Information About Genital Herpes

Genital Herpes Symptoms and Treatments

Herpes simplex type 2 virus, illustration
Illustration of Herpes simplex type 2. Mehau Kulyk/Science Photo Library

People need good information about genital herpes whether they have it or not. Depending on where you look or who you listen to, misinformation about genital herpes abounds. This page is a good starting point to learn what you need to know.

Genital Herpes Facts

It's estimated that 500,000 to 1,000,000 people in the United States get their first genital herpes infection every year. Some studies show that the total number of people in the United States with genital herpes is 40 to 60 million.

Genital herpes is caused by infection with the herpes simplex virus (HSV), the most common sexually transmitted infection in the world. There are two types of herpes simplex viruses:

  • Herpes simplex virus type 1 (HSV-1)
  • Herpes simplex virus type 2 (HSV-2)

HSV and Genital Herpes

HSV-2 is still the main cause of genital herpes infections. It is spread by direct contact with infected secretions, primarily through sexual contact with someone who is shedding the virus, whether they have a rash or not. Someone who has antibodies to HSV-2 has been infected by the virus. The number of people with antibodies to HSV-2 has increased by over 30% in the past 20 years, although the rate of people getting new infections is slowing down.

Even though most genital herpes infections (70 to 90%) are caused by HSV-2, a smaller percentage (10 to 30%) are caused by HSV-1, although such infections are on the rise.

Genital Herpes Infection

If someone with a normal immune system doesn't have antibodies to HSV-2, he or she hasn't been infected.

If that person is exposed to HSV-2 and gets infected, this is called a primary infection. After a primary infection, the virus doesn't leave the body. It's transported back through nerves to nerve roots where it waits in an inactive (latent) form. Certain triggers can reactivate the virus, which then travels back down the nerve to the skin causing a recurrent infection.

For more in-depth information about herpes infections, check out:

Symptoms

Because herpes is such a significant disease, you would think that anyone who gets infected with the virus would know it because they would get symptoms of an infection. In fact, the opposite is true. Less than one-fourth of people who have antibodies to HSV-2, meaning the virus has infected the body, are aware they have been infected.

With a primary infection, if symptoms are going to develop, they usually happen 3 to 7 days after the exposure. The symptoms of a primary infection can last up to 3 weeks and are worse than symptoms of a recurrent infection. Often the symptoms can be confused with other medical problems, especially in women. You can read more about herpes symptoms here:

How Genital Herpes is Diagnosed

It is important that any diagnosis of genital herpes is confirmed by laboratory tests.

There are times when a breakout in the genital area looks typical, but there are other infections and diseases that can cause similar rashes. The best way for the doctor to test for HSV is to take a sample of fluid inside one of the blisters, and the best time to do this is in the first couple of days after an initial infection. The sample is taken with a cotton swab and sent to the laboratory for one of three different types of tests:

Genital Herpes Treatment

An HSV-2 infection can be treated with medications that inactivate the virus and reduce symptoms. You should talk to your doctor when deciding on a treatment for HSV-2 because there are several factors to consider, such as whether this is an initial infection or a recurrent infection. Other important considerations are how treatment would impact your current or future sexual partner(s), and how frequently you get recurrent outbreaks (if you get them at all). For a more in-depth discussion about treatment considerations and medication options, take a look at:

Final Thoughts on Genital Herpes

Most people are embarrassed talking about previous or current herpes infections, often associating herpes with certain stereotypes. In my family practice, I see a wide range of people who have herpes, supporting the fact that herpes knows no social or economic boundaries. If you have any questions about herpes or even think you might have it, talk to your doctor right away. It's better to know whether you have a problem so you can start to do something about it than to worry about possibilities and suffer when you don't have to.

Sources:

Aral, Sevgi, et. al. "Sexually Transmitted Diseases in the USA: Temporal Trends." Sexually Transmitted Infection Journal. 83(2007): 257-66.

Gupta, R et al. “Genital herpes.” Lancet. 370(2007): 2127-37.

Habif, Thomas. "Sexually Transmitted Viral Infections." Clinical Dermatology, 4th Edition. Ed. Thomas Habif, MD. New York: Mosby, 2004. 63.

Madkan, Vandana, et al. "Human Herpesviruses." Dermatology. 2nd. Ed. Jean Bolognia. New York: Mosby, 2008: 1199-1218.

Xu, F et al. “Trends in herpes simplex virus type 1 and type 2 seroprevalence in the United States.” Journal of the American Medical Association. 296(2006): 964-73.

Yeung-Yue, Kimberly. "Herpes simplex viruses 1 and 2." Dermatologic Clinics 20(2002): 1-21.

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