Controlling Recurrent Genital Herpes: The Use Of Oral Antivirals In Herpes Management
The following section gives you in-depth information about the use of oral antivirals to treat herpes. Aciclovir has been used for this indication for a number of years now and found to be highly effective in controlling herpes recurrences.
Some people with genital herpes have identified factors which may influence the frequency or severity of recurrences. Factors such as stress, diet and lifestyle may be worth considering when looking at ways of managing herpes in your life. Each case is individual and what works for one may not work for another.
Frequent or severe recurrences of genital herpes infection may interfere with normal work and social activities, and cause disruption to your sex life. However, there are steps which you can take to reduce outbreaks and help bring the herpes virus under control. This section explains what you can do and answers some other questions which you may have about living with genital herpes.
Questions To Ask Your Doctor
- What is the best treatment for me?
- Are there any side effects to my treatment?
- Is it safe to have unprotected sex if I dont have any sores?
- Can I give myself genital herpes if I also have oral herpes?
- Can I give someone else herpes even if Im not having an outbreak?
- What is the best way to prevent herpes outbreaks?
- Can I live a normal life with herpes?
- Am I at risk of developing any other diseases?
- Are there any support groups in my area?
- If I give my baby herpes, what is the treatment?
Should You Get Tested
Its a good idea for the partners of people with genital herpes to have a blood test for herpes antibodies. This can help them to decide whether to use antiviral medication as protection, for example. Both partners may already have the same virus type. Then theres no reason to take medication to protect each other.
If one of the partners has HSV-1 or cold sores and the other one has HSV-2 or genital herpes, they could infect one another with the other virus. If one partner has herpes viruses in their body and the other doesnt, condoms are one way to prevent infection.
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How Do You Know If You Have Genital Herpes
The only way to know if you have genital herpes is by amedical exam. Your health care provider can examineyou and test for it. Lab samples are taken from a sore,blister, or blood. Your health care provider may ask totest you for other infections at the same time.
Tell current and most recent sex partners of your herpes infection.
Could I Pass Herpes Simplex To A Partner If I Have No Symptoms
This sometimes happens but is not likely. When the virus is inactive inside the nerve cells it cannot be caught by a partner. If there is virus on the skin surface where you get your symptoms, it may be passed on.
Before the outbreak begins, there may be a tingly or itchy feeling at the place where this will happen. This means that diagnosed people are less likely to pass it on when there is nothing to see on the skin, because they are usually more aware of these prodromes , whereas undiagnosed people often ignore highly infectious and obvious symptoms, because they do not know what they are. This is not asymptomatic as you can feel something and you should not have sex at this time.
Asymptomatic shedding means without sensation and a scientific test can virus on the skin when the person feels nothing. This applies to type 2. Type 1 doesnt like the genital region and is less likely to recur and to shed asymptomatically. This happens only in some people, mostly in the first six months. After a year or two, if a person is not having many outbreaks, they will rarely have virus on the skin without symptoms.
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How Is Herpes Transmitted
Herpes is easily spread from skin-to-skin contact with someone who has the virus. Genital herpes is transmitted from one person to another through sexual contact. Sexual contact includes intercourse, oralgenital contact and rubbing the genitals together without clothing in between .
Direct contact with the live virus including:
- Any direct contact with an herpes infection
- Kissing, touching or caressing actively infected areas
The skin on your genitals, mouth, and eyes can be infected easily. Other areas of skin may get infected if theres a way for the herpes virus to get in, like through a cut, burn, rash, or other sores. You dont have to have sex to get herpes. Sometimes herpes can be passed in non-sexual ways, like if a parent with a cold sore gives you a peck on the lips. Most people with oral herpes got it when they were kids. A mother can pass genital herpes to a baby during vaginal childbirth, but thats pretty rare.
What Is The Difference Between Genital Herpes And Genital Warts
Both genital herpes and genital warts are STIs, are spread through skin-to-skin contact, and are caused by a virus. But the viruses that cause genital herpes and genital warts are different:
- Herpes simplex virus is the virus that causes genital herpes.
- Human papillomavirus is the virus that causes genital warts.
There is no cure for either genital herpes or genital warts. But, different medicines can help manage the symptoms of herpes and treat the complications of HPV infections that can cause genital warts.
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Herpes Myths To Stop Freaking Out About
A surprising number of people you know probably have herpes.
