At present, there are more than 30 different bacteria, viruses, and parasites that are known to cause sexually transmitted infections. Mode of transmission includes via sexual contact, including vaginal, anal, and oral sex, while some can be transmitted from mother to child during pregnancy, childbirth, and breastfeeding.
Among the 30 different pathogens, 8 are linked to the greatest incidence of STIs. Of these, 4 are currently curable: syphilis, gonorrhea, chlamydia, and trichomoniasis. While the other 4 are incurable viral infections: hepatitis B, herpes simplex virus (HSV), HIV, and human papillomavirus (HPV).
In this article, we will discuss one of the incurable STIs known to man, HSV or herpes infection. Although common, regrettably, herpes carries a big social stigma and is generally misunderstood. Hence, the fear of humiliation and being judged can have a big impact on the mental health of someone who has herpes. Consequently, some may be too scared and embarrassed to tell a sexual partner and may avoid telling them altogether, which is disastrous to public health.
Understandably, even the mention of any sexually transmitted infection sounds scary—even taboo, but what’s scarier is not talking about it at all. The lack of education about STIs is a big part of the problem and why they are continuously spreading. But knowing what is out there and educating ourselves on how to best protect ourselves (and others) will allow us to ultimately live a healthier life—and a life without fear.
A herpes diagnosis shouldn’t feel like a death sentence or a modern-day scarlet letter; understanding it is the key. Continue reading to find out more about herpes, its treatment, and how we can protect ourselves from it.
What is Genital Herpes
Genital herpes is a sexually transmitted infection (STI) caused by two types of herpes simplex virus– herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2).
It causes painful blisters (fluid-filled bumps) on the skin that can break open and ooze fluid. It is passed mostly by sharing of bodily fluids (saliva, vaginal secretions and semen), which usually happens through sexual intercourse including vaginal, anal and oral sex. But non-sexual transmission through sharing of food/drinks has also been recorded.
Unfortunately, people infected with HSV can still pass along the virus even with no visible symptoms. It is also very contagious from day one of symptoms such as tingling or itching to when the sores have fully healed.
HSV 1 is known to typically cause oral herpes, which presents as cold sores on or around the mouth, however, it can also cause genital herpes (via oral sex). Unfortunately, most people with HSV 1 do not show any symptoms.
And remarkably, most of them were infected with the virus during childhood or young adulthood from non-sexual contact with saliva or even just simple skin-to-skin contact with someone infected.
HSV-2 is the most common cause of genital herpes, but it can also cause cold sores. The virus can be present on herpetic sores or the fluid from ulcers, the moist lining or fluids of the mouth, and the moist lining or fluids of the vagina or rectum.
Luckily, the virus is unlikely to spread through surfaces, such as doorknobs, toilet seats, bedding, or swimming pools. Nor can it be spread by touching objects, such as silverware, soaps, or towels. But kissing or sharing a drinking glass or utensils might spread the virus.
What are the Symptoms of Genital Herpes
Most people who have genital herpes are unaware that they have the virus because they either exhibit no symptoms or have very mild symptoms that they just tend to brush off. Some symptoms may go unnoticed or be mistaken for benign skin conditions like a small pimple or ingrown hair, hence, most of them do not even think that they could have herpes infection.
Herpetic sores or blisters are usually the first sign of herpes infection. The appearance of these blisters is known as an “outbreak”. According to the CDC, on average, a first outbreak may appear 4 days after contracting the virus. However, it can also appear as early as 2 days, or as many as 12 days or more, to appear.
These blisters can appear singly (one) or in clusters on or around the genitals, rectum, anus, buttocks, scrotum, thighs, mouth, lips, or face. Typically, the patient would feel itching or a tingling sensation around the area that has contracted the virus even before blisters actually appear. After a while, these blisters would break, ooze or bleed and leave very painful sores that usually take a week or more to fully heal. Along with the blisters, flu-like symptoms like fever, body pain or swollen glands (usually in the groin area) may also accompany the first outbreak.
Other symptoms may include:
- Pain, burning sensation, tingling or itching around the genitals
- Painful urination
- Unusual penile discharge from the urethra (the tube that releases urine from the body)
- Unusual vaginal discharge
Within a week of the outbreak, there may be a visible scab or crust that would form over the sores signaling its end.
What are the Risks Factors For Getting Genital Herpes
Your risk of contracting genital herpes is higher if you have the following risk factors:
- Having sexual contact/intercourse without using protection or barrier. Direct contact with genitals through oral, vaginal or anal sex increases your risk of contracting the virus. Barriers including condoms and condom-like protectors called dental dams (used during oral sex) are effective in reducing the chances of transmitting HSV during sexual contact.
