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.
How Herpes Is Spread
You are most likely to spread herpes when you have a herpes sore or blister. But many people have time periods when they can still spread the virus even though they don’t have symptoms.
And some people spread the infection because they don’t realize that they have a herpes sore. Or they may have different symptoms, such as painful urination, that they don’t realize are part of an outbreak.
Is Herpes Simplex Related To Herpes Zoster
Like HSV-1 and HSV-2, shingles can cause a painful, blistering rash. The shingles rash usually shows up on the back, side, abdomen , neck and face. It is often only on half of your body, following the pattern of your nerves. See your healthcare provider if you have a new rash and suspect you may have shingles.
A note from Cleveland Clinic
Herpes simplex is a virus. Once you have herpes, its a lifelong condition. A herpes infection can lead to outbreaks , but youll also have times when you have no symptoms. The main sign of herpes is sores that appear on the infected skin. Some people choose not to treat herpes, especially if symptoms are mild. Others take antiviral medications to reduce the severity and frequency of outbreaks.
Last reviewed by a Cleveland Clinic medical professional on 05/17/2022.
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When To See A Healthcare Provider
The early recognition of genital herpes, ideally during the prodromal stage, allows you to access treatments that can shorten the duration and severity of an outbreak.
Clearly, this can be difficult during your first outbreak, given that you probably won’t be expecting it. But, over time, you will be better able to recognize the tell-tale signs and know when it’s time to act.
Symptoms Of Genital Herpes
Many people who have genital herpes may not be aware they have the infection, because they may not have any symptoms.
The first episode of herpes can cause considerable pain and distress. Symptoms of the first episode may include:
- flu-like symptoms such as feeling unwell, headaches and pains in the back and legs, with or without enlarged glands in the groin
- small blisters around the genitals these break open to form shallow, painful ulcers, which scab over and heal after one to two weeks
- small cracks in the skin with or without an itch or tingling
- redness or a distinct rash
- some people also have considerable pain and swelling in the genital area, and hence may have additional pain and difficulty passing urine.
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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.
Im Pregnant What Do I Need To Know
To get the best care, tell your doctor you have genital herpes, because it could make you more likely to have a miscarriage or give birth too soon.
Its possible to pass along the virus to your baby. For infants, it can be life-threatening. Your doctor can talk to you about how to lower the chances that this will happen.
If you have an outbreak while youre pregnant, your doctor can give you medicine to treat your symptoms and stop them sooner.
Your doctor may give you a drug to prevent an outbreak as your due date gets closer. This is because your baby could get herpes by passing through your birth canal if youre having an outbreak when you go into labor. If thats a possibility, your doctor will most likely want to do a C-section, which is surgery to deliver the baby.
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How Common Is Genital Herpes
Genital herpes infection is common in the United States. CDC estimated that there were 572,000 new genital herpes infections in the United States in a single year.1 Nationwide, 11.9 % of persons aged 14 to 49 years have HSV-2 infection .2 However, the prevalence of genital herpes infection is higher than that because an increasing number of genital herpes infections are caused by HSV-1. 3 Oral HSV-1 infection is typically acquired in childhood because the prevalence of oral HSV-1 infection has declined in recent decades, people may have become more susceptible to contracting a genital herpes infection from HSV-1. 4
HSV-2 infection is more common among women than among men the percentages of those infected during 2015-2016 were 15.9% versus 8.2% respectively, among 14 to 49 year olds. 2 This is possibly because genital infection is more easily transmitted from men to women than from women to men during penile-vaginal sex. 5 HSV-2 infection is more common among non-Hispanic blacks than among non-Hispanic whites . 2 A previous analysis found that these disparities, exist even among persons with similar numbers of lifetime sexual partners. Most infected persons may be unaware of their infection in the United States, an estimated 87.4% of 14 to 49 year olds infected with HSV-2 have never received a clinical diagnosis. 6
The age-adjusted percentage of persons in the United States infected with HSV-2 decreased from 18.0% in 19992000 to 12.1% in 2015-2016. 2
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 don’t know they are infected and don’t 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.
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Onset Of First Outbreak
The first outbreak of oral herpes usually develops within about one to three weeks after infection. This initial outbreak may last for up to three weeks.
With genital herpes, the first outbreak usually occurs within about two to 20 days. Similar to oral herpes, the initial outbreak may last as long as three weeks.
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.
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Genital Herpes And Pregnancy
It is important to avoid contracting herpes during pregnancy. A first episode during pregnancy can create a greater risk of transmission to a newborn.
Fortunately, it is rare for women with genital herpes to infect their babies. If you know that 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, a C-section may be recommended. Depending on individual diagnosis, though, the American Congress of Obstetricians and Gynecologists endorses suppressive therapy to reduce the frequency of C-section.
Can Herpes Be Prevented Or Avoided
The best way to prevent getting herpes is to not have sex with anyone who has the virus. It can be spread even when the person who has it isnt showing any symptoms. If your partner has herpes, there is no way of knowing for sure that you wont get it.
