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.
Is There A Cure For Herpes Simplex
There is no cure for herpes simplex. Once you have the virus, its a lifelong infection.
What is the outlook for people with herpes simplex?
For many people, the first herpes outbreak is the most severe. Many outbreaks are less frequent and milder after the first year of infection. Some people may have only one outbreak and never have another again.
Herpes infection doesnt usually pose a serious health risk. The risk of a health complication due to herpes is higher in infants and if you have HIV/AIDS, cancer or an organ transplant.
Factors Affecting The Probability Of Transmission
The probability of herpes transmission among couples if one of the partners has the infection depends on various factors, such as the clinical manifestation of the disease , frequency of sexual intercourse, and time since the herpes-positive partner was infected. In general, it is more common to get herpes from someone newly infected. Also, a person with other sexually transmitted infections is at higher risk of contracting herpes through sexual intercourse with a herpes-positive partner.3
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Valacyclovir Lowers Herpes Transmission Rates
If you have herpes, youve probably taken valacyclovir before as part of an outbreak or initial infection treatment protocol. Valacyclovir is extremely helpful in the management of herpes. During an outbreak, it can speed up the rate of recovery and quickly remove herpes sores.
When it comes to preventing the transmission of herpes, valacyclovir can be helpful but shouldnt be relied on as a 100% effective solution.
Study data shows that people with symptomatic herpes who take valacyclovir are almost 50% less likely to transmit the virus to others than non-medicated people with herpes. In one study, the HSV-2 acquisition rate was reduced from 3.6% to 1.9% using valacyclovir treatment.
Other studies show a similar reduction in herpes transmission rates when the infected person used valacyclovir.
For example, in a 2004 study, researchers noticed that people with non-symptomatic genital herpes were 50% less likely to transfer the virus to their sexual partner. People with herpes symptoms had an even higher drop in transmission ratea reduction of 77 percent.
Its important to remember that this still means there are cases where herpes is transmitted between sexual partners, even when the infected person takes valacyclovir.
In short, while valacyclovir doesnt completely block genital herpes transmission through sex and genital contact, using valacyclovir does lower your risk of catching herpes from a sexual partner.
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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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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.
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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Valacyclovir For Preventing Hsv
There are antiviral medicines that can prevent outbreaks. Using daily valacyclovir or Valacyclovir treatment can help to reduce asymptomatic shedding as well as outbreaks. In the study mentioned above, there were 743 of the 1484 couples who were instructed to take 500 mg Valacyclovir daily. Doctors also told them to use a condom for extra protection. Amongst these couples, only 14 were infected, and of those, four experienced outbreaks.
The study results were promising because taking 500 mg Valacyclovir daily can reduce the transmission of Genital Herpes. However, Valacyclovir can help reduce transmission of HSV-2, but it is not yet confirmed that Valacyclovir can be effective in treating genital sores due to HSV-1. HSV-1 is the herpes virus that causes cold sores around the mouth. HSV-2 most commonly causes genital herpes cases, but now there are increasing cases of genital herpes due to HSV-1. The reason for this cause is the growing social sexual change and high rate of oral sex.
The dosage of Valacyclovir is 500 mg for people who have fewer than nine outbreaks. However, doctors can adjust the dosage for those people who have more outbreaks and different organ problems.
Genital Herpes And Hiv:
Genital herpes can increase the risk of HIV transmission and acquisition. HSV can cause sores and breaks in the skin, making it easier for HIV to enter the body.
People with a herpes infection have an increased risk of contracting HIV if exposed to it during sex. The herpes virus increases the number of CD4 cells found in the lining of the genitals, which are the cells that HIV targets for entry into the body.
HSV infection may double the risk of HIV infection.
HSV also increases HIV in the genital area of people living with HIV, thereby increasing their risk of transmitting HIV to a sexual partner. Sources:
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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.
Is There Any Resistance To Genital Herpes Medication
Resistance to drugs that treat genital herpes even after 20 years of use is very rare. Herpes medications may not work as well in patients who are very immunosuppressed and have been treated with these drugs for a long time. Each individuals response to treatment may vary. In some cases, patients may need more drugs to suppress their viral outbreaks than others.
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Can Cold Sores Be Serious
In most cases, cold sores are just unsightly and painful but clear up within 15 days. However, cold sores can be serious when they affect:vii
- Your eyes If the infection reaches the inner layers of your cornea the transparent layer at the front of your eye and remains untreated, it can be sight-threatening.
- Babies Because their immune systems havent yet developed properly, babies cant fight the virus easily and if the infection spreads to their vital organs, it can be fatal.
- People with weakened immunity As with babies, the infection may spread to vital organs. People at risk include those undergoing chemotherapy for cancer or anyone with a condition affecting their immunity such as diabetes or HIV.
How Do I Know If I Have Herpes
The best way for a clinician to determine if someone is infected with HSV-1 or HSV-2 is to perform a laboratory analysis on a sample from a fresh herpes sore. But, because not everyone with herpes has symptoms, your clinician may instead use a blood test that can detect antibodies to the herpes viruses. A blood test can show if you have herpes and, if so, determine whether you are infected with HSV-1 or HSV-2. However, a blood test cannot tell you what part of your body the virus will affect.
If you want to be tested for herpes, ask your clinician. A standard screening for sexually transmitted diseases may not include herpes unless you specifically ask.