- Women are at higher risk of getting genital herpes. The virus can spread more easily from men to women than from women to men. One reason may be that the virus can infect a woman’s genitals more easily than it can a man. Specifically, small tears in vaginal tissue during sexual intercourse can occur, making it easier for the virus to enter the body.
- Having multiple sexual partners. The number of people you have sex with is a strong risk factor especially if you do not use any barrier or protection.
- Having a partner with a diagnosed herpes infection and he/she is not taking medications for it. Unfortunately, once you contract the herpes virus, you have it for life. However, taking medications can help prevent or reduce the number of outbreaks you have and can also reduce the risk of transmission to others.
- Compromised immune system. If you are immunocompromised due to another STI or a different illness like cancer or HIV, you have a decreased ability to fight off infections.
- If you belong to a particular group within the population. These groups include, women, people with a history of sexually transmitted diseases, the elderly, black people, and men who have sex with men. Statistically these groups are diagnosed with genital herpes at a higher-than-average rate.
What are the Possible Complications of Genital Herpes
There are several possible complications associated with genital herpes, here are some:
- Other sexually transmitted infections. Having genital herpes increases your risk of giving or getting other STIs, including HIV/AIDS.
- Neonatal herpes. A pregnant mother can pass her herpes infection to her unborn child before birth, but more commonly it is passed during delivery. Less often, the virus is passed during pregnancy or by close contact after delivery. Herpes in newborns can affect their internal organs or their nervous system. And unfortunately, even with treatment, they still have a high risk of developmental or physical disorders and a risk of death.
- Inflammatory diseases. Swelling and inflammation can occur in some internal organs of patients who have HSV infection. Most commonly affected organs are the ureter, rectum, vagina, cervix and uterus.
- Painful blisters on your fingers/fingertips. This specific infection in the fingers caused by HSV is called herpetic whitlow. Symptoms include discoloration, swelling and intensely painful blisters or sores on the fingers.
- Eye infections. HSV infection of the eye can cause pain, sores, blurred vision and even blindness.
- Brain swelling. Also called, HSV encephalitis, it is a rare neurological disorder and rare complication of HSV infection. It happens when the virus enters the brain and causes inflammation and swelling inside the brain. It is most often fatal.
How is Genital Herpes Treated
Sadly, there is no cure for genital herpes yet. Once you contract the virus, it stays in your body forever. Oddly, the virus will not cause blisters elsewhere but instead, stay nearby a nerve and cause blisters in the same are. The disease stays dormant in the body until something triggers an outbreak. Fortunately, despite having no available cure, the infection can be well managed with medication.
Taking anti-viral medication as soon as symptoms appear may give the following advantages:
- Help herpetic sores heal faster during a first outbreak
- Shorten an outbreak by 1 or 2 days
- Lower the occurrence of repeated outbreaks
- Reduce the severity and period of symptoms in recurrent outbreaks
- Lessen the risk of transmission of the herpes virus to a partner
Commonly prescribed anti-viral medications for genital herpes include Acyclovir, Famciclovir, and Valacyclovir.
Aside from anti-viral pills, there are some home remedies that you can do, as well as important reminders during an outbreak. Here are some of them:
- Use mild cleansers when bathing or showering in warm water.
- To prevent blisters from becoming infected, always keep the area clean using plain or salt water. Make sure to dry it after.
- You may apply an ice pack to soothe the pain, but make sure to wrap it in a clean towel or flannel. Do not put ice directly on the skin.
- You may apply petroleum jelly or painkilling cream (such as 5% lidocaine) to reduce pain when you pee.
- Make sure to wash your hands before and after applying cream or jelly. Do not touch your blisters or sores unless you’re applying the cream.
- You may try pouring water over your genitals while peeing to help ease the pain.
- Wear loose cotton clothing to keep the affected area/s comfortable and to avoid irritating the blisters or sores.
- Do not have vaginal, anal, or oral sex until the sores have completely healed.
As mentioned earlier, HSV infection usually stays dormant in the body up until something triggers an outbreak and so, it is important, if you can, to avoid things that can trigger an outbreak.
Triggers can include the following:
- UV light (ultraviolet light) – for example, from sunbathing or tanning beds
- Abrasion, rubbing, or chafing in your genital area – for example, from sex (using lubricants may help) or wearing tight clothing.
- Drinking alcoholic beverages
However, there are some triggers that cannot be avoided, these include:
- Being sick – for example, coming down with the flu.
- Immunocompromised condition– for example, undergoing chemotherapy for cancer
Fortunately, most outbreaks usually resolve spontaneously, so treatment may not always be necessary. In addition, recurrent outbreaks are usually milder than the first episode of genital herpes. Eventually, the outbreaks would be less frequent and the symptoms less severe.
