Genital Herpes During Pregnancy
Prevention of neonatal herpes depends both on preventing acquisition of genital herpes during late pregnancy and avoiding exposure of the neonate to herpetic lesions and viral shedding during delivery. Mothers of newborns who acquire neonatal herpes often lack histories of clinically evident genital herpes . The risk for transmission to the neonate from an infected mother is high among women who acquire genital herpes near the time of delivery and low among women with prenatal histories of recurrent herpes or who acquire genital herpes during the first half of pregnancy . Women who acquire HSV in the second half of pregnancy should be managed in consultation with maternal-fetal medicine and infectious disease specialists.
All pregnant women should be asked whether they have a history of genital herpes or genital symptoms concerning for HSV infection. At the onset of labor, all women should be questioned thoroughly about symptoms of genital herpes, including prodromal symptoms , and all women should be examined thoroughly for herpetic lesions. Women without symptoms or signs of genital herpes or its prodrome can deliver vaginally. Although cesarean delivery does not eliminate the risk for HSV transmission to the neonate , women with recurrent genital herpetic lesions at the onset of labor should have a cesarean delivery to reduce the risk for neonatal HSV infection.
Acyclovir 400 mg orally 3 times/dayORValacyclovir 500 mg orally 2 times/day
Drug Treatment For Genital Herpes
If you are infected with genital herpes, your doctor may prescribe oral antiviral drugs to help ease your symptoms during both a first episode and recurrent episodes. Your doctor may also suggest taking antiviral drugs daily as a suppressive therapy to reduce symptoms and protect partners.
Remember, though, that antiviral drugs do not wipe out the virus completely. It continues to live in your body, so if you stop taking the drugs that suppress it, you may have more frequent or more intense symptom outbreaks, and the risk of your transmitting the virus to others rises.
Three antiviral drugs, all taken by mouth, are used to treat genital herpes:
Protecting Your Partner: Ways To Reduce Herpes Transmission
When people are diagnosed with herpes, one of the first things they think about is how to protect other people.
- How can I protect my current and future partners?
- How can I keep my kids and other family members from getting it?
- Can I prevent transmission or at least lower the risk?
In this section, weâll summarize the most common and practical ways of reducing the risk of transmitting herpes to your partners and other loved ones. First, weâll present some statistical information in tables. That will be followed by frequently asked questions with Dr. Fâs answers.
If you want to know how to protect your sexual partner and your family, this chapter is for you!
How to protect your partner from getting herpes. By STD expert
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Is Genital Herpes Related To Shingles
Shingles, also called herpes zoster, is caused by the varicella zoster virus , which causes chickenpox earlier in life. The natural history of varicella zoster infection is similar to genital herpes infection in that VZV also becomes latent in the sensory nerve roots. Later in life the virus may exit, causing shingles.
Recurrences in shingles cause blister lesions in a single area of skin called a dermatome. Shingles is not a sexually transmitted infection and is independent from genital herpes.
Can Genital Herpes Come Back
Yes. Genital herpes symptoms can come and go, but the virus stays inside your body even after all signs of the infection have gone away. The virus becomes “active” from time to time, leading to an outbreak. Some people have outbreaks only once or twice. Other people may have four or five outbreaks within a year. Over time, the outbreaks usually happen less often and are less severe.
Experts do not know what causes the virus to become active. Some women say the virus comes back when they are sick, under stress, out in the sun, or during their period.
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How To Get Rid Of Herpes The Conventional Way
For most people with herpes, the virus typically represents nothing more than an inconvenience however, the real risk is for immuno-compromised patients who cant easily manage infections. In these patients, such as those with HIV/AIDS, herpes simplex infection is associated with increased morbidity and mortality.
As of 2017, there is not currently a herpes vaccine available to prevent HSV-1 or HSV-2.
Doctors sometimes prescribe medications to help keep the herpes virus suppressed or to speed up healing of cold sores by reducing bacteria that can cause infections. Some medications that are now used to control herpes include:
- Nucleoside analogues and antiviral medications
- Creams/ointment to help lower pain and inflammation near the site of sores
- Over-the-counter painkillers to reduce aches, tenderness or fever
However, its important to understand that even with early detection and prescription medications, either form of the herpes virus cannot be totally cured so transmission is always still possible. Medications for viruses dont always work long term and are not a cure-all.
