How Is Genital Herpes Diagnosed
HSV nucleic acid amplification tests are the most sensitive and highly specific tests available for diagnosing herpes. However, in some settings viral culture is the only test available. The sensitivity of viral culture can be low, especially among people who have recurrent or healing lesions. Because viral shedding is intermittent, it is possible for someone to have a genital herpes infection even though it was not detected by NAAT or culture. 11
Type-specific virologic tests can be used for diagnosing genital herpes when a person has recurrent symptoms or lesion without a confirmatory NAAT, culture result, or has a partner with genital herpes. Both virologic tests and type-specific serologic tests should be available in clinical settings serving patients with, or at risk for, sexually transmitted infections. 11
Given performance limitations with commercially available type-specific serologic tests , a confirmatory test with a second method should be performed before test interpretation. If confirmatory tests are unavailable, patients should be counseled about the limitations of available testing before serologic testing. Healthcare providers should also be aware that false-positive results occur. In instances of suspected recent acquisition, serologic testing within 12 weeks after acquisition may be associated with false negative test results. 11
Providers are strongly encouraged to look at CDCs STI Treatment Guidelines for further diagnostic considerations.
What Treatment Is Available For Genital Herpes
Though genital herpes is not curable, it can be managed. Your physician may prescribe an antiviral medication, including acyclovir, valacyclovir, and famciclovir, to use during an outbreak. Over-the-counter pain medication can also be used to soothe symptoms. Your physician can provide advice on how to prevent transmission of the virus to sexual partners along with suggestions about how to discuss the topic of genital herpes openly.
Is There A Cure Or Treatment For Herpes
There is no cure for herpes. Antiviral medications can, however, prevent or shorten outbreaks during the period of time the person takes the medication.11 In addition, daily suppressive therapy for herpes can reduce the likelihood of transmission to partners.11
There is currently no commercially available vaccine that is protective against genital herpes infection. Candidate vaccines are in clinical trials.
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Can Genital Herpes Be Prevented
The only sure way to keep from getting genital herpesor any other sexually transmitted infection is to not have sex. If you do have sex, practice safer sex.
- Before you start a sexual relationship, talk with your partner about STIs. Find out whether he or she is at risk for them. Remember that a person can be infected without knowing it.
- If you have symptoms of an STI, don’t have sex.
- Don’t have sex with anyone who has symptoms or who may have been exposed to an STI.
- Don’t have more than one sexual relationship at a time. Having several sex partners increases your risk for infection.
- Use condoms. Condom use lowers the risk of spreading or becoming infected with an STI.
- Don’t receive oral sex from partners who have cold sores.
Taking medicine for herpes may lower the number of outbreaks you have and can also prevent an episode from getting worse. It also lower the chances that you will infect your partner.
If you are pregnant, you should take extra care to avoid getting infected. You could pass the infection to your baby during delivery, which can cause serious problems for your newborn. If you have an outbreak near your due date, you probably will need to have your baby by caesarean section. If your genital herpes outbreaks return again and again, your doctor may talk to you about medicines that can help prevent an outbreak during pregnancy.
How Can I Best Learn To Cope With Herpes Simplex
Some people feel distressed or embarrassed about their herpes simplex infection. Its important to understand that the herpes virus is common. For most people, herpes doesnt significantly interfere with daily life.
To cope with negative feelings, you may consider:
- Connecting with others through support groups or online forums.
- Sharing your feelings with a trusted friend or loved one.
- Speaking with a therapist.
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No Ulcers Doesnt Equal No Herpes So Then What
If youve never had genital ulcers and as far as you know, have never been exposed, is it worth getting tested? Thats a controversial point and in fact, the widely followed official guidelines discourage screening.
Why? Many reasons: Lets say a person has a blood test that comes back positive for HSV-2. This means that the patient may have been exposed to HSV-2 at some point in their lives, somehow, somewhere. Research tells us that these folks may be periodically shedding virus particles in their genital fluids. These patients would then be diagnosed with genital herpes, encouraged to share their status with future partners, and offered daily antiviral medication to prevent possibly spreading the virus.
All of this can be a tough pill to swallow, so to speak. There is significant social stigma and shame associated with herpes. In addition, there are occasionally false-positive tests. Labeling someone with the diagnosis can be devastating to their future relationships, and asking someone to take a pill for a condition they may or may not have and may or may not spread seems unreasonable.
However, not all experts agree with the official guidelines. Except for the uncommon case of a false positive blood test for HSV-2, a seropositive test means one of three things:
If you are not sure about getting tested, talk with your doctor.