If you are infected, there is no time that is completely safe to have sex and not spread herpes. If you have herpes, you must tell your sex partner. You should avoid having sex if you have any sores. Herpes can spread from one person to another very easily when sores are present.
You should use condoms every time you have sex. They can help reduce the risk of spreading herpes. But its still possible to spread or get herpes if youre using a condom.
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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.
What Are The Symptoms Of Genital Herpes
Most individuals infected with HSV are asymptomatic or have very mild symptoms that go unnoticed or are mistaken for another skin condition. 9 When symptoms do occur, herpes lesions typically appear as one or more vesicles, or small blisters, on or around the genitals, rectum or mouth. The average incubation period for an initial herpes infection is 4 days after exposure. 10 The vesicles break and leave painful ulcers that may take two to four weeks to heal after the initial herpes infection. 5,10 Experiencing these symptoms is referred to as having a first herpes outbreak or episode.
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Why Do I Get Cold Sores So Often
Find out why you get cold sores so often and what can be done to reduce the number of recurring outbreaks.The facts about cold sores
Cold sores are an infectious chronic inflammatory skin disease caused by the herpes simplex virus. The infection occurs in the form of vesicular eruptions, usually located on the periphery of the mouth and lips. Herpes is a contagious and recurrent disease thats why its impossible to get rid of. Unfortunately, outbreaks will erupt and subside throughout your lifetime. However, that doesnt mean you have no control over the frequency with which that typical tingling and burning sensation will be felt.
What causes cold sore outbreaks?
You can stop wondering why you get cold sores so often and instead make every effort to avoid conditions that trigger an outbreak. They include:
- stress and anxiety
- some foods and allergies
It goes without saying that you should also avoid kissing anyone when you have a cold sore, as well as sharing your utensils or towels.
If youve tried to avoid conditions that can encourage cold sore outbreaks, and still cant seem to avoid them, you may need to consult a doctor and get some more advice on what you can do to control it.
Ask your doctor for help
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How Often Do Recurrent Herpes Outbreaks Occur
Frequency of recurrent outbreaks vary for different individuals. For some lucky few, the body will build up an antibody tolerance and the disease will become perpetually asymptomatic, never to have an episode again, while others will continue to experience repeated chronic outbreaks for months and years.
Statistically, approximately 80% of the infected individuals will suffer from a recurrent outbreak within the first 6 months of the first episode. On average, the number of recurrent outbreaks is 3 to 5 times a year depending on the general health of the patient.
Additionally, if the infection is herpes type-2, one is also 5 times more likely to experience a recurrent outbreak than a person who is infected with herpes type-1.
The good news is, over years, the frequency of outbreaks typically diminishes with time and the outbreaks become less severe. However, even if an outbreak has not occurred for a long period of time or a person become perpetually asymptomatic, the individual is still a carrier of the virus and may still be contagious to others.
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What Causes Recurrent Herpes Outbreaks
Once a patient acquires a herpes virus, it stays in the body for life.
The immune system puts viruses into dormancy.
Many people get the herpes simplex virus and never experience an outbreak or symptoms.
Others will have an initial outbreak, but no recurrences.
Some people get more frequent herpes outbreaks.
HSV-1 or oral herpes causes an average of one recurring outbreak after the initial infection for between 20-50% of people who have the virus.
HSV-2 causes an average of four outbreaks in the first year for as many as 90% of people who have the virus.
Outbreaks of herpes simplex typically become less frequent, and less severe, the longer the virus is in the body.
People who have compromised immune systems may experience more frequent, or more severe, outbreaks.
What Is Genital Herpes
Genital herpes is a common viral infection caused by a virus known as the herpes simplex virus .
There are two types of the virus, types 1 and 2 . As well as genital herpes, HSV can infect your mouth and cause cold sores. HSV-1 and HSV-2 infections look the same and you can only tell them apart by lab testing.
Because genital herpes can be passed to others through sexual contact, it is often referred to as a sexually transmitted infection .
As many as 1 in 3 adults has the virus that causes genital herpes. Once you have HSV it remains in your body and becomes active again from time to time.
On average, symptoms of genital herpes are likely to recur 45 times in the first 2 years after being infected with HSV. However, over time the virus tends to become active less often and each time you get symptoms they are less severe.
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Break It Down For Me Jenelle
Utterly confused? Heres the deal:
- If you have an oral HSV2 infection, you probably wont ever experience an outbreak or visual symptoms.
- If you have a genital HSV1 infection, you might experience one outbreak per year.
- If you have a genital HSV2 or an oral HSV1 infection, the number of outbreaks you experience and their severity will largely depend upon how healthy you keep your immune system. Some folks experience fairly severe and somewhat frequent outbreaks, and others dont.
- The longer you have an HSV infection, the fewer outbreaks youre likely to have.
Remember: there are exceptions to every rule. One of those exceptions? If you have a compromised immune system, you are likely to experience more outbreaks than the average person in any of the categories previously mentioned.
Lastly, and this is very important, whether or not you experience physical symptoms/outbreaks, you are still able to transmit the infection to others .
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.
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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.