First And Subsequent Episodes
The first genital herpes outbreak will generally be worse than the ones that follow. During a first outbreak, the appearance of lesions will often be accompanied by:
- Pain or burning with urination
- Unusual vaginal discharge
Subsequent attacks tend to be shorter and less severe. They are often preceded by genital pain or shooting pain in the legs, hip, or buttocks several hours or days before the attack.
Over time, the number of outbreaks tends to decrease and become less severe.
Can Antivirals Reduce Herpes Risk
Genital herpes is treated with antiviral drugs that quickly block the replication of the virus and bring the infection under control. Three are approved for the treatment of genital herpes:
The drugs can be used “on-demand” for episodic outbreaks.
If you have frequent outbreaks, they can be taken in low doses on a daily basis as a form of suppressive therapy to lower the risk of recurrence.
At one time, suppressive therapy was thought to reduce the risk of HSV transmission given that it keeps the viral load low. This, in turn, was thought to reduce the risk of asymptomatic shedding.
As reasonable as these assumptions seem, the theory has yet to be proven. According to a 2012 study in the Lancet, even with fully suppressive therapy, a person can still experience short episodes of asymptomatic shedding during which transmission can occur.
While suppressive therapy may reduce the risk of HSV transmission, it doesn’t erase it.
Dont Be Afraid To Get Emotionally Intimate
An open and honest conversation about your diagnosis can require emotional intimacy that may be scary to have in a new relationship. Harbushka says to relax and realize that it can be sexy to communicate with your partner about sex and other important intimate topics.
With the right information and adequate protection, you can still enjoy a healthy sexual relationship. Here are some tips to help you and your partner stay safe during sex.
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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.
Persons With Herpes Simplex Virus Type 2 But Without Symptoms Still Shed Virus
- JAMA and Archives Journals
- Persons who have tested positive for herpes simplex virus type 2 but do not have symptoms or genital lesions still experience virus shedding during subclinical episodes, suggesting a high risk of transmission from persons with unrecognized HSV-2 infection, according to a new study.
Persons who have tested positive for herpes simplex virus type 2 but do not have symptoms or genital lesions still experience virus shedding during subclinical episodes, suggesting a high risk of transmission from persons with unrecognized HSV-2 infection, according to a study in the April 13 issue of JAMA, a theme issue on infectious disease and immunology.
Anna Wald, M.D., M.P.H., of the University of Washington and Fred Hutchinson Cancer Research Center, Seattle, presented the findings of the study at a JAMA media briefing at the National Press Club in Washington, D.C.
Dr. Wald and colleagues compared the rates and patterns of genital HSV shedding in 498 immunocompetent HSV-2-seropositive persons between March 1992 and April 2008. Each participant obtained daily self-collected swabs of genital secretions for at least 30 days. The rate of viral shedding was measured by polymerase chain reaction from the swabs.
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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.
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 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.
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.
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Genital Herpes: How Can You Prevent The Spread Of Herpes In Sexual Relationships
Herpes viruses are most likely to be transmitted during an outbreak, so it’s better to not have sex during this time. Herpes can also be passed on to others in symptom-free phases, though. This risk can be reduced considerably by using condoms.
If you have genital herpes, there are some things you can do on your own to protect your partner from infection. The main things are
- not having sex during an outbreak,
- using condoms during symptom-free phases, and
- talking openly with your partner about the disease.
Preventive treatment with antiviral medication may be an option for people who have genital herpes very frequently. This medication inhibits the activity of the virus, thereby lowering the risk of infecting partners.
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
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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.
When To Call The Doctor
Even though HSV sores can hurt and be unsightly, most cases of herpes do not cause serious illness. The sores go away in a few days. Contact the health provider if:
- Sores are present and you think it might be a first herpes infection. The diagnosis is usually made by examining the sores. If the sores have not healed, sometimes a laboratory test is done.
- Sores do not heal by themselves or show signs of infection such as pus, spreading redness or fever.
- Sores are near the eyes.
- You have another health condition with a weakened immune system.
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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.
Recurrent Episodes Of Genital Herpes
Recurrences are usually less painful and shorter in duration than the first episode of genital herpes. Over time, episodes usually become less frequent and may eventually stop altogether. Infections caused by HSV1 are less likely to recur in the genital area than infections caused by HSV2.
Recurrences may be triggered by:
- no apparent reason noted.
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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.
Support And Advice For Genital Herpes
If you have just found out you have genital herpes, you may feel shocked and may have a lot of questions. It may help you to gather as much information as you can about herpes. This can help you to make fully informed decisions about your treatment, safe sex and preventing further recurrences. Talking to a counsellor about your concerns may also help.
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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.
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.
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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.
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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How Big Is The Risk Of Infection
The likelihood of being infected with genital herpes during sex depends on many factors, including how often you have sex, whether and how frequently you use condoms, and how long your partner has already been infected. Someone who has had the virus for a long time is less contagious than someone who has just been infected. In general, women have a higher risk of becoming infected than men. Having other sexually transmitted diseases such as HIV also increases the risk of transmission.
In studies with couples where one partner had genital herpes, the other partner became infected within one year in 5 to 10% of the couples. The people in these studies only rarely used condoms, though and if they did, it was mostly during an outbreak. One of these studies showed that infection occurred in an estimated 1 out of 1,000 sexual acts.
How Can I Prevent Giving Genital Herpes To My Partner
You can reduce the risk of passing the herpes virus to your sexual partners by taking the following steps:
Tell current sexual partners that you have genital herpes. You also should tell future partners before having sexual contact.
Be alert to the symptoms that signal an outbreak is coming. Avoid sexual contact from the time you feel symptoms until a few days after the sores have gone away.
Wash your hands with soap and water after any possible contact with sores.
Take antiviral medication on a daily basis .
Use male latex condoms.
Its also important to know that you can pass HSV to someone else even when you do not have sores . The virus can be present on skin that looks normal, including right before and after an outbreak.
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