Ask Your Partner If They Have Ever Had A Sexually Transmitted Disease
Most people who have genital herpes don’t know they’re infected, so ask whether they have had any other sexually transmitted disease. People with a history of STDs are more likely to have genital herpes.
It may be awkward, but it’s important to be honest with each other. Your partner may be afraid to tell you the truth if they fear a negative reaction. If your partner feels comfortable talking with you, you’ll be more likely to get straight answers.
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Home Care Measures For Genital Herpes
First, simple self-care may be enough to relieve most discomfort caused by genital herpes. Taking an over-the-counter pain reliever, such as aspirin, acetaminophen, or ibuprofen, can help ease the pain of herpes symptoms. Doctors sometimes recommend soaking the affected area in warm water. But the area should be kept dry most of the time. If toweling off after bathing is uncomfortable, try using a hair dryer. Then put on cotton underwear. Cotton absorbs moisture better than synthetic fabric does.
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What Are The Different Types Of Herpes
There are two types of herpes simplex virus: HSV I and HSV II. HSV I commonly causes oral herpes, or cold sores. This virus can show up as an upper respiratory tract infection during early childhood. HSV II is the cause of most cases of genital herpes. However, it is possible for HSV I to cause genital herpes and HSV II to cause oral herpes.
Clinicians cannot tell the difference between the two types by physical examination alone, but there are differences between the two viruses. For example, genital herpes caused by HSV II is much more likely to recur. This diagnosis can be helpful in establishing a health care plan.
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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.
How To Alleviate Lower Back Pain
- Since lower back pain is associated with swelling, applying a cold compress on your back will help in mitigating the soreness youre experiencing. Aside from easing the pain, it relaxes the muscles by loosening the skin tissues.
- Just because you are having lower back pain doesnt mean that you have to sit or lay all day and do nothing. Keeping yourself moving by doing your regular daily activities will help in mitigating backaches.
- Do some stretching. Regular exercise can help in extending your legs, which also promotes movement and mitigates back pain.
When you are diagnosed with herpes, ensure that you are doing your best to remain healthy. That way, you can prevent episodes of outbreaks. Preventing outbreaks also prevents you from having to experience the symptoms associated with the infection, which also includes lower back pain.
Only eat nutritious foods and strengthen your immune system by exercising regularly and taking care of your body. These methods do not only bolster your health but also reduces your risk of acquiring other infections or illnesses.
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Pay Attention To What You Eat
ASHA reports that some people believe foods containing the amino acid arginine, such as legumes and whole grains, can contribute to outbreaks. A few older studies, conducted in 1981 and 1987, showed a possible connection, but ASHA states there is no clinical evidence to support these studies. However, because triggers may vary based on the individual, keep track of the foods you eat to determine if there is a connection.
Other Ways To Reduce Genital Herpes
Following are several ways that can reduce herpes transmission.
- Using condoms is one of the best ways to reduce the transmission rate. According to a 2016 study, over 900 couples and the findings suggest that condoms drastically reduced the transmission rate. The transmission rate from men to women went down by 96% and by 65% vice versa. Therefore, using condoms correctly can help reduce transmission.
- If your partner has an active sore on their genitals, it is advisable to refrain from sexual contact. However, if you want to proceed, go ahead with a condom.
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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.
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.
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Some Important Facts Affecting The Risk Of Herpes Transmission
- Herpes is transmitted through skin-to-skin contact
- The first outbreak is the most contagious
- There is a greater statistical chance of passing herpes when youâve been recently diagnosed whether you have symptoms or not
- Herpes infects skin areas that are thin and moist because itâs easier for the virus to penetrate those areas. For that reason, females are three times more likely to be infected than males
- Younger people having casual sex are more likely to contract herpes
- HSV-1 in the genital area recurs less often than HSV-2
- Being positive for HSV-2 gives some protection against getting HSV-1. The opposite is not true
- If a person with one type of herpes acquires a different type, the flare-up symptoms are milder
- Sex toys should not be shared. But if they are shared, they should be cleaned with water and soap before being used
Symptoms Of Oral Herpes
Oral herpes is most often caused by HSV-1, but can also be caused by HSV-2. It usually affects the lips and, in some primary attacks, the mucous membranes in the mouth. A herpes infection may occur on the cheeks or in the nose, but facial herpes is very uncommon.
