Boosting Your Immune System
Another way to potentially speed up healing for herpes outbreaks and reduce the frequency of future outbreaks is to strengthen your bodys natural immunity. When your immune system is strong, it will be more capable of suppressing the virus.
Some of the recommended ways to boost your immunity include:
- Minimize stress.
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How Is Genital Herpes Treated During Pregnancy
You should take acyclovir or valaciclovir tablets, as above.
If it’s your first outbreak of genital herpes, your baby may be more at risk because you haven’t had time to develop immune protection against the virus, which also helps protect the baby.
Some women experiencing an outbreak of genital herpes might be advised to have a caesarean. This would prevent the herpes virus passing from mother to baby during a vaginal birth. But most women in Australia with genital herpes do give birth safely to healthy babies vaginally.
It’s often recommended that women who have ever had genital herpes take antiviral tablets prior to the birth, even if the herpes isn’t active at the time.
Talk to your doctor or midwife about the best course of action for your situation.
Can You Pass Herpes To Your Child
Yes, since cold sores are extremely contagious, HSV can be passed to babies and toddlers. Transmission commonly occurs via saliva, skin-to-skin contact or when touching something thats been handled by a person whos infected with the virus.
Its also possible for HSV from cold sores to spread to a childs eye and infect the cornea. These outbreaks usually heal on their own, but more severe cases can lead to corneal scarring or blindness. And HSV is of great concern to babies under 6 months as their immune systems are still immature. Nix kissing and close cuddles from parents or relatives with cold sores.
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How Do You Prevent Genital Herpes
People with genital herpes outbreaks are highly contagious. Anyone with active disease should avoid any sexual contact when sores are present. Even the use of a condom does not prevent the spread of disease because not all sores are covered by the condom.
Although the chance of spreading disease is greatest when sores are present, people who have had genital herpes may always be contagious to some degree, even if they have received medical treatment. The virus can become active and be transmitted to a sexual partner even when the skin appears completely normal. For this reason, safe sex practices should be used between disease outbreaks to lessen the chance of spreading the disease to a sexual partner. There is no vaccine available to prevent genital herpes infection.
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Who Might Get Genital Herpes
Genital herpes affects teens and adults of all genders and races. It can spread if you have multiple sexual partners and dont use condoms.
Women are more at risk. Delicate vaginal tissue can tear, making it easier for the infection to get in. Black women are especially vulnerable. An estimated 1 in 2 African-American women between the ages of 14 and 49 is infected with HSV-2, the virus that causes genital herpes.
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What Is Genital Herpes
Genital herpes is a sexually transmitted infection caused by herpes simplex virus type 1 or type 2 .
Genital herpes is contagious from when you get your first symptoms until the sores have healed.
Once you have had the virus, herpes simplex stays in your body in a nearby nerve. That means you could have another outbreak of genital herpes at any time.
How Can I Prevent Genital Herpes
If you are sexually active, you can do the following things to lower your chances of getting genital herpes:
- Being in a long-term mutually monogamous relationship with a partner who does not have herpes.
- Using condoms the right way every time you have sex.
Be aware that not all herpes sores occur in areas that a condom can cover. Also, the skin can release the virus from areas that do not have a visible herpes sore. For these reasons, condoms may not fully protect you from getting herpes.
If your sex partner has/have genital herpes, you can lower your risk of getting it if:
- Your partner takes an anti-herpes medicine every day. This is something your partner should discuss with his or her healthcare provider.
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Coping With Your Feelings
Finding out that you have genital herpes may cause you to have negative thoughts or feelings about yourself or about sex, such as:
- Feeling ashamed or embarrassed.
- Being afraid of the consequences of the infection.
- Being angry at the person who infected you.
- Feeling frustrated with treatment or recurrent outbreaks.
- Feeling scared to have sex.
A counsellor or support groups for people with herpes may be helpful.
Can Herpes Be Transmitted To An Infant During Pregnancy Or Delivery
When babies contract herpes, its known as neonatal herpes. Also called birth-acquired herpes, neonatal herpes can happen if your baby is exposed to genital herpes during vaginal delivery.
Neonatal herpes is considered rare, but when it does happen, there can be serious complications, such as permanent injury to the babys nervous system, developmental disabilities, and death.
The risk to your baby is greatest if you acquire HSV for the first time during the third trimester of pregnancy. Thats because the levels of the HSV in your system will be highest during that time, and youll have fewer protective antibodies to pass on to the baby prior to delivery.
If you contract a genital herpes infection during the third trimester, the risk of passing the virus to your baby during delivery is
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Genital Herpes Treatment During Pregnancy
Women taking antiviral drugs for herpes either daily suppressive therapy or occasional therapy for outbreaks should consult their doctor about whether to take the drugs during pregnancy. The answer is not set in stone: You and your doctor have to discuss the risks and benefits to decide whats right for you.
For pregnant women with a history of genital herpes, the doctor might recommend daily doses of an antiviral medication during the month before their due date.
