What Causes Herpes To Flare Up
Approximately 22% of pregnant women have genital herpes. While it’s a manageable condition in most adults, herpes can be serious and even fatal for newborns. Fortunately, your risk of spreading it to your baby is very low, especially if you contracted it before your pregnancy. If you have it, your doctor will take measures to prevent you from passing it to your baby during delivery.
Usually your first herpes outbreak is the worst. Outbreaks generally become milder because your body makes antibodies to the virus. There’s no evidence that pregnancy causes herpes outbreaks, but approximately 75% of pregnant women with herpes will have an outbreak at some point during their pregnancy.
Herpes can lie dormant for many years. Sometimes what appears to be a new case of herpes is actually a dormant case that is causing symptoms for the first time. If you don’t know whether you have herpes, talk to your doctor about being tested.
After your initial herpes infection subsides, the virus travels to a bundle of nerves at the base of your spine. During this period it’s latent, and you won’t have any symptoms. Recurrent outbreaks happen when the virus travels from your nerves to the surface of your skin. Recurrent outbreaks may be triggered by:
Herpes Testing During Pregnancy
Of course, knowing whether or not your birth plan should be reassessed depends on knowing you indeed have genital herpes.
Doctors can certainly test for viral DNA during pregnancy. Still, there is some question about how useful these tests are, particularly when they’re done more than a few days before birth.
As well, an increasing percentage of genital herpes cases are due to HSV-1, and testing for it would not distinguish between the site of an outbreak .
ACOG, the American Academy of Family Physicians , and the Centers for Disease Control and Prevention do not recommend routine serologic screening for genital herpes simplex virus infection in those who are pregnant.
How Genital Herpes Affects Reproduction
The following important facts from the Centers for Disease Control and Prevention will give you an additional perspective on genital herpes as you consider your options to get pregnant:
- Genital herpes is common in the United States, affecting one in 16 people ages 14 to 49.
- Herpes simplex type 2 causes most cases of genital herpes, while type 1 mostly infects the mouth and is responsible for “fever blisters.”
- More women are infected than men, and men pass the disease to women more frequently than vice versa.
- Most of those infected with herpes simplex have had minor or no active symptoms.
- People infected with genital herpes only shed the virus 10% of the time when there are no lesions.
In the absence of lesions, a doctor can swab your genital area and send it to test for herpes simplex DNA to see if you are shedding the virus. However, because the virus only sheds 10% of the time, a negative test doesn’t mean you don’t ever shed virus.
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Can You Have A Healthy Pregnancy With Herpes
A person with herpes has a good chance of having a healthy pregnancy. Because herpes lies dormant for months or years at a time, some pregnant individuals may not experience an outbreak during their pregnancy.
Most people with herpes have mild symptoms, although first-time infections can be more severe.
Control Herpes Before Pregnancy
The goal in preconception is to limit herpes outbreaks on the genital area to improve your chances of getting pregnant. Let your doctor know that you have herpes so he can help you prepare for conception.
Depending on the severity of your infection, you might be prescribed topical or oral antiviral medications to help you control the outbreaks.
Focus on foods that will boost your immune system, prevent outbreaks, and promote fertility. They should contain:
Phytoestrogens, which can regulate your hormones and menstruation: beans, broccoli, and tomatoes
Lysine, which can prevent blisters: apples, beets, and cauliflower
Antioxidants, which can ward off infections and boost your immunity: strawberries, green tea, and ginger
Vitamin C and B, which can reduce stress, boost immunity, and make you more fertile: salmon, mushrooms, and parsley
Citrus bioflavonoids can help herpes blisters heal faster: tea, leafy green veggies, and red clover
Probiotics, which restore your intestinal flora and improve your immunity: yogurt, fermented cabbage, and kombucha
Filtered water with lemon to keep an alkaline balance in the diet
Stress is a known trigger of herpes outbreaks, and exercise is one of the best ways to relieve it. It can also help you regulate your menstrual cycle and boost your fertility.
Vitamins and Supplements
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Treatment If The Blisters Come Back
Go to a GP or sexual health clinic if you have been diagnosed with genital herpes and need treatment for an outbreak.
Antiviral medicine may help shorten an outbreak by 1 or 2 days if you start taking it as soon as symptoms appear.
But outbreaks usually settle by themselves, so you may not need treatment.
Recurrent outbreaks are usually milder than the first episode of genital herpes.
Over time, outbreaks tend to happen less often and be less severe. Some people never have outbreaks.
Some people who have more than 6 outbreaks in a year may benefit from taking antiviral medicine for 6 to 12 months.
If you still have outbreaks of genital herpes during this time, you may be referred to a specialist.