Primary Oral Herpes Infection
If the primary oral infection causes symptoms, they can be very painful, particularly in children. Symptoms include:
- Tingling, burning, or itching around the mouth are the first signs.
- Red, fluid-filled blisters that may form on the lips, gums, mouth, and throat.
- Blisters that break open and leak. As they heal, they turn yellow and crusty, eventually turning into pink skin. The sores last 10 to 14 days and can be very uncomfortable.
- Blisters that may be preceded or accompanied by sore throat, fever, swollen glands, and painful swallowing.
Recurrent Oral Herpes Infection
A recurrent oral herpes infection is much milder than the primary outbreak. It usually manifests as a single sore, commonly called a cold sore or fever blister . The sore usually shows up on the outer edge of the lips and rarely affects the gums or throat.
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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.
Take Precautions To Make Sex Safer
Taking an antiviral medication like valacyclovir can greatly reduce both the number of genital herpes outbreaks and asymptomatic shedding. This makes herpes transmission much less likely.
If you’re in a long-term, monogamous relationship, it’s important to talk with your partner about a herpes infection and how to create the safest environment possible. You can also talk with a health care provider about safe sex practices when one partner has a herpes infection.
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Genital Herpes Transmission Risk By Gender
About 12% of people aged 14 to 49 in the United States have genital herpes. The risk of genital herpes can differ depending on gender and sexual orientation.
The following are relevant findings pertaining to genital herpes transmission risk:
- Women are more likely to have genital herpes. This might be because it is easier for the virus to transmit from a man to a woman via penile-vaginal sex.
- About 16% of women aged 14 to 49 have genital herpes.
- For men aged 14 to 49, the rate of genital herpes is about 8%.
- The rate of genital herpes among men who have sex with men is about 16% to 28%, depending on ethnicity. Rates are higher among nonwhite men, and studies say this is likely because of less access to health care and higher poverty rates.
- Rates of herpes transmission were lower among gay women than among bisexual women
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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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.
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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How Do I Know If I Have Genital Herpes
Most people with genital herpes have no symptoms or have very mild symptoms. Mild symptoms may go unnoticed or be mistaken for other skin conditions like a pimple or ingrown hair. Because of this, most people do not know they have a herpes infection.
Herpes sores usually appear as one or more blisters on or around the genitals, rectum or mouth. This is known as having an outbreak. The blisters break and leave painful sores that may take a week or more to heal. Flu-like symptoms also may occur during the first outbreak.
People who experience an initial outbreak of herpes can have repeated outbreaks, especially if they have HSV-2. However, repeat outbreaks are usually shorter and less severe than the first outbreak. Although genital herpes is a lifelong infection, the number of outbreaks may decrease over time.
Ask a healthcare provider to examine you if:
- You notice any symptoms or
- Your partner has an STD or symptoms of an STD.
STD symptoms can include an unusual sore, a smelly genital discharge, burning when peeing, or bleeding between periods .
One Option For Ongoing Therapy: Taking Drugs Regularly
Some people with genital herpes choose to take antiviral medication daily to reduce the number of symptom outbreaks they have. In some cases, daily therapy prevents outbreaks completely.
Numerous studies over the years have demonstrated the safety and effectiveness of all three of the approved antivirals used to treat genital herpes.
Studies have also shown that daily antiviral therapy reduces the rate of transmission from an HSV-2 infected person to an uninfected partner of the opposite sex.
Daily therapy also lowers the odds of infecting other people if you have multiple sex partners or if you are a man who has sex with men.
The drugs work both for people who have had herpes symptoms and for those whose blood tests show they have an HSV-2 infection but who have never had symptoms.
Some people choose to take antiviral drugs only as needed, for outbreaks that occur after the first one. For this to work, you need to start taking the medicine within one day of sores cropping up or during the time period that comes before some outbreaks.
During the prodrome, you may feel
- Burning in the area where the virus first entered your body
- Itching or tingling in that area
- Pain in your back, buttocks, thighs, or knees
Your doctor will probably give you a prescription you can fill and keep handy for timely use, and tell you to start taking the drugs just as soon as symptoms begin.
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