What You Need To Know
- Herpes simplex virus , also known as genital herpes, is most likely to be spread when an infected person is having an outbreak, but it can also be transmitted without any symptoms being present.
- Medications can help reduce your symptoms, speed up the healing of an outbreak and make you less contagious.
- If you know you have genital herpes before becoming pregnant, your physician will monitor your condition throughout your pregnancy. If you have an active outbreak at the time of delivery, cesarean section may be recommended.
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How Can I Reduce My Risk Of Herpes Simplex
You can reduce your risk of contracting HSV-1 by avoiding physical contact with someone who has a cold sore. People can still spread HSV-1 when cold sores arent present, but its less likely.
If someone has an active HSV-1 infection, avoid:
- Sharing utensils, cups, lip balms or other personal care products.
- Touching the skin near their mouth.
If youre sexually active, you can take these steps to protect yourself and others from the herpes virus and other STIs:
- Be monogamous with one sexual partner or limit your number of partners.
- Get tested for STIs and complete any prescribed treatment.
- Tell your sexual partners if you have genital herpes so they can get tested.
- Use condoms during intercourse and dental dams during oral sex.
Wash your hands often if you have an outbreak or are around someone with symptoms.
If your sexual partner has genital herpes, these actions can lower your risk of getting the virus:
- Dont have sex when your partner has active symptoms. Condoms may not cover all sores, so you may still get the virus.
- Make sure your partner takes antiviral medication as prescribed.
- Wait to have sex until scabs fall off active lesions.
How To Recognize Genital Herpes
Genital herpes is a very common sexually transmitted disease . It is so common that many people, when they find any skin lesion around the genital areas, are likely to think that it is herpes. They are not entirely wrong to think that way. Genital herpes is the main cause of genital ulcers worldwide.1 And the condition is usually associated with a stigma that can itself cause anxiety and even depression2 and might influence the affected personâs decision to disclose the infection to others or seek care.3
A genital sore is not great news regardless of what is causing it. However, many other conditions causing genital sores have a prognosis different from that of herpes. Some can be worse, but others, unlike herpes,4 can be completely cured. Thatâs why weâre beginning this article with an explanation of how to recognize genital herpes and differentiate it from other genital skin lesions.
A sleeping virus
The herpes virus is known for staying âasleepâ in the body for a long time without showing symptoms. This feature is called latency: once the virus infects a person, after an initial phase that does not necessarily manifest with symptoms, it remains hidden in the body for many years, reactivating every now and then.4 Its reactivation is usually triggered by weakness of the immune system, such as in times of sustained stress, accumulated fatigue, heavy physical activity, or fever, but may not have any apparent cause.5, 6
Herpes skin lesions
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What Happens If I Dont Get Treated
Genital herpes can cause painful genital sores and can be severe in people with suppressed immune systems.
If you touch your sores or the fluids from the sores, you may transfer herpes to another part of your body, such as your eyes. Do not touch the sores or fluids to avoid spreading herpes to another part of your body. If you do touch the sores or fluids, immediately wash your hands thoroughly to help avoid spreading your infection.
If you are pregnant, there can be problems for you and your developing fetus, or newborn baby. See Im pregnant. How could genital herpes affect my baby? above for information about this.
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Im Pregnant How Could Genital Herpes Affect My Baby
If you are pregnant and have genital herpes, prenatal care visits are very important. Some research suggest that a genital herpes infection may lead to miscarriage or make it more likely to deliver your baby too early. You can pass herpes to your unborn child before birth, but it more commonly passes during delivery. This can lead to a deadly infection in your baby . It is important that you avoid getting genital herpes during pregnancy. Tell your healthcare provider if you have ever had a genital herpes diagnosis or symptoms. Also tell them about any possible exposure to genital herpes.
If you have genital herpes, you may need to take anti-herpes medicine towards the end of your pregnancy. This medicine may reduce your risk of having signs or symptoms of genital herpes when you deliver. At the time of delivery, your healthcare provider should carefully examine you for herpes sores. If you have signs or symptoms of genital herpes at delivery, a C-section is likely to occur.
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How Are These Conditions Diagnosed
Pimples are easily managed with changes in your personal hygiene or by using over-the-counter treatments.
If the bumps dont respond to treatment or if you notice painful, fluid-filled blisters after having sex see your doctor right away. Your doctor may be able to make a diagnosis just by looking at the bumps.