Shocked? You shouldnt be, since the virus is very common. According to the World Health Organization, 3.7 billion people under age 50 have herpes simplex virus type 1 thats 67 percent of the global population in that age bracket. Another 417 million people between ages 15 and 49 worldwide have herpes simplex virus type 2 .
Many people consider HSV-1 more benign, but it turns out theres not much difference between the two types of virus. While its true that HSV-2 is a sexually transmitted disease and can cause genital sores or blisters, type 1 can do the same thing.
One big misconception is that cold sores are caused by HSV-1 and genital herpes are always type 2, but thats not always the case, says Sarah Vensel, a physician assistant in San Francisco. Cold sores are so common theyve been normalized at this point. But genital herpes is sometimes the exact same virus just in a different location.
Not only is herpes incredibly common its also totally manageable. Allow us to set your mind at ease and debunk three widespread herpes myths:
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What Are Signs Of Genital Herpes In Women
Women who have the herpes virus may have nooutbreaks or signs of infection. Many do not know theyhave the virus. Once you are infected, the virus staysin your nerve cells for life. When the virus is not active,there is no sign of infection. When the virus becomesactive, a herpes outbreak occurs. Some womenmay not have any outbreaks or may have only oneoutbreak, while others may have multiple outbreaks.
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How To Protect Yourself Against Genital Herpes During Pregnancy
If you are pregnant and your partner has genital herpes, it is important to avoid contracting the virus during pregnancy. Avoid skin-to-skin contact when herpes sores are present and remember to use condoms, even when there are no obvious genital herpes lesions, to reduce the risk of possible transmission.
Becoming infected with genital herpes during the third trimester of pregnancy increases the risk of the baby becoming infected with the virus. Abstaining from sex with an infected partner is usually recommended during the third trimester of pregnancy.
If a first ever episode of herpes infection occurs during pregnancy, the mother is usually given antiviral medicines. Additionally, if this infection occurs in late pregnancy, it is recommended that the baby is delivered by Caesarean section.
There is less risk of infecting the baby if you have a recurrent episode of genital herpes during pregnancy. Caesarean section is only recommended if the woman has genital herpes sores at the time of delivery. Antiviral medicines may also be given in the last few weeks of pregnancy to women with recurrent genital herpes to reduce the risk of an outbreak at the time of delivery.
Babies are always monitored closely after birth to check for infection.
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
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What Happens At A Sexual Health Clinic
The doctor or nurse at the sexual health clinic will:
- ask about your symptoms and your sexual partners
- use a small cotton bud to take some fluid from 1 of your blisters or sores for testing
The test cannot:
- be done if you do not have visible blisters or sores
- tell you how long you have had herpes or who you got it from
Symptoms might not appear for weeks or even years after youre infected with the herpes virus.
If you have genital herpes, your previous sexual partners should get tested.
The doctor or nurse at the clinic can discuss this with you and help you tell your partners without letting them know its you who has the virus.
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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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How Is Genital Herpes Diagnosed
Often, your doctor can diagnose genital herpes by looking at visible sores. Your doctor or nurse may also use a cotton swab to take a fluid sample from a sore to test in a lab.
Genital herpes can be hard to diagnose, especially between outbreaks. Blood tests that look for antibodies to the herpes virus can help diagnose herpes in women without symptoms or between outbreaks.
A Pap test is not used to detect genital herpes.
I Had Lesions When I Was Evaluated But My Culture Was Negative Does This Mean That I Dont Have Herpes
Not necessarily. Although lesions can be caused by something other than herpes, false negative herpes tests can occur if the samples are not taken appropriately, if there is a long transport time between the clinic and the laboratory, or if cultures were taken late in the course of the lesions. Lesions that occur early in the course of a herpes outbreak are much more likely to have positive cultures than cultures taken after the lesions crust over.
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How Does Genital Herpes Affect A Pregnant Woman And Her Baby
Neonatal herpes is one of the most serious complications of genital herpes.5,16 Healthcare providers should ask all pregnant women if they have a history of genital herpes.11 Herpes infection can be passed from mother to child during pregnancy or childbirth, or babies may be infected shortly after birth, resulting in a potentially fatal neonatal herpes infection. 17 Infants born to women who acquire genital herpes close to the time of delivery and are shedding virus at delivery are at a much higher risk for developing neonatal herpes, compared with women who have recurrent genital herpes . 16,18-20 Thus, it is important that women avoid contracting herpes during pregnancy. Women should be counseled to abstain from intercourse during the third trimester with partners known to have or suspected of having genital herpes. 5,11
What Are The Types Of Herpes Viruses
Herpes is a group of contagious viruses. All of these viruses cause blisters and sores. Some of the more common herpes viruses include:
- Type 1: HSV-1, or oral herpes, causes cold sores to form on lips, gums, tongue and inside the mouth. It can cause genital herpes in some cases This type usually spreads through saliva when you kiss someone with open herpes sores. You can also get HSV-1 by sharing items like toothbrushes, lipsticks or eating utensils.
