genital area, and should not be regarded as a
source of shame or guilt, or a serious barrier to sexual and other loving
relationships.
If you are having difficulty coping with the diagnosis
of herpes, a doctor or health adviser can tell you about counselling
services that are available. There are also numerous support groups on the
internet. |
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