Remember, however, that HSV-1 is a very common virus, and there is a 5060 percent probability that you will test positive for it. If you are a sexually active adult who has had multiple partners, there is a 1020 percent probability that you will test positive for HSV-2.
Here are some other things to consider before you get tested:
- If you test negative for one or both of these viruses, what will you do to prevent them?
- If you test positive for one or both of these viruses, will you tell potential partners before you engage in sexual activity or, in the case of HSV-1, before you kiss them or engage in oral sex?
Learning that you have herpes can be confusing and scary. We encourage you to have an in-depth conversation with your healthcare provider before you decide to get tested.
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How Is Herpes Simplex Caught And Passed On
The facts about passing on/transmitting herpes are clear:
Herpes is passed directly from the affected area of skin , by direct skin to skin contact, with friction, when the virus is present.
It can be passed from the face of one person to the genitals of another through oral sex, when the virus is active.
You can pass it on from the affected area, when the virus is present on the skin surface: from the first warning signs that a recurrence is starting , through the time when there are sores or blisters, until they have healed and fresh skin has grown back.
Get this two-page summary which covers the basics.
About six in ten adults by age 25 carry herpes simplex virus type 1 and one in ten carries type 2. Even more people carry herpes simplex virus in older age groups but most dont know. Only around one in three of those infected with either type is aware of this.
How Can Herpes Be Prevented
Correct and consistent use of latex condoms can reduce, but not eliminate, the risk of transmitting or acquiring genital herpes because herpes virus shedding can occur in areas that are not covered by a condom.25,26
The surest way to avoid transmission of STDs, including genital herpes, is to abstain from sexual contact, or to be in a long-term mutually monogamous relationship with a partner who has been tested for STDs and is known to be uninfected.
Persons with herpes should abstain from sexual activity with partners when herpes lesions or other symptoms of herpes are present. It is important to know that even if a person does not have any symptoms, he or she can still infect sex partners. Sex partners of infected persons should be advised that they may become infected and they should use condoms to reduce the risk. Sex partners can seek testing to determine if they are infected with HSV.
Daily treatment with valacyclovir decreases the rate of HSV-2 transmission in discordant, heterosexual couples in which the source partner has a history of genital HSV-2 infection. 27 Such couples should be encouraged to consider suppressive antiviral therapy as part of a strategy to prevent transmission, in addition to consistent condom use and avoidance of sexual activity during recurrences.
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How Effective Is Medication At Preventing Infection
If you have genital herpes, you will probably be somewhat less likely to infect your partner if you use antiviral medication for prevention. The medications used for this purpose include aciclovir, famciclovir and valaciclovir. They must be taken every day over a long period of time, though. One study showed that over a period of eight months,
- 4 out of 100 people became infected when the partner with the virus took a placebo, and
- 2 out of 100 people became infected when the partner with the virus took antiviral medication every day.
These couples were also advised to use condoms as well but many didn’t use them consistently. So its not clear whether taking antiviral medication can lower the risk of infection even further if you always use condoms anyway, or whether using condoms is just as effective on its own.
Whether or not you would like to use preventive medication is ultimately an individual decision. Many factors can play a role, such as how long you or your partner have had the infection, how frequent and severe the outbreaks are, whether you are male or female, the frequency of sexual contact and whether you use condoms.
How Will My Healthcare Provider Know If I Have Genital Herpes
Your healthcare provider may diagnose genital herpes by simply looking at any sores that are present. Providers can also take a sample from the sore and test it. If sores are not present, a blood test may be used to look for HSV antibodies.
Have an honest and open talk with your healthcare provider about herpes testing and other STDs.
Please note: A herpes blood test can help determine if you have herpes infection. It cannot tell you who gave you the infection or when you got the infection.
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How Is Genital Herpes Spread
- Saliva from a partner with an oral herpes infection
- Genital fluids from a partner with a genital herpes infection
- Skin in the oral area of a partner with oral herpes or
- Skin in the genital area of a partner with genital herpes.
You also can get genital herpes from a sex partner who does not have a visible sore or is unaware of their infection. It is also possible to get genital herpes if you receive oral sex from a partner with oral herpes.
You will not get herpes from toilet seats, bedding, or swimming pools. You also will not get it from touching objects, such as silverware, soap, or towels.
If you have more questions about herpes, consider discussing your concerns with a healthcare provider.
How Can I Prevent Genital Herpes
If you are sexually active, you can do the following things to lower your chances of getting genital herpes:
- Being in a long-term mutually monogamous relationship with a partner who does not have herpes.
- Using condoms the right way every time you have sex.
Be aware that not all herpes sores occur in areas that a condom can cover. Also, the skin can release the virus from areas that do not have a visible herpes sore. For these reasons, condoms may not fully protect you from getting herpes.
If your sex partner has/have genital herpes, you can lower your risk of getting it if:
- Your partner takes an anti-herpes medicine every day. This is something your partner should discuss with his or her healthcare provider.
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Talking To Your Partner
Talking to your partner about your herpes condition helps to develop trust, improves the relationship, and makes regular use of condoms more likely.
When you talk to your partner, youâll find out if theyâre one of the people who understand the risk of getting herpes and are OK with it or if theyâre in the group of people who want the most protection possible.
You should ask your partner to get tested for herpes. Most people have never been tested for herpes because this isnât a routinely ordered test even if a âfull STD panelâ is requested.
A type-specific herpes test is necessary. If your partner is positive for the same virus type, you wonât need to use protection.