Genital herpes is a common chronic sexually transmitted disease (STD), caused by herpes simplex viruses (HSV) and transmitted during sexual contact. Some people have distinct symptoms (blisters, pain, redness) that are easy to recognise if they recur. However, many only have very mild symptoms or so atypical ones that they can have the infection and pass it on to their partners without knowing it. After infection, HSV remains in the body for life. It cannot be eliminated with medication or by any other measures. Some people never have a recurrence or any symptoms, but about 80% of those infected experience repeat outbreaks every now and then. Sometimes they have no symptoms at all, until the symptoms recur with blisters and other symptoms in the genital mucosa. Two HSV types present in the genital area: HSV 2, commonly known as the genital herpes virus, and HSV 1, previously thought to cause just cold sores (oral herpes). In practice, both virus types may be present in both areas.
HSV is transmitted during sexual contact. The risk is highest when the infected person has symptoms, but more than half of genital HSV infections still occur when there are no symptoms at all. Symptoms typically start 4 to 14 days after infection and involve fever, muscle pain and headache. There is genital burning and pain when urinating as well as small painful blisters and sores on the genitals. The lymph nodes in the groin also swell because of the infection. The symptoms continue for about 2 to 3 weeks. The first herpes outbreak can usually be diagnosed on the basis of its symptoms. Some people nevertheless have no symptoms at all after infection. The virus may also be transmitted by the fluid in herpes blisters, for instance when infected persons touch the blisters on their genitals and then touch their eyes. Good hand hygiene is therefore important if you have blisters. If a woman catches genital herpes when pregnant, the infection passes on to the foetus in about half of cases. Women who have their first symptomatic herpes outbreak during pregnancy thus need follow-up.
About 80% of those with genital herpes infection will have repeat outbreaks, usually with milder symptoms than during the first outbreak. The recurrence frequency is individual and varies greatly. Typically, the symptoms of a recurrence last about a week.
Herpes is usually diagnosed on the basis of typical symptoms, but viral culture performed in a laboratory is sometimes also required. This is performed on a sample taken from a fresh blister. Blood antibody tests only show whether the person has caught HSV at some point. They do not show when the infection took place, where in the body it was, and whether this is recurrent herpes.
Herpes cannot be cured with medication. During the first outbreak, a course of medication lasting 5 to 10 days clearly shortens the duration of symptoms, though. The aim is therefore to treat the first herpes outbreak with a course of antivirals as soon as the symptoms have been diagnosed. Genital herpes must be treated with prescription medicines taken by mouth. Topically applied creams for the treatment of oral herpes (cold sores) are not enough. The symptoms of repeat outbreaks can also be treated with a course of antiviral medication. If the symptoms recur and are troublesome, the same medicines can also be used to prevent an outbreak.
Genital herpes is a very common condition. Many people are shocked to hear about the infection, and knowing the virus is permanently in the body may be scary and stressful. Nevertheless, herpes is a condition that you can learn to live with, identifying the early symptoms of a repeat outbreak and taking medication as required. HSV infections can be transmitted at least / particularly easily when you have symptoms, and at these times, it is therefore sensible to use a condom even in a long-term relationship. During other times, you should discuss the use of condoms with your long-term partner and point out that without a condom, your partner may catch the infection as well. With a new partner and in casual sex contacts, the use of a condom in every sexual contact is the only way to avoid infection. The same applies to using protection in oral sex.
Sukuelinherpes, Duodecim, Terveysportti [article in Finnish]
Eija Hiltunen-Back: Genitaaliherpeksen hoito [Treatment of genital herpes], Finnish Medical Journal Duodecim 11/2001
This article was written by
This article was reviewed on 26 Nov. 2012 by SI
Key words: Sex, Sexually transmitted diseases, Genital herpes