What is Genital
Genital herpes is an infection caused by the herpes simplex virus or
HSV. There are two types of HSV, and both can cause genital herpes.
HSV type 1 most commonly infects the lips, causing sores known as
fever blisters or cold cores, but it also can infect the genital
area and produce sores. HSV type 2 is the usual cause of genital
herpes, but it can also infect the mouth. A person who has genital
herpes infection can easily pass or transmit the virus to an
uninfected person during sex.
Both HSV 1 and 2 can
produce sores (also called lesions) in and around the vaginal area,
on the penis, around the anal opening, and on the buttocks or
thighs. Occasionally, sores also appear on other parts of the body
where the virus has entered through broken skin.
HSV remains in
certain nerve cells of the body for life, and can produce symptoms
off and on in some infected people.
According to the U.S.
Centers for Disease Control and Prevention, 45 million people in the
United States ages 12 and older, or 1 out of 5 of the total
adolescent and adult population, are infected with HSV-2.
Nationwide, since the
late 1970's, the number of people with genital herpes infection has
increased by 30%. The largest increase is occurring in young teens.
HSV-2 infection is more common in three of the youngest age groups
which include people aged 12 to 39 years.
How Does Someone
Get Genital Herpes?
Most people get genital herpes by having sex with someone who is
having a herpes "outbreak." This outbreak means that HSV is active.
When active, the virus usually causes visible lesions in the genital
area. The lesions shed (cast off) viruses that can infect another
person. Sometimes, however, a person can have an outbreak and have
no visible sores at all. People often get genital herpes by having
sexual contact with others who don't know they are infected or who
are having outbreaks or herpes without any sores.
A person with genital
herpes can also infect a sexual partner during oral sex. The virus
is spread only rarely, if at all, by touching objects such as a
toilet seat or hot tub.
What Are the
Unfortunately, most people who have genital herpes don't know it
because they never have any symptoms, or they do not recognize any
symptoms they might have. When there are symptoms, they can be
different in each person. Most often, when a person becomes infected
with herpes for the first time, the symptoms will appear within 2 to
10 days. These first episodes of symptoms usually last 2 to 3 weeks.
Early symptoms of a
genital herpes outbreak include:
- Itching or burning feeling in the genital or anal area
- Pain in the legs, buttocks, or genital area
- Discharge of fluid from the vagina
- Feeling of pressure in the abdomen
Within in a few days,
sores appear near where the virus has entered the body, such as on
the mouth, penis, or vagina. They also can occur inside the vagina
and on the cervix in women, or in the urinary passage of women and
men. Small red bumps appear first, develop into blisters, and then
become painful open sores. Over several days, the sores become
crusty and then heal without leaving a scar.
Other symptoms that
may go with the first episode of genital herpes are fever, headache,
muscle aches, painful or difficult urination, vaginal discharge, and
swollen glands in the groin area.
If you have been infected by HSV 1 and/or 2, you will probably
have symptoms or outbreaks from time to time. After the virus has
finished being active, it then travels to the nerves at the end of
the spine where it stays for a while. Even after the lesions are
gone, the virus stays inside the nerve cells in a still and hidden
state, which means that it's inactive.
In most people, the
virus can become active several times a year. This is called a
recurrence. But scientists do not yet know why this happens. When it
becomes active again, it travels along the nerves to the skin, where
it makes more viruses near the site of the very first infection.
That is where new sores will usually appear.
Sometimes, the virus
can become active but not cause any sores that can be seen. At these
times, small amounts of the virus may be shed at or near places of
the first infection, in fluids from the mouth, penis, or vagina, or
from barely noticeable sores. You may not notice this shedding
because it often does not cause any pain or feel uncomfortable. Even
though you might not be aware of the shedding, you still can infect
a sex partner during this time.
After the first
outbreak, any future outbreaks are usually mild and last only about
a week. An infected person may know than an outbreak is about to
happen by a tingling feeling or itching in the genital area, or pain
in the buttocks or down the leg. For some people, these early
symptoms can be the most painful and annoying part of an episode.
Sometimes, only the tingling and itching are present and no visible
sores develop. At other times, blisters appear that may be very
small and barely noticeable, or they may break into open sores that
crust over and then disappear.
The frequency and
severity of recurrent episodes vary greatly. While some people have
only one or two outbreaks in a lifetime, others may have several
outbreaks a year. The number and pattern of repeat outbreaks often
change over time for a person. Scientists do not know what causes
the virus to become active again. Although some people with herpes
report that their outbreaks are brought on by another illness,
stress, or having a menstrual period, outbreaks are often not
predictable. In some cases, outbreaks may be connected to exposure
How is Genital
Because the genital herpes sores may not be visible to the naked
eye, a doctor or other health care worker may have to do several
laboratory tests to try to prove that symptoms are caused by the
herpes virus. A person may still have genital herpes, however, even
if the laboratory tests do not show the virus in the body.
A blood test cannot
show whether a person can infect another person with the herpes
virus. A blood test, however, can show if a person has been infected
at any time with HSV. There are also newer blood tests that can tell
whether a person has been infected with HSV 1 and/or 2.
How is Genital
Although there is no cure for genital herpes, your health care
worker might prescribe one of three medicines to treat it as well as
to help prevent future episodes: Acyclovir (Zovirax), Famciclovir (Famvir),
Recently, the Food
and Drug Administrations approved Valtrex for use in preventing
transmission of genital herpes.
During an active
herpes episode, whether the first episode or a repeat one, you
should follow a few simple steps to speed healing and avoid
spreading the infection in other places on the body or to other
- Keep the infected area clean and dry to prevent other infections
- Try to avoid touching the sores
- Wash your hands after contact with the sores
- Avoid sexual contact from the times you first feel any symptoms
until the sores are completely
healed, that is, the scab as fallen off and new skin has formed where the
Can Genital Herpes
Cause Any Other Problems?
Usually, genital herpes infections do not cause major problems
in healthy adults. In some people whose immune systems do not work
properly, genital herpes episodes can last a long time and be
If a woman has her
first episode of genital herpes while she is pregnant, she can pass
the virus to her unborn child and may deliver a premature baby. A
baby born with herpes can develop serious problems that may affect
the brain, the skin, or the eyes. If babies born with herpes are
treated immediately with acyclovir, their chances of being healthy
If a pregnant woman
has an outbreak, which is not the first episode, her baby's risk of
being infected during delivery is low. In either case, if you are
pregnancy and infected with genital herpes, you should stay in close
touch with your doctor before, during, and after your baby is born.
If a women is having
an outbreak during labor and delivery and there are herpes lesions
in or near the birth canal, the doctor will do a cesarean section to
protect the baby. Most women with genital herpes, however, do not
have signs of active infection with the virus during this time, and
can have normal delivery.
Is Genital Herpes
Worse in a Person with HIV Infection or AIDs?
Genital herpes, like other genital infections that produce
lesions, increases a person's risk of getting HIV, the virus that
causes AIDs. Also, prior to better treatments for AIDs, persons
infected with HIV had severe herpes outbreaks, which may have helped
them pass both genital herpes and HIV infection to others.
Note: All information
is based upon materials published by the National Institute of
Allergy and Infectious Diseases (NIAD).
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