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Despite Being Amongst The Most Common Sexually Transmitted Infections Genital Herpes Is Not Part Of The General Sti Screening
The Center of Disease Control and Prevention backs up this recommendation by saying Genital herpes infections can cause intermittent symptoms that may be uncomfortable, but infection does not usually result in serious complications in healthy adults. Because the tests can be expensive and the diagnosis may have adverse psychological effects for some people, widespread testing for HSV is not currently recommended. Isnt the dissemination of genital herpes significant enough for the medical industry to spend resources to let oblivious carriers know of their condition, and empower them to take action? Get it together, CDC.
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How To Prevent An Outbreak
Some people only take their medications if they feel the itching and tingling that means an outbreak is coming on or when sores show up to stop it from getting worse. Your doctor may suggest you take an antiviral every day if you:
- Have lots of outbreaks
- Want to prevent more outbreaks
- Want to lower the risk of spreading it to your partner
No One Should Feel Shame For Having A Viral Infection
Having herpes really just means you have a viral infection. Thanks to stigma some people experience a sense of shame with their diagnosis. Although its easy to say just get over it, whats important to remember is that people with herpes can and should live their lives in the way that want, have relationships, have sex and experience intimacy.
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Can Women Who Have Sex With Women Get Genital Herpes
Yes. It is possible to get genital herpes, or any other STI, if you are a woman who has sex only with women.
Talk to your partner about her sexual history before having sex, and ask your doctor or nurse about getting tested if you have signs or symptoms of genital herpes. Use a during oral sex and avoid sexual activity during an outbreak.
How Can I Avoid Getting Genital Herpes
No vaccine can protect you from HSV infection, but you can do some things to prevent getting infected:
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Limit the number of sexual partners you have in your lifetime.
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Make sure that you and your sexual partner use condoms every time you have sex.
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Consider sexual abstinence .
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Don’t have any kind of sex with someone who has herpes sores, itching or scabs, and remember that genital herpes can be spread even when there is no sign of a sore.
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Always wash your hands after touching a cold sore.
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What Is Herpes Simplex
Herpes simplex is one of the most frequent infections of mankind throughout the world. There are two main types of herpes simplex virus type 1, which is mainly associated with facial infections and type 2, which is mainly genital, although there is considerable overlap.
Both type 1 and type 2 herpes simplex viruses reside in a latent state in the nerves that supply sensation to the skin. With each episode of herpes simplex, the virus grows down the nerves and out into the skin or mucous membranes where it multiplies, causing the clinical lesion. After each episode, it dies back up the nerve fibre and enters the resting state again.
What Does Genital Herpes Look Like
While some people with genital herpes will never have any symptoms, other people can develop symptoms within a few weeks of being infected.
Often, before the lesions appear, patients describe a prodrome, characterized by a tingling or burning sensation in the area where the lesions will develop that can be noticed during urination, along with itching or discomfort in the genital area.
You can also have the following symptoms:
- Blisters on the mouth or lips
- Fever, headache or pain in the joints
- Trouble urinating
The symptoms of genital herpes often go away and come back as recurring outbreaks. For most people, the first outbreak is the worst, and can last from two to three weeks. Future flare-ups are often less severe and do not last as long. Still, some people shed the virus regularly. The following triggers can make outbreaks more likely to occur:
- Viral or bacterial infections
- Menstrual periods
Recurrent genital herpes is most common in the first year after the initial infection and decreases as time goes on.
In many cases, anti-herpes medicine can help patients. When a person experiences a prodrome and suspects a recurrence is going to happen, they begin taking anti-herpes medications that lessen symptoms and shorten the time of the outbreak.
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How Does Herpes Simplex Spread
Herpes spreads through close contact with a person who has the infection. The virus can be found in skin and saliva. If you have herpes simplex, you are most likely to pass the virus to another person when you have sores. But you can infect someone else even if you have no symptoms. Healthcare providers call this asymptomatic viral shedding.
People may get HSV-1 through
- Touching a persons skin near the mouth.
- Sharing food utensils, lip balm or razors.
- If you receive oral sex from someone who has a cold sore, it may spread a herpes infection to your genitals.
People may get HSV-2 through
- Oral sex with someone whos infected.
- Skin-to-skin contact without ejaculation.
- Touching open sores, including while breastfeeding.
- Childbirth by a mother or gestational parent who has an active infection.
You cant get genital herpes from objects like toilet seats. But you could pass genital herpes through shared sex toys.
Genital Herpes Treatment In Pregnancy
You may be offered antiviral treatment:
- to treat outbreaks in pregnancy
- from 36 weeks to reduce the chance of an outbreak during birth
- from diagnosis until the birth if you first get herpes after 28 weeks of pregnancy
Many women with genital herpes have a vaginal delivery. You may be offered a caesarean, depending on your circumstances.