How Herpes May Affect Infant Health
In many cases, you can have a healthy baby despite a herpes infection. However, the Institute for Quality and Efficacy in Healthcare conducted an analysis of factors affecting herpes transmissions during pregnancy and found the following:
- A baby can get sick if they acquire herpes from their infected mother during vaginal birth.
- A doctor might also suggest a mother take daily herpes suppressive therapy starting at 36 weeks to reduce the chance of passing the virus to the fetus.
- Herpes does not pass through breast milk, so you can safely breastfeed your baby. However, do not breastfeed if you have open herpes sores on your breasts or anywhere your baby can touch.
- If a mother has an active infection or is shedding the virus near term, a cesarean section is recommended to avoid the risk of newborn infection.
- Rarely, a fetus will acquire the herpes simplex virus from placental transmission from the mother during pregnancy. This can increase the risk of miscarriage or preterm delivery, and it’s much more common in the last trimester of pregnancy.
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How Can A Baby Become Infected
Approximately 85 percent of neonatal herpes infections occur during delivery. This happens when the mother is shedding the virus from her genitourinary tract. As the baby passes through the birth canal, they can become infected with HSV.
Approximately 85 percent of neonatal herpes infections occur during delivery. Around 10 percent of all cases of neonatal herpes is contracted after birth.
In-utero transmission only accounts for approximately five percent of all cases of neonatal herpes. A baby can also contract an HSV infection after birth, usually from being kissed by someone who has active oral herpes. They can also get the virus while breastfeeding if there are any open sores on their mothers nipples or areolas. Around 10 percent of all cases of neonatal herpes is contracted after birth.
How Often Do Outbreaks Occur
The number of outbreaks someone has varies from person to person. The average number of outbreaks for a person with genital HSV-2 is four to five per year. The average for genital HSV-1 is less than one outbreak per year.
Usually, there are more outbreaks during the first year, and many people find that outbreaks become less severe and less frequent with time.
Herpes triggers are highly individual, but with time, many people learn to recognize, and sometimes avoid, factors that seem to reactivate HSV in their own bodies. Illness, poor diet, emotional or physical stress, friction in the genital area, prolonged exposure to ultraviolet light , surgical trauma, and steroidal medication may trigger a herpes outbreak.
The frequency of outbreaks can often be managed through effective stress management, and getting adequate rest, nutrition, and exercise. For people with frequent outbreaks, suppressive therapy with any one of the antiviral treatments can reduce outbreaks by as much as 80%.
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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 what’s 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, don’t kiss the baby, and wash hands with soap and water before touching the baby.
How Do You Get Genital Herpes
Genital herpes can be passed on by:
- when a cold sore touches genitals
- transferring infection on fingers to genitals
- sharing sex toys with someone who has herpes.
Dont panic about other types of contact though: herpes isnt transmitted by sharing towels, cutlery or cups. The virus dies quickly when its away from the skin .
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Pregnancy Alternatives When You Have Genital Herpes
If you prefer not take a risk of sharing the virus through unprotected sex, you and your partner might want to consider alternate ways to have a family. These options include the following:
- Artificial insemination – You can work with a doctor to get with your partner’s or donor’s sperm without skin-to-skin sexual contact.
- In vitro fertilization – In vitro fertilization, which can be complex and expensive, involves combining the egg and sperm outside the body and then transferring fertilized embryos to the uterus.
- Surrogacy – If you have the virus and your partner doesn’t and you want to avoid the concerns of transmitting herpes to your baby during pregnancy, you might want to consider using a surrogate to carry the baby. The cost of surrogacy can also be expensive.
For most people, having a diagnosis of genital herpes can be stressful and life-changing. Because there is no cure, trying to get pregnant can be challenging but not impossible. And other options are available.
Knowing the essentials about the virus and how to decrease the chance of infecting your partner , and how and when to time intercourse can help you get pregnant safely. Talk to your doctor for more help and insight.
What Are The Chances Of Spreading The Infection To A Baby
Most people who are infected with HSV dont even know that they have the virus. In fact, nearly 80 percent of all babies who contract neonatal herpes are born to mothers who didnt report having HSV before.
The risk of passing HSV to the fetus varies greatly depending on when the mother was infected. If you were infected with herpes before your pregnancy and have a herpes outbreak while pregnant, the chance of passing the infection to your baby is less than 1 percent. The risk is so low because your body has already had time to develop antibodies against the virus.
Its estimated that the incidence of neonatal herpes in the United States is 1 per 15,000 live births.
Women who contract herpes during the later stages of their pregnancy have a higher risk of passing the virus to their babies. The risk of neonatal herpes ranges between 3050 percent when a primary HSV infection occurs during late pregnancy.
