Genital Herpes
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Genital Herpes

(Herpes, Genital; Herpes Genitalis; Herpes Simplex 2; Herpes Simplex, Genital; Herpes Simplex Virus [HSV]—Types 1 and 2)

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Definition

Genital herpes is an infection that causes small, painful, fluid-filled blisters. These blisters break open and leave an indented sore or ulcer. They can be found on:

  • Genitals, buttocks, or thighs
  • Other parts of the body (eg, mouth, face, or eyes)

Genital Herpes

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Causes

Genital herpes is caused by the herpes simplex virus type 1 or type 2. The virus enters the body through a break in the skin or through mucous membranes. After the first outbreak, the virus migrates to nerve endings at the base of the spine, and lies dormant until the next outbreak.

The virus is spread through:

  • Sexual contact, including intercourse, oral sex, and anal sex
  • Fluid from herpes blisters that gets on other parts of the body
  • An infected mother passing it on to her child during pregnancy or childbirth

The virus is most contagious when blisters are present. It is also contagious during the "shedding" stage, before blisters or sores are visible. The virus may also spread when inactive between visible outbreaks.

Risk Factors

The strongest risk factor for getting genital herpes is having unprotected sex with an infected partner. Once herpes simplex is in the body, other risk factors can trigger the blisters to form. These can include:

  • Fever
  • Illness or infection
  • Stress
  • Weakened immune system
  • Menstruation
  • Long periods of exposure to sunlight

Often, the cause of an outbreak is unknown.

Symptoms

Symptoms depend on whether this is your first (primary) episode or a recurrent episode. The virus remains dormant between outbreaks. During this time, you may not have visible symptoms, but you may still be shedding the virus. This means the virus can be spread during sex.

The number of outbreaks varies. Most people have an outbreak at least once per year.

Primary Infection

This is when you are first exposed to the virus. You may not have any symptoms, or you may feel like you have the flu (eg, fever, muscle aches). The blisters may be in the genital area or other areas, like the mouth, lips, or tongue. The size and number of ulcers are usually larger during this first time. It takes about two weeks for the primary infection to resolve. If you get another infection, though, it may take up to six weeks for the blisters to go away.

Recurrent Infection

This happens when the virus reactivates in your body. How severe the virus is, how long it lasts, and how much is shed all vary. In most cases, these infections are shorter (3-7 days) with smaller and fewer ulcers. Symptoms are usually around the blister or ulcer area. Remember that you can still spread the virus even if you don't have any symptoms.

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. The blisters and ulcers will be looked at. Lesions inside the urinary tract, vagina, or cervix may not be easily seen. To help with the diagnosis, your doctor may:

  • Open a blister to take a sample of it
  • Have blood tests done

Treatment

Treatments to ease pain include:

  • Over-the-counter pain medication
  • Antiviral creams and ointments
  • Cool cloths placed on blisters or sores
  • Lukewarm baths
  • Loose-fitting clothing

Treatments to speed healing include:

  • Taking oral antiviral medications
  • Keeping blisters or sores dry when not bathing

Treatments for bacterial infection of the blisters or sores include:

  • Antibiotic medications

Prevention

To prevent the spread of the herpes simplex virus:

  • Use condoms to help prevent the spread of genital herpes.
  • Avoid oral sex if your partner has herpes blisters on the mouth or genital area.
  • Avoid touching blisters to prevent spreading to other parts of the body.
  • Ask your doctor about medications (like valacyclovir) that may reduce the chance of spreading the virus.
  • If you are pregnant and have herpes, tell your doctor. Medication given to newborns immediately after birth can decrease the chance of infection. If you have herpes blisters during delivery, you may need a Cesarean section.

RESOURCES:

The American College of Obstetrics and Gynecology
http://www.acog.org/

American Social Health Association
http://www.ashastd.org/

International Herpes Alliance
http://www.herpesalliance.org/

CANADIAN RESOURCES:

Health Canada
http://www.hc-sc.gc.ca/index_e.html/

Sex Information and Education Council of Canada
http://www.sieccan.org/

Sexually Transmitted Diseases
Ministry of Health and Long-Term Care
http://www.health.gov.on.ca/

References:

Berkow R. The Merck Manual of Medical Information . New York, NY: Pocket; 2000.

Contraception and STDs. Mayo Foundation for Medical Education and Research website. Available at: http://mayoresearch.mayo.edu/mayo/research/ndc_education/upload/most_contraception.pdf. Published 2003. Accessed June 24, 2008.

Herpes genitalis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated June 2008. Accessed June 24, 2008.

Herpes simplex. American Academy of Dermatology website. Available at: http://www.aad.org. Published 2005. Accessed June 24, 2008.



Last reviewed November 2007 by David L. Horn, MD, FACP

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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