What Happens If I Dont Receive Treatment
Genital herpes can cause painful genital sores and can be severe in people with suppressed immune systems.
If you touch your sores or fluids from the sores, you may transfer herpes to another body part like 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, quickly wash your hands thoroughly to help avoid spreading the infection.
If you are pregnant, there can be problems for you and your unborn fetus, or newborn baby. See Im pregnant. How could genital herpes affect my baby? for information about this.
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.
What Is Herpes Simplex
Herpes simplex is a virus that causes skin infections. The infection lasts your lifetime, and it causes painful or itchy sores and blisters that come and go. Herpes simplex virus typically doesnt cause severe problems. But it can be dangerous in infants and people with weakened immune systems. There are two types of herpes simplex:
- Herpes simplex 1 tends to affect your mouth or face. It causes cold sores. HSV-1 spreads through contact with saliva .
- Herpes simplex 2 is a sexually transmitted disease . It causes sores on skin that comes in contact with the genitals of an infected person.
Sometimes a herpes infection can affect other parts of your body, such as your eyes or other parts of your skin.
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What Happens At A Sexual Health Clinic
The doctor or nurse at the sexual health clinic will:
- ask about your symptoms and your sexual partners
- use a small cotton bud to take some fluid from 1 of your blisters or sores for testing
The test cannot:
- be done if you do not have visible blisters or sores
- tell you how long you have had herpes or who you got it from
Symptoms might not appear for weeks or even years after you’re infected with the herpes virus.
What Is Oral Herpes
Oral herpes is primarily caused by HSV-1, although it is also possible to have an HSV-2 infection around the mouth.
A person with an oral herpes outbreak may first feel itching, burning, or tingling around the mouth, lips, or tongue. Later, cold sores or small blisters may develop in these areas or anywhere on the skin.
Roughly four to six days after these cold sores start leaking, they start healing by forming a crust. Outbreaks of oral herpes can last for two to three weeks, which can be shorter than the two to six weeks of a genital herpes outbreak.
People who develop symptoms of herpes may first experience tingling, itching, or burning, then notice sores or blisters forming around the mouth or genitals.
Symptoms tend to develop 220 days after exposure to the virus.
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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 Both Partners Have Herpes
Congratulations you can skip having the talk! If you and your partner have the same type of herpes, you have more freedom than a couple not trying to infect one partner. If you both have HSV-2, for example, you both already have the antibodies built up and cannot be re-infected. Your outbreaks and symptoms will instead be affected by the strength of your immune system, so keep it strong.
You will also not necessarily have the same need to avoid sex during and around times of outbreaks, but you will probably want to, for the sake of avoiding discomfort or prolonging the outbreak by irritating it.
If you have different strains of herpes i.e. one of you has HSV-1 and one has HSV-2, read on. You are already well-protected by your antibodies. If you have HSV-2, you can still get, but might not be as likely to get, genital HSV-1. If you have HSV-1, however, you are still as susceptible to get HSV-2. Getting tested.
There are dating sites for people with herpes that can help you to meet potential partners with the same type of HSV as you. .
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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.
When You Do Not Have Symptoms
It is less likely that you will pass the virus on when you have sex. However, some virus will be present on the genital skin surface from time to time, although infrequently. So, there is still a small chance that you may pass on the virus when you have sex when you do not have symptoms. It is best to discuss things with your sexual partner. Using a condom each time you have sex is thought to reduce the chance further. However, using a condom cannot completely stop the chance of passing on the virus.
Taking antiviral medication long-term to prevent recurrences also reduces the risk of passing on the virus. However, very few people need to take this treatment all the time.
Note: if your sexual partner already has the same virus then you cannot re-infect each other. Your partner may be infected but may not have symptoms. It may be helpful to discuss things with a doctor or nurse at a GUM clinic.
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It Is Common Not To Develop Any Symptoms
Most people never develop any symptoms when they are infected with the virus. At least 8 in 10 people with genital herpes simplex virus do not know that they are infected. In such people, the virus stays inactive in the root of a nerve that supplies the genitals, but never causes recurrent episodes of symptoms. However, even people who do not develop symptoms may, on occasions, have virus in their genital area and therefore be infectious to sexual partners. In fact, this is how many genital herpes simplex infections are passed on.
Do I Need To Tell My Partner
In Canada, genital herpes is not a reportable sexually transmitted infection. While it is not legally required, we recommend that you inform any sexual partners youâve had 60 days before symptoms appeared or before the diagnosis date.