There are many strains of the herpes virus, but the two that are commonly referred to as herpes are called herpes simplex virus type 1 and herpes simplex virus type 2. Approximately one third to half of all cases of neonatal herpes are caused by HSV-1. Its estimated that the incidence of neonatal herpes in the United States is 1 per 15,000 live births. However, these estimates vary greatly from location to location.
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Time Intercourse To Your Most Fertile Days
To limit unprotected intercourse to only your most fertile days, and therefore decrease the chance of sharing the virus, it is helpful to know a few things about your body and your signs of fertility. One of the best ways to do this is by monitoring your most fertile days by using an ovulation predictor kit . An OPK is up to 99% accurate as a predictor of when ovulation is likely to occur. The at-home urine test measures the pituitary luteinizing hormone , which increases as you approach ovulation.
- The day you see your strongly positive result is the day of the biggest increase in your LH secretion from your pituitary gland. This “LH surge” is what triggers release of an egg from your ovary .
- In the average 28-day menstrual cycle, you will see this result around day 12 or 13. It will be easier to figure out your fertile window if your cycles are regular.
- The LH surge predicts that ovulation will likely occur 24 to 36 hours later – around day 13 to 14 of a 28-day cycle.
Have intercourse the day of the surge and about 36 hours later. This is your best fertile window for live sperm to catch the egg while it is still fertilizable. The timing takes into account the lifespan of the sperm and the egg. According to Clinical Gynecologic Endocrinology and Infertility, sperm can survive in a woman’s reproductive track for three to five days. The egg is only viable for fertilization from 12 to 24 hours.
Why Is It Important To Have A Sexual Health Check
Sexually transmitted infections are passed from one person to another through sex or genital contact. They are sometimes referred to as sexually transmitted diseases .
If you have a new partner, or you have any symptoms or are worried about STIs it is important to get tested. STIs can affect your chances of getting pregnant, as well as your baby.
Common symptoms of an STI include:
- pain when peeing
However, most STIs have no symptoms or only mild symptoms that you may not realise are caused by an infection. This means that many people who have an STI will not know they are infected and can pass it on to any sexual partners.
If they are not treated, some STIs can:
- cause health problems for you and your baby during pregnancy
- be passed on to your baby
Most STIs can be treated with antibiotics, special creams or shampoos. But some treatments are not suitable if you are pregnant. Its a good idea for you and your partner to get checked before you try for a baby.
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Can Herpes Cause Infertility
Herpes simplex does not adversely affect egg production or ovulation. However, a couple of studies did show a possible correlation with fertility challenges:
- Infertility in people with uteruses – One small study from 2016 found that there was a link between a certain strain of herpes and unexplained infertility in people with uteruses. This study showed that 43% of 30 participants with unexplained infertility had a uterine lining that was infected with this specific herpes strain . However, the 36 participants in the study who had no problems conceiving were not found to have the herpes strain in their uterine lining.
- Infertility in people with penises – Other studies have focused on the effect of genital herpes on infertility in people with penises. It was determined that having genital herpes may lower sperm count, which, in turn, may affect your chances of getting pregnant. Herpes may actually be a significant factor in unexplained infertility for these individuals.
- Reduced fertility in a couple – A common complication that may also occur is if it is time to try to conceive and you have a herpes outbreak. This could delay intercourse and therefore interfere with potential conception and pregnancy.
Viral Shedding Without An Outbreak
A large 2011 study published in JAMA investigated how often people with symptom-free herpes infections shed the virus and how much virus they shed.
The researchers found that people with asymptomatic genital HSV-2 shed detectable levels of virus 10% of the time. That’s about half as often as people with symptomatic infections. However, the amount of virus they shed was similar.
Other studies showed that pregnant women with a history of recurrent genital herpes infections have a 1.4% rate of shedding at the time of delivery.
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How Can I Reduce The Risk To My Unborn Baby
Medication for you and your baby should help prevent or reduce the chance of your baby being seriously ill:
- if your first episode is before 28 weeks of pregnancy, you may be offered antiviral treatment at that time and again from 36 weeks of pregnancy until your baby is born
- if your first episode is at or after 28 weeks of pregnancy, you will be advised to continue your treatment until your baby is born.
If your first episode is late in pregnancy , you should be offered a planned caesarean section to reduce the chance of your baby getting neonatal herpes.
If your first episode is earlier in pregnancy, the risk to your baby is low and you should be able to have a vaginal birth. Talk to your midwife or doctor if you have any concerns.
Some people have no signs or symptoms at all. Some people just get a few blisters in the genital area, which are not particularly painful. Flare-ups are usually mild. An early-warning tingling sensation often happens before the flare-up occurs.
However, for some people, the symptoms can be very painful. This is particularly so if it is your first episode when you may also feel unwell and notice very painful sores or watery blisters.
Symptoms can occur within a short time of coming into contact with the virus or it may take many weeks, months or years before any signs or symptoms appear.