Your doctor can confirm a diagnosis with one of several tests.
Faqs About Cold Sores Answered
Most cases of genital herpes are caused by HSV-2. Since sexual contact is the major means by which genital herpes is transmitted, the illness does not usually arise before adolescence. When a child develops genital herpes, healthcare providers must consider the possibility of abuse. This is true whenever a person contracts a sexually transmitted disease prior to the teen years.
People at heightened risk for HSV-2 infection include those who have multiple sexual partners, women, people with low incomes, and those infected with human immunodeficiency virus . In fact, among people who tested positive for HIV, one study found that the prevalence of HSV-2 infections ranged from 70 to more than 90 percent.
- A herpes sore on any part of the body
- Saliva, if your partner has oral herpes, or genital fluids, if your partner has genital herpes
- Skin around the mouth if your partner has an oral herpes infection, or the skin in the genital region of a partner who has genital herpes
You can catch genital herpes from a partner who has no visible sores, or from a partner who doesnt know that they have the infection. But a person is most infectious during their first outbreak of herpes, when they have sores, and during later outbreaks that produce sores.
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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.
Herpes Might Not Have Any Symptoms
You or your partner may not have any herpes symptoms that you can see or feel, or the signs of herpes may be so mild you dont even notice them. Sometimes people confuse herpes symptoms with other things, like pimples, ingrown hairs, and the flu.
Herpes symptoms come and go, but that doesnt mean the infection goes away or that you cant spread it to other people. Once you have herpes, it stays in your body for life.
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Should I Talk To A Doctor About It
Now that you have a broad idea of how to differentiate a genital herpes ulcer from other commonly encountered conditions, you should consult your doctor when you suspect genital herpes for the first time. The first episode of herpes can have more noticeable symptoms than recurrences later will and it will be less difficult to ensure that the prognosis is benign and rule out more harmful conditions.
Herpes is still a condition often associated with anxiety, fear, and shame. Your healthcare provider can talk to you about your feelings in that regard and give you support and guidance.
With any genital condition, it is important to have the correct diagnosis made by your doctor, who will use laboratory tests for confirmation to establish a proper management plan.
What About Chlamydia The Most Common Std
Chlamydia is caused by bacteria, whereas herpes is caused by a virus. This is why chlamydia is easily treated and cured with antibiotics. However, many people have chlamydia and dont know it because they don’t have any symptoms. That’s why people who are at higher risk of chlamydia, including sexually active young women and men who have sex with other men, are advised to get a test for chlamydia every year.
If you don’t treat chlamydia, it can increase the chances of both men and women getting or giving HIV and AIDS, according to Medline Plus. Untreated chlamydia can also cause serious pelvic inflammatory disease in women, which can lead to infertility, and in men it can spread to the testicles and the tube that carries sperm, causing inflammation.
Screening for chlamydia is usually done by taking a urine sample or a swab from your genitals. Results of these tests are usually found quickly. Different testing methods are used for infections of the rectum and throat, and these take more time.
While the only way to completely avoid getting chlamydia or herpes is to not have sex, you can reduce your chances of getting both by being in a long-term, mutually monogamous relationship with a partner who is not infected with an STD and by using latex condoms every time you have sex.
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What Are The Complications Of Genital Herpes
Genital herpes may cause painful genital ulcers that can be severe and persistent in persons with suppressed immune systems, such as HIV-infected persons. 5 Both HSV-1 and HSV-2 can also cause rare but serious complications such as aseptic meningitis . 5 Development of extragenital lesions may occur during the course of infection. 5
There are also potential complications for a pregnant woman and her newborn child. See How does herpes infection affect a pregnant woman and her baby? below for information about this.
Do You Need To Tell Them
Before you tell anyone that you have genital herpes, its worth asking yourself whether or not they need to know. Your friends, colleagues and family probably dont need to know about it, as theres minimal risk of them catching the virus from you through sexual contact.
If you have close friends and the subject of herpes comes up in discussion, feel free to tell them about your HSV-1 or HSV-2 status if you feel comfortable. Just remember that you dont owe an explanation or confession to anyone youre not putting at risk of catching the virus from you.
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Genital Herpes Is Spread By Skin
The virus can be spread when someone with HSV has an episode or an outbreak characterised by having a sore, blister, ulcer or skin split . It can also be spread between episodes, when there is no sore, blister, ulcer or skin split present called asymptomatic viral shedding.