There are even some who never have recurrent outbreaks. However, people who experience more than 6 outbreaks in a year are usually advised to take prophylactic anti-viral medication for 6 to 12 months.
How Can I Prevent Genital Herpes
The only fool-proof way to completely avoid sexually transmitted infections (STIs) is abstain from any sexual activity, which as we know, is not applicable for everyone. So, if you are sexually active, there are ways to lower your chances of contracting genital herpes, such as:
- Being in a mutually monogamous relationship with a partner who does not have herpes.
- Using barrier methods, such as condoms (the right way) every time you have vaginal, anal or oral sex. Keep in mind though that herpes can still be passed on if the condom does not cover the infected area. Also, an infected person’s skin can still release or shed the virus from areas that do not have a visible sore or blister. Hence, condoms may not fully protect you from getting herpes, but chances of getting the virus is a LOT higher if you do not use them.
- Be informed of your sexual partner/s STI status. Ask your sexual partner when they were last tested for STIs.
- Avoid vaginal, anal or oral sex if you or your partner has blisters or sores, or is displaying possible herpes symptoms. Even a tingle or an itch can mean that an outbreak is coming, so it helps to be mindful of the symptoms.
- Avoid sharing sex toys – but if you do, be sure to wash and disinfect them thoroughly and put a condom on them when in use.
However, if you have a sexual partner who has been diagnosed with genital herpes, you can lower your chances of contracting it if:
- Your partner consistently takes a prophylactic anti-viral medicine every day.
- You abstain from having vaginal, anal, or oral sex with your partner, when he/she has herpes symptoms or an ongoing outbreak.
Is Genital Herpes Contagious For Life
A person is highly contagious and more likely to infect another person during an outbreak or when sores are present. However, as was mentioned above, even between outbreaks, and no visible herpes symptoms, it is still possible to transmit HSV to anyone.
Therefore, to help lower the chances of transmission, the importance of using a barrier method during sexual activities is a must.
Genital Herpes VS Herpes Zoster? What's the Difference?
Some people may be confused with these two distinct medical conditions and some may even interchange them. The key difference between genital herpes and herpes zoster (more commonly known as shingles) is that they are caused by two different viruses.
Strangely enough though, the two viruses that cause these two conditions belong to the same family, the herpes virus family.
Genital herpes is caused by herpes simplex virus-1 (HSV-1) or herpes simplex virus-2 (HSV-2). While, herpes zoster or shingles is caused by the varicella-zoster virus (VZV).
When it comes to the areas affected by the infection, they also have a noticeable difference. For genital herpes, areas affected include the genitals, buttocks, rectal area, and thighs. People with genital herpes can also experience recurrent outbreaks throughout their life. Meanwhile, for herpes zoster, it can present anywhere on the body but usually presents on only one side of the body and in a band-like appearance.
It’s often seen on the torso or face and only rarely in the genital area. Like genital herpes, the herpes zoster virus also remains in the body forever and lies dormant until triggered, but unlike genital herpes, most people do not get repeat or recurrent outbreaks.
They also differ in the mode of transmission. Genital herpes can be contracted through skin-to-skin contact with a herpetic sore or through exchange of bodily fluids (saliva, semen and vaginal discharge) usually during sexual intercourse (vaginal, oral or anal). While for herpes zoster or shingles, it can not only be passed through skin contact with fluid from the lesions, but also by air or respiratory droplets.
Lastly, both conditions have no cure, nonetheless both can be treated with the same anti-viral medications. However, for herpes zoster, a vaccine is presently available which can prevent the infection.
How can EVA TELECONSULT help in the Management of Genital Herpes?
Here at EVA Teleconsult we have skilled Primary care physicians as well as expert specialists like our Ob-gyne doctors (for female conditions) and our Urologist (for male conditions), who can diagnose and give the appropriate treatment for genital herpes. Moreover, our doctors are always ready to address any questions or concerns you may have about genital herpes, or almost any other related condition. Here is how EVA works, at EVA our patients are guaranteed to experience the following:
- Timely appointments – No more time wasted while waiting outside a doctor’s office. With us, appointments begin right when they’re supposed to, even if they’re made the same day.
- Guaranteed 30-minute consultation times – No more rushing or quickly dashed off prescriptions with no explanations. Our doctors take the time needed to give you information about your concerns, and are open to answering all your questions.
- 5-star ratings for our doctors – Because our doctors know how to explain things in a way patients can understand, we frequently get positive feedback from them.
If you are concerned about possible symptoms of genital herpes, embarrassed and in pain, you do not need to struggle alone. Don’t live in fear and take action to protect yourself and others. Seek medical advice and get the best possible treatment from a caring health care professional right away. Book an online consultation today.