1Overview

The number of sexually transmitted infections has continuously increased over the past years. One of the most common STIs is genital herpes.

Genital herpes is one of the most common sexually transmitted infections (STI) caused by the herpes simplex virus (HSV). The main mode of transmission is through sexual contact. The infection causes painful sores or blisters on the genital area and adjacent areas.

The virus can affect the mucous membranes like the genitals and mouth. When a person contracts the virus, it may remain dormant in the body but becomes active after a few years.

The types of the herpes simplex virus include the HSV-1 and the HSV-2. The HSV-2 is usually the cause of genital herpes and the HSV-1 causes cold sores. Genital herpes is a common condition affecting people between 14 and 49 years old.

2Symptoms

Most people infected with HSV are not aware that they have the infection because they do not have any manifestations of the disease. The symptoms usually begin about two to 12 days after exposure to the virus.

The appearance of blisters is called as an “outbreak.” The first outbreak will appear days after contracting the infection. However, the general symptoms in males include blisters in the scrotum, penis and the area near the buttocks.

The symptoms of genital herpes include:

  • Itching, tingling, and pain on the infected site, before the actual appearance of the blisters
  • Ulcerated blisters where there is oozing fluid
  • Blisters in the mouth, lips, face and other infected areas.
  • Crust may appear over the sores
  • Swollen lymph glands
  • Headache
  • Fever
  • Body pains

Babies who are born with the herpes simplex virus may have worse symptoms including:

  • Ulcers on the face, genitals, and body
  • They may develop complications like blindness, brain damage, and death.

3Causes

Two types of the herpes simplex virus case the infection:

Herpes Simplex Virus – 1 (HSV-1)

This is the virus that usually causes the cold sores or fever blisters around the mouth.
This type is spread to direct skin-to-skin contact. However, it can be spread to the genital area because of oral sex.

Herpes Simplex Virus (HSV-2)

This virus is the one that usually causes genital herpes. The virus is usually transmitted through sexual contact and even skin-to-skin contact. This condition is highly-contagious, whether a person has an open sore or not.

These viruses can be spread in infected people’s body fluids through saliva, semen, and vaginal secretions.

4Risk Factors

Anyone can acquire genital herpes, but the risk is higher if you are:

  • A woman – women are at a higher risk of acquiring genital herpes than men.
  • Having multiple sexual partners – People with many sexual partners and who engage in risky sexual behaviors are at a higher risk of contracting the infection.
  • Inconsistent or incorrect condom use
  • Sexual contact with a person who is infected with genital herpes
  • Sexual activity at an early age
  • History of STIs
  • Human immunodeficiency virus (HIV) infections
  • Weakened immune systems

5Complications

In some cases, the blisters or sores can become infected. As a result, the infection may spread to surrounding areas and other parts of the body.

The other complications associated with the virus include:

Brain damage in newborns

Babies born to mothers with genital herpes may have blindness, brain damage and may die from the infection.

Meningitis

If the infection spreads to the brain, it may lead to meningitis, which is potentially-fatal.

Bladder conditions

Genital herpes may increase the risk of having inflamed ureters.

Acquiring other sexually transmitted diseases

Being sexually active and having genital sores heightens the risk of acquiring other diseases and infections like HIV.

Proctitis or rectal inflammation

The infection may cause the inflammation of the rectum’s lining, which is commonly seen in men who have sex with men (MSM).

6Diagnosis

Early detection and testing of STIs are important to prevent the transmission of the virus and also, to reduce the risk of complications. Genital herpes can be diagnosed more accurately when the infection is still active.

Based on the first symptoms and if the person has an increased risk, the patient may seek medical attention as soon as he or she observed these symptoms.

The diagnostic tests include:

Polymerase chain reaction (PCR) test

PCR is used to detect the presence of HSV and see what type has infected the person.

Viral culture

The viral culture test is used to examine the tissue sample from the genitals to see the presence of the virus.

Blood test

Blood tests are used to detect the presence of the antibodies for HSV.

