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Genital Herpes

Overview, Causes, & Risk Factors

Genital herpes is a sexually transmitted disease caused by the herpes simplex virus.

What is going on in the body?

Genital herpes can be caused by either type of herpes simplex virus. Most cases are caused by herpes simplex virus type 2, or HSV 2. This type can also infect the person's mouth if he or she has oral sex with an infected partner. Some cases of genital herpes are caused by HSV 1, which usually causes cold sores on the lips.

The viruses infect nerve cells and remain in the body permanently after infection. When a person is first infected, blisters form on the genitals in what is called the primary episode. The blisters can then recur at any time in the future. The primary episode is usually more severe than the recurrences. Recurrences last about 10 days.

What are the causes and risks of the infection?

Herpes simplex virus infections are spread by close contact with a person who is actively shedding viral particles. The person usually has blisters during shedding, but the skin might look quite normal. Sexual intercourse is not necessary for transmission of genital herpes.

Symptoms & Signs

What are the signs and symptoms of the infection?

Some people with genital herpes don't realize they are infected because they don't have symptoms. Others have mild symptoms but don't know that they have herpes. The first outbreak of symptoms usually occurs within 2 to 10 days of exposure. It usually lasts 2 to 3 weeks. Following are early symptoms of the first outbreak:

  • a feeling of fullness in the abdomen
  • fluid leaking from the vagina
  • itching or burning around the genitals or anus
  • pain in the buttocks, genitals, or legs
  • A few days later, multiple sores develop where the virus entered the body. This may be the vagina, penis, or mouth. The sores start as small red sores that blister. They may blend together into larger blisters. The blisters open, then crust over. Other symptoms of the first outbreak may include are as follows:

  • fever
  • headache
  • muscle aches
  • painful urination
  • swollen lymph nodes in the groin
  • vaginal discharge
  • Someone who has genital herpes will usually have several recurrences a year. A recurrence usually lasts about a week. The person may have no sores, or very few sores. Some people have genital itching or pain in the buttocks or legs.

    Diagnosis & Tests

    How is the infection diagnosed?

    Diagnosis of genital herpes begins with a medical history and physical exam. Lab tests are rarely needed but are available.

    Prevention & Expectations

    What can be done to prevent the infection?

    Safer sex practices can help prevent the spread of genital herpes. Condoms do not offer complete protection since blisters can occur on skin surfaces not covered by the condom.

    What are the long-term effects of the infection?

    Most people with genital herpes suffer no long term effects. Individuals with immunodeficiency disorders, such as AIDS, can develop life-threatening infections. Genital herpes in pregnant women may be passed to a newborn during the birth process. The child may have a serious infection.

    What are the risks to others?

    Genital herpes is a contagious disease. The exact risk of transmission from a single exposure is unknown. The virus is harbored within nerve tissue even when there are no blisters and may be transmitted to others.

    Treatment & Monitoring

    What are the treatments for the infection?

    Acyclovir, valacyclovir, and famciclovir are the most commonly used medicines for genital herpes. They reduce the amount of time that viral particles are shed. They also help the blisters to heal faster. These medications can also be taken on a regular basis to reduce recurrences.

    A person with genital lesions may use warm compresses or sit in warm water several times a day for comfort. A drying agent such as povidone-iodine solution may be recommended to soothe the discomfort of lesions. Medications for pain or fever may be needed, particularly during the first outbreak.

    What are the side effects of the treatments?

    Medicines used to treat genital herpes can occasionally cause nausea, vomiting, and diarrhea. They can also cause headaches or a rash. More serious side effects, such as kidney or nerve damage, are quite rare at normal doses.

    What happens after treatment for the infection?

    Medications may reduce recurrences. They will not stop active blisters and shedding of viral particles. There is no cure for genital herpes. Lifelong treatment may be needed if symptoms are severe or bothersome.

    How is the infection monitored?

    Some people who are familiar with their disease are given medication to use at home when blisters return. Any new or worsening symptoms should be reported to the healthcare provider.

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