It is not mandatory to inform sexual partners you have been diagnosed with genital herpes in Canada.â
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Antiviral Medication For Recurrent Episodes Of Genital Herpes
Further episodes of symptoms tend to be milder and usually last just a few days. You usually have 7-10 days of symptoms rather than 10-28 days that can occur with a first episode. Antiviral medication is often not needed for recurrences. Painkillers, salt baths, and local anaesthetic ointment for a few days may be sufficient to ease symptoms. However, an antiviral medicine may be advised for recurrent episodes of genital herpes in the following situations:
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.
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Genital Herpes: The Painful Facts About A Tricky Virus
There are two main types of herpes simplex virus infections, HSV-1 and HSV-2. Generally speaking, HSV-1 is responsible for those annoying cold sores that can pop up during times of stress or lack of sleep. Genital sores are usually caused by HSV-2. Many people dont realize that HSV-1 can cause genital ulcers as well, though these tend to be less severe and less likely to recur.
It can take as little as a few days and up to a week after a person has been exposed before any herpes symptoms appear. First, there will be redness and tingling, followed by small painful bumps that progress to fluid-filled “blisters.” Eventually, these burst to form shallow skin ulcers which then crust over, with gradual healing over a couple weeks. An initial genital herpes infection can be very painful, also cause fever, body aches and fatigue. Recurrent outbreaks tend to cause less severe symptoms. Rarely a genital herpes infection can cause inflammation of the membrane that covers the brain .
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.
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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.
How Is It Spread
The herpes virus is spread by skin-to-skin contact with a person who has the herpes virus:
- Most often, from herpes sores or blisters
- Less often, from normal looking skin where the virusfirst entered the body
- The herpes virus enters the body through the:
- Lining of the mouth
- Regular skin that has small cracks or cuts
People with a weak immune system can get a herpesinfection more easily. A weak immune system is causedby some diseases and by somemedicines used to treat serious diseases.
People who don’t know they have herpes can still spread the virus to others.
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No Ulcers Doesnt Equal No Herpes So Then What
If youve never had genital ulcers and as far as you know, have never been exposed, is it worth getting tested? Thats a controversial point and in fact, the widely followed official guidelines discourage screening.
Why? Many reasons: Lets say a person has a blood test that comes back positive for HSV-2. This means that the patient may have been exposed to HSV-2 at some point in their lives, somehow, somewhere. Research tells us that these folks may be periodically shedding virus particles in their genital fluids. These patients would then be diagnosed with genital herpes, encouraged to share their status with future partners, and offered daily antiviral medication to prevent possibly spreading the virus.
All of this can be a tough pill to swallow, so to speak. There is significant social stigma and shame associated with herpes. In addition, there are occasionally false-positive tests. Labeling someone with the diagnosis can be devastating to their future relationships, and asking someone to take a pill for a condition they may or may not have and may or may not spread seems unreasonable.
However, not all experts agree with the official guidelines. Except for the uncommon case of a false positive blood test for HSV-2, a seropositive test means one of three things:
If you are not sure about getting tested, talk with your doctor.
About the Author
How Do I Talk With People About Having Herpes
It might feel scary to admit you have herpes, but talking about things can really ease your mind. You could lean on a close, non-judgmental friend that you trust to keep the conversation private. Parents, brothers and sisters, aunts and uncles, and other family members can also be a source of comfort. Remember, herpes is really common, so its possible the person youre talking to has herpes, too.
There are a lot of online support groups for people who have herpes, and the American Sexual Health Association has a list of support groups that meet in person.
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A First Episode Of Symptoms
At first you may feel generally unwell with a mild fever and aches and pains. Groups of small, painful blisters then appear around your genitals and/or back passage . They tend to erupt in crops over 1-2 weeks. The blisters soon burst and turn to shallow, sore ulcers.
Images above via Wikimedia Commons
The glands in your groin may swell and feel like lumps at the top of your legs. It is common to have pain when you pass urine, especially in women.
Sometimes less typical symptoms occur. For example, you may just have a small raw area, one or two small ulcers, or just an area of irritation with nothing to see. Sometimes symptoms last just a few days.
Note: sometimes a first episode of symptoms appears months or years after being first infected. This is why a first episode of symptoms can occur during a current faithful sexual relationship. You may have been infected months or years ago from a previous sexual partner who did not realise that they were infected.
It is not clear why some infected people develop symptoms, some don’t and some have a first episode of symptoms months or years after first being infected. It may be something to do with the way the immune system reacts to the virus in different people.
What Are Signs Of Genital Herpes In Women
Women who have the herpes virus may have nooutbreaks or signs of infection. Many do not know theyhave the virus. Once you are infected, the virus staysin your nerve cells for life. When the virus is not active,there is no sign of infection. When the virus becomesactive, a herpes outbreak occurs. Some womenmay not have any outbreaks or may have only oneoutbreak, while others may have multiple outbreaks.
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