- Type 2: HSV-2 causes genital herpes.
- Herpes zoster: This virus causes chickenpox and shingles.
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Are You More Likely To Contract Hsv Through Oral Or Penetrative Sex
Penetration using a sex toy can also cause genital herpes, which is why experts usually advise against sharing toys.
You probably wont know youve contracted herpes until you have an outbreak, which is the case for most people who have it.
HSV-1 can be asymptomatic or cause very mild symptoms that can be easy to miss.
An outbreak can cause cold sores or blisters in and around your mouth. Some people notice tingling, burning, or itching in the area before sores appear.
If you contract genital herpes caused by HSV-1, you may develop one or more sores or blisters in your genital or area.
Genital herpes caused by HSV-2 can also be asymptomatic or cause mild symptoms that you may not notice. If you do develop symptoms, the first outbreak is often more severe than subsequent outbreaks.
You may experience:
Do Condoms Help Prevent The Spread Of Genital Herpes
Yes. To prevent transmission of herpes, we recommend that condoms be used 100% of the time. Many patients will shed the virus and be contagious when they dont have symptoms. Studies have shown that asymptomatic shedding occurs between 1% and 3% of the time in patients with HSV II genital infections. Many new herpes infections occur from partners who are shedding the virus asymptomatically, so condoms are highly recommended.
Condoms may not be an attractive option for monogamous couples or for couples who desire to become pregnant. Couples may opt to have serological tests to determine if either partner has an asymptomatic infection. In close monogamous relationships, the risks of transmission can be weighed against other relationship issues, such as intimacy and pregnancy.
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Can I Still Have Sex If I Have Herpes
If you have herpes, you should talk to your sex partner about their risk. Using condoms may help lower this risk but it will not get rid of the risk completely. Having sores or other symptoms of herpes can increase your risk of spreading the disease. Even if you do not have any symptoms, you can still infect your sex partners.
You may have concerns about how genital herpes will impact your health, sex life, and relationships. While herpes is not curable, it is important to know that it is manageable with medicine. Daily suppressive therapy can lower your risk of spreading the virus to others. Talk to a healthcare provider about your concerns and treatment options.
A genital herpes diagnosis may affect how you will feel about current or future sexual relationships. Knowing how to talk to sexual partners about STDs is important.
Can Genital Herpes Be Treated
Your physician can prescribe different medications to help reduce your symptoms and speed up the healing of an outbreak. These medicines work best when you start them soon after an outbreak occurs.
To reduce pain during an outbreak:
- Sit in warm water in a portable bath or bathtub for about 20 minutes. Avoid bubble baths.
- Keep your genital area clean and dry, and avoid tight clothes.
- Take over-the-counter medications, such as acetaminophen or ibuprofen. Avoid aspirin.
Let your physician know if you are worried about your genital herpes. He or she can recommend a support group to help you cope with the virus.
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Where Does The Herpes Virus Live In The Body
The herpes simplex viruses are latent, meaning they can live in the body without causing symptoms. After the initial infection, the virus gets into the nerve roots and spreads to the sensory nerve ganglia, the junctions where nerves from different parts of the body come together. For the genital area, the ganglia are adjacent to the spinal cord in the lower back. For orofacial herpes , the ganglia are located behind the cheek bone.
How Is Genital Herpes Treated
Herpes has no cure. But antiviral medicines can prevent or shorten outbreaks during the time you take the medicine. Also, daily suppressive therapy for herpes can lower your chance of spreading the infection to your partner.
Your doctor will either give you antiviral medicine to take right after getting outbreak symptoms or to take regularly to try to stop outbreaks from happening. Talk to your doctor about treatment options.
During outbreaks, you can take the following steps to speed healing and prevent spreading herpes to other parts of your body or to other people:
- Keep sores clean and dry.
- Try not to touch the sores.
- Wash your hands after any contact with the sores.
- Avoid all sexual contact from the time you first notice symptoms until the sores have healed.
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