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The Pain Of Herpes Can Be More Emotional Than Physical
“I don’t know why genital herpes has this pariah, fearful component to it,” H. Hunter Handsfield, MD, professor emeritus of medicine at the University of Washington Center for AIDS and STD, told Health. “People are more afraid of herpes than they are of chlamydia, and in the long run chlamydia is more likely to cause serious damage to their reproductive and general health than herpes ever is.”
But getting a herpes diagnosis does come with emotional baggage. “If you are infected, you have a duty to warn partners and that is a big deal for lots of people,” said Dr. Handsfield. “You’re impairing the natural development of a relationship, which is a big psychological burden for people to carry.”
Prevention Of Genital Herpes
The best protection against STIs is to always use barrier protection such as condoms, female condoms and dams . Because herpes is spread by skin-to-skin contact, condoms will reduce the risk of transmission, but it will not protect sexual partners completely as condoms do not cover the entire genitals.
Using lubricant with a condom during sex will also reduce the risk of trauma to the genital skin. This has been shown to reduce HSV transmission, especially in the first six months of a sexual relationship. Silicone-based lubricants are recommended.
Remember that herpes transmission can occur when symptoms are present , but may also occur even if there are no genital symptoms through asymptomatic viral shedding.
For people who have frequent episodes of genital herpes, antiviral medication, taken daily, helps to reduce transmission of herpes to a sexual partner.
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How Does Genital Herpes Affect Pregnancy
Herpes simplex virus doesnt affect fertility or your ability to conceive. Pregnant women diagnosed with HSV-2 should start a daily antiviral at 36 weeks of pregnancy as prescribed, to prevent outbreaks during delivery. If you have an active infection at the time of childbirth, you can pass the herpes virus to your baby. Neonatal herpes puts a baby at risk for blindness, brain damage, skin infections and death. Your healthcare provider will perform a cesarean section to lower this risk.
What Should I Do If I Have Genital Herpes
If you have genital herpes:
- See a doctor or nurse as soon as possible for testing and treatment.
- Take all of the medicine. Even if symptoms go away, you need to finish all of the antiviral medicine.
- Tell your sex partner so they can be tested and treated if necessary.
- Avoid any sexual contact while you are being treated for genital herpes or while you have an outbreak.
- Remember that genital herpes is a lifelong disease. Even though you may not have a genital herpes outbreak for long periods of time, you can still pass the virus to another person at any time. Talk with your doctor or nurse about how to prevent passing the virus to another person.
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Complications Of Genital Herpes
Complications may include:
- Urethritis , which results in ulceration. There may be no tell-tale blisters so that the presentation is identical to gonorrhoea or chlamydia urethritis.
- Proctitis , which can occur without external lesions. Symptoms include fever, rectal pain, watery discharge, and autonomic nerve dysfunction that may result in difficulty passing urine.
- Neurogenic pain -leg and thigh pain, which often leads up to a recurrence.
- Meningitis is rare.
- Widespread infection is seen in debilitated or immune-suppressed patients.
You Can Only Get Genital Herpes If Your Partner Has An Active Infection With Sores Right Wrong
A person can be exposed to the virus and pass it to someone else without ever having symptoms. It happens more often than youd think. Thats because the virus can exist in genital fluids even without any ulcers. This is called “asymptomatic shedding of virus.” Although there is a lot more active virus when there are sores, asymptomatic shedding is probably how most people get herpes. Whats more, only one out of four people who tests positive for genital herpes actually knows that they have the virus. Thats a lot of people. Combine the two and you have many people unknowingly infecting others.
Many people who learn they have genital herpes are shocked. They often didnt see any sores on their partner or that their partner had never had any ulcers, ever. This is common and true, because people can have genital herpes and not know it.
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How Does Genital Herpes Spread
Herpes can be spread when an infected person has lesions blisters and open sores on their body or when you do not have any symptoms. Taking antiviral medicine can help you reduce the risk of spreading genital herpes to your sexual partners. You can also:
- Inform your sexual partner that you have genital herpes.
- Use a condom every time you have sex.
- Refrain from having sex when you have symptoms.
- Abstain from performing oral sex if you have blisters or open sores around your mouth.
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.
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Is Genital Herpes Contagious
Yes. When blisters or crusts are present, the virus can be passed by direct contact to others. But the virus can be just as contagious even when you cannot see any sores. Using condoms helps to prevent the spread of infectionbut condoms cannot protect you completely. Because HSV also causes cold sores on the mouth, a person with cold sores can spread HSV through mouth contact with the genital area of another person. The virus can also be carried on hands from the mouth to another area. You can even spread the virus to yourself by touching cold sores on your mouth and then touching other areas of your body.