7Treatment

The treatment of genital herpes depends on whether the patient has the infection for the first time or if the patient has recurrent symptoms. There is no cure for the viral infection. The goals of the treatment include:

  • Help sores heal sooner
  • Reduce the chances of recurrence
  • Reduce the severity of the symptoms
  • Lessen the chance of transmitting the virus to others

A herpes infection is treated through the following procedures:

Primary infection treatments:

Antiviral tablets

if you visit sexual health clinics, the GP may prescribe antivirals like acyclovir.
This drug works by preventing the virus from replicating. However, these medicines do not make entirely clear the virus from the body.

Other antiviral tablets include famciclovir and valaciclovir.

After the initial treatment, there are two options:

Intermittent treatment

This entails using an antiviral drug on hand in case another outbreak happens.
This is called intermittent because it’s not continuous. The pills are taken for two to five days as soon as the sores appear.

Suppressive treatment

This treatment is done if the patient has recurrent outbreaks. This entails taking antiviral drugs every day. If a patient has more than six outbreaks a year, the doctor may prescribe suppressive treatment. This type of treatment has shown to reduce the number of outbreaks by as much as 70 to 80 percent. In some cases, those who take the drugs every day may have no outbreaks at all.

Recurrent outbreaks:

For recurrent outbreaks, here are simple ways to reduce the symptoms and discomforts:

  • Apply an ice pack to the affected area and sores to help soothe the pain. However, cover the ice pack with a flannel and don’t directly apply the ice to the sores.
  • Keep the affected area clean. You can wash them with warm salt water.
  • Apply petroleum jelly or anesthetic cream to ulcers for pain relief.
  • Drink plenty of water to dilute the urine. Passing the urine on the blisters is painful.
  • Wear loose clothing.

8Prevention

For people with genital herpes, it is important to avoid having sexual intercourse.
This includes anal, oral and vaginal sex until all blisters and sores have cleared up.
Here are other ways to prevent genital herpes.

The preventive measures applied to genital herpes is the same with other sexually transmitted infections. Of course, the best way to prevent the infection is to abstain from sexual activity with an infected person or limit sexual contact to only one individual who has no infection. Other preventive measures include:

  • Use or have the partner use condom during every sexual contact.
  • Avoid intercourse if the partner has outbreaks in the genital area or other parts of the body

Pregnancy precautions:

For women who are pregnant, it is important to get tested if they know they have the condition. This is to make sure that the baby will not suffer from certain complications linked to the virus.

Furthermore, the doctor may provide preventive measures or medicines to make sure there are no outbreaks at the time of the delivery. However, the most important thing is for the doctor to suggest a cesarean section to decrease the risk of transmitting the virus to the baby.

In people with the HSV-1 type of virus, some of the preventive measures include:

  • Avoid direct physical contact with other people.
  • Do not kiss people with the lesions on their lips.
  • Don’t share items that can transmit the virus-like utensils, makeup, lipstick, cups, towels, and clothing.
  • Do not engage in oral sex, kissing and other types of sexual activities
  • Practice proper hand washing and when applying for medicines, do not use your fingers but use cotton swabs to limit the contact with sores.

9Outlook

The long-term outlook for people with genital herpes is a long-time battle with the disease. People who contract the disease will have it for the rest of their lives. The viral infection may not manifest any symptoms, but the virus will continue to thrive inside the person’s nerve cells.

In some cases, people might experience recurrent outbreaks after the initial infection. Others, on the other hand, may only experience one outbreak and the virus will turn dormant. However, dormant viruses can be triggered through these stimuli:

  • Menstrual periods
  • Sun exposure
  • Sunburn
  • Stress
  • Illness
  • Fever

Some outbreaks may become less serious or intense in time because the immune system has started producing antibodies for the virus. Moreover, in healthy people, the infection might not manifest any complications. The best way to manage this infection is to prevent having it in the first place. Prevention is better than cure, so make sure you practice safe sex and prevent exposure to infected people.