Herpes infection in a newborn is also serious. Do not allow anyone with a cold sore on the mouth to kiss the baby. If you have a cold sore, dont kiss the baby, and wash hands with soap and water before touching the baby.
Is There A Cure Or Treatment For Genital Herpes
There is no cure for genital herpes. However, daily use of antiviral medicines can prevent or shorten outbreaks. Antiviral medicines also can reduce the chance of spreading it to others.
Though several clinical trials have tested vaccines against genital herpes, there is no vaccine currently available to prevent infection. One vaccine trial showed efficacy among women whose partners had HSV-2, but only among women not infected with HSV-1. Efficacy was not observed among men whose partners had HSV-2. Another trial testing the same vaccine showed some protection from genital HSV-1 infection, but none from HSV-2.
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Study Procedures And Follow Up
Baseline socio demographic and obstetric data was collected and recorded onto interviewer administered case report forms for the enrolled participants by midwives who were trained in the research procedures. HIV serostatus was obtained from the antenatal records. An obstetric examination was done followed by a pelvic examination and then two vaginal swabs were taken off for candidiasis and Trichomonas vaginalis. Four millilitres of blood was drawn for renal function, liver functions and full haemogram.
Study visits were conducted at 32, 36, 38 weeks and delivery. The 32-week visit was 4 weeks after enrollment and served as routine antenatal care as per the guidelines for the Ministry of Health and for refill of study drug with similar random code. At the 36-week visit the following were done: antenatal care, review on completion of the randomised intervention study period and giving of routine suppressive acyclovir. During the visits at 32 and 36 weeks, compliance with drugs and complaints were assessed. Compliance was measured by self-report of the duration the study medication was taken. In addition, any concomitant medications were noted and documented. Furthermore, relevant investigations were done. All patients were given iron and folic acid for oral intake. In addition, Sulphadoxine/pyrimethamine for prevention of malaria was given as per the Uganda Ministry of Health guidelines . For all participants, relevant documentation was done at every visit.
What Is The Treatment For Genital Herpes During Pregnancy
If you have genital herpes, you may be prescribed an oral antiviral medication, such as acyclovir, valacyclovir, or famciclovir starting at around 35 weeks to help reduce the chances that youll have an outbreak of genital herpes at the time of delivery. The drugs cant cure genital herpes, but they can help speed up healing if you have an outbreak of genital herpes and suppress future outbreaks while you get ready to have your baby.
As your labor begins, your doctor will carefully check for any genital herpes lesions blisters or sores. If you dont have any signs of an active outbreak of genital herpes when labor starts, you will probably be able to have a vaginal delivery.
If there are genital herpes lesions present during your labor, you will likely need to have a cesarean delivery to prevent tranmission of the herpes virus to the baby during delivery. Your doctor will discuss your options with you prior to your due date.
Your risk factors for contracting genital herpes are the same during pregnancy as they would normally be. Your risk factors for HSV are linked to being directly exposed to the virus. Risk factors include:
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Take Care During Pregnancy
A woman who gets genital herpes while she is pregnant could pass the infection to her baby during delivery. Herpes can make newborns seriously ill.
If you are pregnant, follow these steps:
- Tell your doctor if you have been exposed to genital herpes or have had an outbreak in the past.
- Let your doctor know if you are currently having an outbreak, especially if you are in the last part of your pregnancy.
- Avoid unsafe sex. Herpes is often transmitted by people who dont know they are infected and dont have symptoms. Use condoms.
- Avoid receiving oral sex from partners who have cold sores. Herpes in newborns can be caused by HSV-1, the virus that most commonly causes cold sores. Most experts advise pregnant women not to receive oral sex in the last 3 months of their pregnancy. It increases their risk of genital infection with HSV-1.
Antiviral medicine can be used safely in pregnancy to reduce the risk of an outbreak at the time of delivery. This lower risk, in turn, makes it less likely that delivery by caesarean section will be needed.
Can You Take Acyclovir During Pregnancy
You may take acyclovir if your doctor prescribes it. But do not take it without prescription or proper consultation.
The US Food and Drug Administration has classified acyclovir as pregnancy category B drug, which means the studies conducted on animals demonstrated low risk, but there are no adequate and well-controlled studies in pregnant women .
The American Sexual Health Association says that the FDA has not approved any drug for treatment of herpes during pregnancy. However, many physicians prescribe this acyclovir at the end of pregnancy if the potential benefits outweigh the potential risks .
The American Academy of Family Physicians has observed that the use of acyclovir in the first trimester did not increase birth defects. It recommends acyclovir as the antiviral drug of choice in early pregnancy . Studies on the effects of acyclovir during second and third trimesters are limited .
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How Can You Prevent Your Baby From Getting Herpes
While no method can guarantee the prevention of a fetus or baby from acquiring an infection, a person can lower the risk by:
- taking antiviral medications a doctor prescribes toward the end of pregnancy
- having a C-section birth if doctors think there is a high risk of a baby contracting an infection during natural childbirth
- stopping breastfeeding if they notice a sore on or around the nipple, until they can have an HSV test
- covering active cold sores and washing their hands regularly
- avoiding kissing a baby until a cold sore has completely healed
Treatments For Herpes In Pregnancy
There is no cure for herpes. Once you contract the virus, it remains in a bundle of nerves near your spine and can become active again at any time. Some people have outbreaks frequently, but others have them only rarely.