During viral shedding the virus is on the skin surface and can be spread through genital skin-to-skin contact, or from the mouth or face to genital skin during contact.
More Questions From Patients:
Many people with genital herpes have no symptoms, or have very mild symptoms that go unnoticed.
The first time genital herpes symptoms appear is called the “first episode” or “initial herpes.” Initial herpes symptoms are usually more noticeable than later outbreaks.
Symptoms of genital herpes in men may include
burning when you pee if you have sores
trouble peeing if you have sores covering your urethra
itching or pain around your genitals
During initial herpes, symptoms may also include
swollen, tender glands in the pelvic area, throat, or under the arms
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Can I Breastfeed If I Have Genital Herpes
Yes, you can breastfeed if you have genital herpes, but not if you have a herpes sore on one of your breasts. If you have genital herpes, it is possible to spread the infection to any part of your breast, including your nipple and areola.
If you have any genital herpes sores on one or both of your breasts:
- You can keep breastfeeding as long as your baby or pumping equipment does not touch a herpes sore.
- Do not breastfeed from the breast with sores. Herpes is spread through contact with sores and can be dangerous to a newborn baby.
- Pump or hand-express your milk from the breast with sores until the sores heal. Pumping will help keep up your milk supply and prevent your breast from getting overly full and painful. You can store your milk to give to your baby in a bottle for another feeding. But if parts of your pump also touch the sore while pumping, throw the milk away.
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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Where Do Symptoms Appear
When a person has genital herpes, the virus lies dormant in the bundle of nerves at the base of the spine. When the virus reactivates , it travels nerve paths to the surface of the skin, sometimes causing an outbreak.
Genital herpes, regardless of whether it is HSV-1 or HSV-2, does not cause symptoms on the mouth or face. For more on oral-facial herpes, see the oral herpes page.
Before You Tell Them Practice
The one person youll definitely need to have the chat with is your sexual partner/s. This is very important even if you rarely experience herpes outbreaks, as genital herpes can be spread from an infected person into an uninfected person even without any visible outbreak symptoms.
Coming out as herpes positive can feel stressful and difficult, especially when its directed at a person you care about and with whom youd like a romantic or sexual future. Luckily, dating with herpes doesnt have to be such a big deal if you know how to address it.
One way to get over the nervousness of telling a partner you have herpes is to practice ahead of time. Make note of the key points you want to include and practice the script a few times in front of the mirror until you feel comfortable talking about.
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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.
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Pain And/or Itching In Or Around The Blisters
Lesions are usually very painful to touchespecially during the first herpes outbreak, which tends to be more severe. “The main thing that brings women into the office with herpes is pain,” said Dr. Shirazian.
Bumps that you find just by chance when sudsing up in the shower or toweling off probably aren’t herpes. “Herpes lesions will make themselves known and felt,” said Dr. Shirazian. They can also itch, especially as they begin to scab over and heal.
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Tingling Or Pain Before Blisters Form
If you know you’ve been exposed to herpes, you may want to watch for “prodromal” symptoms. “About 50% of people will have symptoms such as itching, tingling, or pain on genital skin before blisters or sores appear,” said Dr. Shim. Usually, you’ll experience an outbreak later, but it’s possible to have this tingling or itching and have no sores emerge.
Treatment The First Time You Have Genital Herpes
You may be prescribed:
- antiviral medicine to stop the symptoms getting worse you need to start taking this within 5 days of the symptoms appearing
- cream for the pain
If you have had symptoms for more than 5 days before you go to a sexual health clinic, you can still get tested to find out the cause.
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How Do People Get Genital Herpes
Infections are transmitted through contact with HSV in herpes lesions, mucosal surfaces, genital secretions, or oral secretions. 5 HSV-1 and HSV-2 can be shed from normal-appearing oral or genital mucosa or skin. 7,8 Generally, a person can only get HSV-2 infection during genital contact with someone who has a genital HSV-2 infection. However, receiving oral sex from a person with an oral HSV-1 infection can result in getting a genital HSV-1 infection. 4 Transmission commonly occurs from contact with an infected partner who does not have visible lesions and who may not know that he or she is infected. 7 In persons with asymptomatic HSV-2 infections, genital HSV shedding occurs on 10.2% of days, compared to 20.1% of days among those with symptomatic infections. 8