Genital Herpes (HSV)

What is Genital Herpes?

Herpes is a sexually transmitted infection caused by the herpes simplex virus (HSV).

There are two types of herpes virus, both of which affect the mouth, lips, genital organs and anus: herpes simplex type 1 (HSV-1) and herpes simplex type 2 (HSV-2).

Cold sores are generally caused by the HSV-1 virus, whereas genital herpes sores are caused by the HSV-2 virus. However, if a person has a cold sore, the herpes virus can be transmitted to his or her partner’s genital organs during oral sex. Conversely, the herpes virus can be transmitted from the genital organs to the lips during oral sex.

Relapses or recurrences are characteristic of both types of the herpes simplex virus.

How do you get Herpes?

  • From sexual relations with or without penetration of the penis in the vagina or anus;
  • From oral sex;
  • When sex toys are shared;
  • An infected mother can transmit the bacteria to her baby during pregnancy or delivery;
  • From intimate contact (skin-to-skin) with an infected person (who may or may not have sores or blisters).

What are the symptoms of Herpes?

Often there are no symptoms.

First infection

Symptoms:

Women Men
  • Sores inside or near the vagina, the vulva, the cervix, on the external genitals, near the anus or on the thighs or buttocks
  • Tender lumps in the groin
  • Some women may develop recurrent outbreaks before or during their menstrual cycles
  • Fever, headaches and muscular pain
  • Sores on the penis, around the testicles, near the anus or on the thighs or buttocks
  • Tender lumps in the groin
  • Anal pain or discharge
  • Fever, headaches and muscular pain

The first outbreak of the infection may produce very severe and intense symptoms in some patients and go undetected in others.

Recurrence of symptoms

A recurrence of symptoms may be preceded by warning signs (e.g. a rash). It is believed that stress can play a role in the frequency and severity of outbreaks.

  • An initial tingling sensation in the affected area (the herpes blisters usually reappear in the same areas).
  • The appearance of a slight redness and/or swelling at the infected area(s).
  • A cluster of fragile blisters may appear very quickly (within hours or days). These blisters can burst, leaving painful sores sensitive to the touch.
  • Within a few days, these sores will form a scab and heal.

A recurrence will typically last from five to seven days, but may take up to several weeks to resolve.

What are the possible complications of Herpes?

Herpes outbreaks often limit the spontaneity of sexual relations. If a woman has an outbreak during childbirth, the fetus may become infected. A newborn baby must not come into direct contact with the mother’s lesions during childbirth. A caesarean section may therefore be recommended to prevent transmission of the virus. Herpes can severely endanger newborns, with symptoms such as brain damage and even neonatal death.

Women with genital herpes are advised to have regular Pap tests, since there is a proven link between genital herpes and cervical cancer.

How is Herpes diagnosed?

A health care professional examines the lesions, and may take a culture of one of them. A blood test may also be performed to confirm the herpes diagnosis.

What is the treatment for Herpes?

There is no effective treatment that can fully cure this infection.

However, medication may be taken:

  • To decrease the severity of symptoms;
  • To reduce the duration and frequency of outbreaks.

Medication may also be taken daily to prevent frequent recurrences, thereby reducing the risk of transmission.

Here are some home remedies that can help relieve the symptoms of herpes:

  • Ice compresses on the affected areas;
  • Long baths and careful drying of the blisters with a hair dryer;
  • Pain medication for the first few painful days of the outbreak;
  • Avoiding contact with the sores in order not to spread the virus.

If you suffer from painful urination, you can make the process less painful by urinating in a shower or bath.

Wash and dry the affected areas well. Wash towels before reusing them.

After a bath, use a hair dryer or gently towel dry the affected areas.

Try to wear loose-fitting clothing made of natural fibres, such as cotton.

How can Herpes be prevented?

  • Use of a condom is essential. However, a condom does not protect sexual partners if there are sores or rashes on other parts of the infected person’s body not covered by the condom.
  • Avoid all contact with the infected area during a severe outbreak or if there are advance warning signs of an imminent outbreak.
  • Do not share sex toys when one of the partners has an outbreak. Wash sex toys well in warm soapy water after each use.
  • Wash your hands after touching a blister or sore.
  • Daily treatment may lower the risk of transmitting the virus from the infected person to his or her sexual partners.
  • Discuss STBBI and herpes openly with your partner before having sexual relations.
  • The presence of herpes may increase the risk of HIV transmission.

What are the risks for HIV-positive people?

For people with a weakened immune system, the infection may become more severe and may spread throughout the body.

People living with HIV who have the herpes virus develop longer-lasting, more frequent and more severe outbreaks of herpes symptoms: more, bigger and longer-lasting sores or blisters. If the immune system is very weak, HSV can spread into the entire blood network and cause herpes lesions to appear on more of the skin’s surface or in the oral mucosa. Internal herpes lesions are diagnosed by a biopsy, and usually require hospitalization and intravenous treatment.

It is important for people living with HIV and the herpes virus to speak to their doctor about the possibility of taking daily treatment for herpes in order to avoid recurrences.

Additional information

Genital herpes:

  • Is very widespread in the general population.
  • May spread even if there are no visible lesions.
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