You might not notice any symptoms during a recurrence, so you may not know when you’re having one. However, your body still sheds the virus at these times, which means you can pass the virus to your baby during labor and birth.
Antiviral medication can help prevent or shorten outbreaks. Antiviral therapy is often recommended for women who have recurrences of symptoms during pregnancy.
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What If I Have A Cold Sore While Breastfeeding
If you have cold sores, it is safe to breastfeed your baby as long as the cold sores are not on the breast or nipple.
If they are, it may be wise to breastfeed from the unaffected nipple only until the lesions have cleared up. You would express and dispose of breastmilk from the affected nipple. Breastmilk itself doesn’t contain the herpes virus but it can be contaminated through the skin lesions.
Talk to your doctor or midwife as soon as you notice any cold sores on your breast or nipple.
How Is Hsv Treated During Pregnancy Or Breastfeeding
You can treat cold sores and genital herpes with:
- aciclovir cream, available from a pharmacist without prescription
- aciclovir or valaciclovir tablets, for which you need a prescription
These ‘antiviral’ drugs are known to be safe for pregnant and breastfeeding women and are effective most of the time.
Famciclovir tablets are not recommended to take during pregnancy. Speak to your doctor if the cold sore is severe.
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Antiviral Tablets To Stop The Herpes Virus Multiplying
Antiviral medicines taken by mouth, such as valaciclovir or acyclovir, are the most effective in controlling symptoms, although they cant cure genital herpes. They stop the virus from multiplying in body cells where the virus is present. The medicine only works while you are taking it. The infection can come back when you stop taking it.
Antiviral tablets are used in the following two ways:
- To treat outbreaks as they happen : The aim is to shorten the time each outbreak lasts and to relieve symptoms. This works best when taken as soon as you get symptoms and before the blisters appear.
- To prevent or reduce recurrences : If you get frequent or severe recurrent outbreaks, your doctor may recommend you take antiviral tablets every day to help prevent recurrences. Suppressive therapy is taken continuously, every day, for months or years. Suppressive antiviral therapy may help reduce the risk of transmitting the virus to sexual partners.
Antiviral creams bought over the counter from the pharmacy are not recommended as a treatment for a first episode or recurrent genital herpes as they are of little benefit. Antiviral tablets are the preferred treatment.
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How Does Valacyclovir Work
Genital herpes is transmitted via vaginal fluids, skin contact, contact with open sores, and contact with the placenta.
The medicine works by suppressing viral shedding and spreading of the herpes simplex virus. It also helps to speed up the healing of active lesions.
Patients usually begin to take Valtrex during the last month of pregnancy at a dose of 500 mg twice a day.
Valtrex suppressive therapy should be prescribed alongside precautionary measures. These include using condoms and dental dams during sex and avoiding contact with affected areas.
Women who experience herpes outbreaks during the final month of pregnancy are usually recommended to undergo a C-section to avoid infection of the child during vaginal birth.
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Is Valtrex Safe During Pregnancy
The FDA has rated Valtrex as a Pregnancy Category B. This means studies performed on animals showed no risks, however, there have been no controlled studies done on pregnant women. Therefore, this Pregnancy Category B drug is not expected to cause harm to a fetus.
Studies have also shown evidence that Valtrex is safe to use during pregnancy and is not associated with an increase in the rate of any major birth defects.
What Is Life Like For Someone Who Has Genital Herpes
The virus that causes genital herpes stays inside your body forever. While many people carry this virus, some dont know that they have it because they never have an outbreak.
If you have an outbreak, taking an antiviral medicine can shorten the outbreak and relieve symptoms. Some people have several outbreaks. For most people, the outbreaks become less severe and occur less often with time.
Anyone who has been infected with the virus, however, can spread the virus to others during sex. Even if you never have an outbreak, you can still spread the virus.
Related AAD resources
Centers for Disease Control. Genital Herpes CDC Fact Sheet . Last accessed December 19, 2016.
Fatahzadeh M and Schwartz RA. Human herpes simplex virus infections: Epidemiology, pathogenesis, symptomatology, diagnosis, and management. J Am Acad Dermatol 2007 57:737-63.
Madkan V Sra K, et al. Human herpesviruses. In: Bolognia JL, et al. Dermatology. . Mosby Elsevier, Spain, 2008:1075-6.
Marques AR, Straus SE, Herpes simplex. In: Wolff K, Goldsmith LA, et al. Fitzpatricks Dermatology in General Medicine . McGraw Hill Medical, New York, 2008: 1199-1204.
US Preventive Task Force. Serologic screening for genital herpes infection: US Preventive Services Task Force recommendation statement. JAMA. 2016 316:2525-30.
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