Everything You Need To Know About Genital Herpes

Symptoms, Diagnosis, Treatments, and Prevention

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Genital herpes is a common sexually transmitted infection (STI) marked by genital pain and sores. Affecting more than 3 million people in the United States every year, once a person is infected, they have it for life. While it remains dormant for much of the time, those with genital herpes experience periodic episodes of active herpes.

What Are the Symptoms of Genital Herpes?

The symptoms of genital herpes can vary widely from person to person.

They usually appear within two to 10 days of transmission, and last an average of two to three weeks. Some of the earliest symptoms can include:

  • an itching or burning sensation
  • pain in the legs, buttocks, or genital area
  • vaginal discharge
  • a feeling of pressure or fullness in the abdominal area

A few days following the initial symptoms, sores or lesions will erupt at the site of the infection. These sores can occur inside the vagina or on the cervix in women, as well as in the urinary passage in both men and women. Genital herpes lesions may first appear as small red bumps that develop into blisters, which eventually become painful, open sores. After several days, these sores become crusted and then heal without scarring.

The first episode of genital herpes can also include symptoms such as:

  • fever
  • headache
  • muscle aches
  • urinary pain or difficulty
  • swollen glands in the groin area.

After genital herpes invades the skin or mucous membranes, the virus travels to the sensory nerves at the end of the spinal cord, where it remains inside the nerve cells in an inactive state.

Most people experience a monthly recurrence of symptoms. During a recurrent episode of genital herpes the virus travels along the nerves to the skin where it multiplies at or near the site of the original herpes lesions, causing new sores to appear.

Genital herpes can reactivate without any visible sores or lesions being present.

During these periods of active virus, small amounts of the virus can shed at or near the site of the original lesions from genital secretions or from indiscernible lesions. Shedding occurs without any accompanying discomfort and may only last a day or two, but it is possible to infect a sexual partner during this time.

How Is Genital Herpes Diagnosed?

Although sores may be visible to the eye, several laboratory tests may be necessary to determine whether the sores are caused by the herpes simplex virus (HSV) or another infection. The most reliable method of diagnosing genital herpes is by viral culture, during which a new lesion is swabbed or scraped, with the sample added to a laboratory culture that contains healthy cells.

These cells are then examined a day or two later under a microscope.

Other methods of diagnosing herpes are available to clinicians. However, it's important to understand that the herpes virus is extremely hard to find, and if a clinician fails to detect the virus in an active sore, it does not mean that a person does not have genital herpes. Sometimes, clinicians even misdiagnose sores as something else, such as ingrown hairs.

New blood tests are currently being developed.

What Are the Treatments for Genital Herpes?

Your doctor may prescribe a medication to shorten the length of the first episode, and reduce the severity and frequency of recurrent episodes. The infection cannot be fully eradicated, however.

Patients can also help speed healing and avoid spreading the infection by following a few simple steps during periods of active herpes:

  • Keep the infected area clean and dry.
  • Don't touch the sores; if you do, wash your hands immediately.
  • Refrain from sex from the time you first notice symptoms until sores/lesions are completely healed and covered by new skin.

Recurrent episodes of herpes can be triggered by minor trauma, other infections such as colds, menstruation, and stress.

In most cases, genital herpes does not cause long-term health consequences. However, those with weakened immune systems can experience long-lasting and severe episodes of herpes. And the open sores associated with herpes leave people at a higher risk of contracting HIV and AIDS.

Pregnant women in particular should be closely monitored for active episodes. If the first episode of herpes occurs during pregnancy, she can pass the virus to her unborn baby, and may also be at a higher risk of premature delivery.

Approximately 50 percent of babies born with neonatal herpes die or suffer neurological damage. Babies can develop encephalitis, severe rashes, and eye problems; however, immediate treatment with medication greatly improves the outcome for many babies.

The risk to babies depends greatly upon whether the mother is experiencing a first episode or a recurrent episode of genital herpes. Because it takes days or even weeks to get results from viral cultures that determine whether the active herpes virus is present, many physicians will perform a cesarean section on pregnant women diagnosed with genital herpes. However, if no active herpes is present at the time of birth, there is little or no risk to the baby with a vaginal delivery. If you are pregnant and have herpes, you should talk with your physician to determine the best delivery method for you.

How Can You Protect Yourself and Your Partner from HSV?

You can avoid transmitting herpes to your partner by not having sex during periods when you notice symptoms. You should also wait for any sores to completely heal and cover with new skin. Condoms offer some protection during the times when you are not experiencing symptoms, although it is possible that not all affected areas are covered by a condom.

If you suspect you may have herpes, discuss your symptoms with your healthcare provider.


US Herpes Cases on the Decline, National Health Information Center, http://www.healthfinder.gov/news/newsstory.asp?docid=534518, Accessed 4/30/07; STD Facts - Genital Herpes, CDC, http://www.cdc.gov/std/Herpes/STDFact-Herpes.htm, Accessed 4/30/07

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