Genital herpes is a sexually transmitted disease (STD) caused by the herpes simplex viruses type 1 (HSV-1) or type 2 (HSV-2).
Most genital herpes is caused by herpes virus type 2 (HSV-2). Herpes type 1 virus (HSV-1) can cause genital herpes, but it more commonly causes infections of the mouth and lips, sometimes referred to as “fever blisters.” Genital HSV-1 outbreaks tend to recur less regularly than genital HSV-2 outbreaks.
Most individuals with genital herpes have no or only minimal symptoms. When symptoms do occur, they typically appear as one or more blisters on or around the genitals. The blisters break, leaving tender ulcers (sores) that may take two to four weeks to heal the first time they occur. Typically, another outbreak can appear weeks or months after the first, but it almost always is less severe and shorter than the first outbreak.
Although the infection can stay in the body indefinitely, the number of outbreaks tends to decrease over a period of years.
How common is genital herpes?
1 out of 5 adolescents and adults, have had genital herpes.
Infection with HSV-2 infection is more common in women (approximately 1 out of 4women) than in men (almost 1 out of 8). This may be due to male-to-female transmission being more likely than female-to-male transmission.
How do people get genital herpes?
Generally, a person can become infected with herpes during sexual contact with someone who has had genital herpes. The herpes virus is released from the herpes sores on the skin.
IMPORTANT: The herpes virus may be released from the skin even if there is no visible herpes lesion. This means that a person who has had genital herpes can infect his or her partner even if there is no visible sore. The virus can be transmitted even by those who do not know that they are infected.
What are the signs and symptoms of genital herpes?
The signs and symptoms associated with HSV-2 can vary greatly
Most people infected with genital herpes are not aware of their infection. However, if signs and symptoms occur during the first outbreak, they can be quite pronounced.
The first outbreak usually occurs within two weeks after the virus is transmitted, and the sores typically heal within two to four weeks. Other signs and symptoms during the primary episode may include a second crop of sores, and flu-like symptoms, including fever and swollen glands. However, most individuals with HSV-2 infection never have sores, or they have very mild signs that they do not even notice or that they mistake for insect bites or another skin condition.
People diagnosed with a first episode of genital herpes can expect to have several (typically four or five) outbreaks (symptomatic recurrences) within a year. Over time these recurrences usually decrease in frequency. It is possible that a person becomes aware of the “first episode” years after the infection is acquired.
What are the complications of genital herpes?
Genital herpes can cause recurrent painful genital sores in many adults, and herpes infection can be severe in people with suppressed immune systems. Regardless of severity of symptoms, genital herpes frequently causes psychological distress in people who know they are infected.
In addition, genital HSV can lead to potentially fatal infections in babies. It is important that women avoid contracting herpes during pregnancy because a newly acquired infection during late pregnancy poses a greater risk of transmission to the baby. If a woman has active genital herpes at delivery, a cesarean delivery (C-section) is usually performed. Fortunately, infection of a baby from a woman with herpes infection is rare.
Herpes may play a role in the spread of HIV, the virus that causes AIDS. Herpes can make people more susceptible to HIV infection, and it can make HIV-infected individuals more infectious.
How is genital herpes diagnosed?
Health care providers can diagnose genital herpes by visual inspection if the outbreak is typical, and by taking a sample from a herpes sore and testing it in a laboratory. HSV infections can be diagnosed between outbreaks by the use of a blood test. Blood tests, which detect antibodies to the herpes viruses (HSV-1 or HSV-2), can be helpful, although the results are not always clear-cut.
A positive blood test for herpes virus type 2 (HSV-2) usually means that the person has been previously been infected with the virus.
Is there a treatment for herpes?
There is no treatment that can cure herpes. However, there are antiviral medications can shorten the duration and lessen the severity of symptoms during an outbreak.
Antiviral medications include the following
- Acyclovir (Zovirax®)
- Famvir® (famciclovir)
- Valacyclovir (Valtrex®)
An antiviral medication can also be taken for prevention. This is referred to as “suppressive therapy”. Suppressive therapy can prevent the number and severity of herpes outbreaks (recurrences) during the time the medication is being taken. It can also reduce the risk of transmitting the herpes virus to a sexual partner.
How can herpes be prevented?
The most effective way to avoid becoming infected with herpes, or infecting another person with herpes, is to abstain from sex, or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected with herpes.
Genital ulcer diseases can occur in both male and female genital areas that are covered or protected by a latex condom, as well as in areas that are not covered. Correct and consistent use of latex condoms can reduce the risk of genital herpes.
Persons with herpes should abstain from sexual activity with uninfected partners when lesions or other symptoms of herpes are present.
It is important to know that even if a person does not have any symptoms he or she can still infect sex partners. Sex partners of infected persons should be advised that they may become infected and they should use condoms to reduce the risk. Sex partners can seek testing to determine if they are infected with the herpes virus type 1 or 2.