Sexual Health: Genital Herpes

Genital herpes is a highly contagious infection usually spread through intercourse with a person with infected sores, but it can be passed through oral or anal sex as well. It may also be spread even when sores are not visible.

Genital herpes can also be transmitted (spread) to a newborn during birth if the mother has an active infection.

What Causes Genital Herpes?
Usually, this infection is caused by the herpes simplex virus-2 (HSV-2) although herpes simplex virus-1 (HSV-1), the virus responsible for cold sores, may occasionally cause this disease. It can be spread by an infected partner who does not have any sores and may not even know they have the disease.

How Common Is Genital Herpes?
At least 45 million American adults and adolescents have genital herpes — that’s 1 out of every 4 to 5 people, making it one of the most common sexually transmitted diseases. Since the late 1970s, the number of Americans with genital herpes infection has increased 30%, mostly in teens and young adults.

Genital herpes is more common in women than in men.

How Do I Know If I Have Genital Herpes?
Most people infected with genital herpes have very minimal or no signs or symptoms of their disease. The first attack of herpes usually follows this course:

Skin on or near the sex organ becomes inflamed. Skin may burn, itch or be painful.
Blister-like sores appear on or near the sex organs.
Sores open, scab over, and then heal.
Symptoms that may also be present when the virus first appears include:

Swollen glands
Fever
Headache
Burning when passing urine
Muscle aches
The first outbreak of herpes can last for several weeks. After the outbreak, the virus retreats to the nervous system, where it remains inactive until something triggers it to become active again.

Typically, another outbreak can appear weeks or months after the first, but it almost always is less severe and shorter than the first episode. Although the infection can stay in the body indefinitely, the number of outbreaks tends to decrease over a period of years.

How Often Do Outbreaks Happen?
How often outbreaks occur depends on the person. On average, people with herpes experience about four outbreaks a year. The first outbreak usually is the most painful and takes the longest to heal. The pain and recovery time often decrease with each outbreak.

What Triggers an Outbreak?
It depends on the person. Some commonly reported triggers include:

Stress
Illness
Surgery
Vigorous sex
Diet
Monthly period
How Are Genital Herpes Diagnosed?
Your doctor can diagnose genital herpes by visual inspection if the outbreak is typical, and by taking a sample from the sore(s). But, HSV infections can be difficult to diagnose between outbreaks. Your doctor may check for ulcers internally — on the cervix in women and the urethra in men. Blood tests that detect HSV-1 or HSV-2 infection may be helpful, although the results are not always easy to interpret.

Genital Herpes: Stigma Still Strong

Stigma Ranks Second to HIV in Poll

By Miranda Hitti
WebMD Health News

Reviewed by Louise Chang, MD

Aug. 24, 2007 — Genital herpes is common but it still carries a big social stigma, an online poll shows.

The poll included 503 U.S. adults with genital herpes and about 1,400 other adults who said they didn’t have genital herpes.

Participants answered questions about their relationships and views of genital herpes.

They ranked genital herpes second for social stigma, out of all sexually transmitted diseases (HIV took the top spot for STD stigma).

The poll also included a list of other potentially taboo topics, including HIV, gonorrhea, mental illness, obesity, substance abuse, and cancer.

Most participants — 64% of those without genital herpes and 56% of those with genital herpes — said they didn’t think any of those topics were taboo. However, genital herpes was the top-ranked “taboo” topic.

Among genital herpes patients, 39% said they were troubled by societal stigma about genital herpes. Far more genital herpes patients — 75% — were troubled by bothersome symptoms of genital herpes outbreaks.

Most people without genital herpes said they would avoid having a relationship with someone who has genital herpes and break up with a partner who had genital herpes.

Among people with genital herpes, 36% said they tell their partners about their genital herpes “well in advance of having sexual intercourse for the first time,” and 68% said they were concerned about transmitting genital herpes to their sexual partners.

But that doesn’t mean it’s easy for patients to talk to their partners about their genital herpes.

For instance, of the 325 genital herpes patients who reported having genital herpes outbreaks, 38% said they’d made up an excuse to avoid having sex during a genital herpes outbreak, instead of telling their partner about their outbreak.

Harris Interactive conducted the poll between Dec. 14, 2006, and Jan. 12, 2007. The poll was commissioned by the drug company Novartis.

Half a Billion Have Genital Herpes Virus

World Health Organization Publishes First Global Estimates of Herpes Simplex Virus Type 2 Infection

Mother-to-Infant Herpes Transmission

Cesarean Section and Other Steps Can Reduce Risk
By Jennifer Warner
WebMD Health NewsReviewed by Ngozi A. Osondu, MDJan. 7, 2003 — Women infected with herpes can reduce the risk of passing the virus on to their children by having a cesarean section and taking other safety precautions during pregnancy and delivery, according to a new study. Researchers say it’s the first real proof that delivering a baby via cesarean section can protect an infant from infection with the herpes simplex virus (HSV), despite the fact that it’s been common practice for the last 30 years.

The results of the study appear in the Jan. 8 issue of The Journal of the American Medical Association.

Researchers looked at 202 women who had HSV at the time of labor and gave birth at several hospitals in Washington State between 1982 and 1999. Of the infected women, 85 delivered by cesarean section and 117 delivered vaginally. Ten infants were infected with the virus.

But the researchers found that several factors appeared to reduce the risk of the mother passing the infection along to her child, and cesarean delivery was one of the biggest factors in preventing transmission. Only one baby who was delivered by C-section acquired HSV, compared with nine babies who tested positive for the virus after a vaginal delivery.

Study author Zane A. Brown, MD, of the University of Washington, and colleagues say women who had genital lesions at the time of labor were also less likely to transmit the virus to their infant, perhaps because these women were much more likely to have a cesarean delivery.

In fact, none of the 74 women who had lesions infected their infants, compared with 10 of the 128 women who were shedding the virus without lesions and infected their child.

Factors that increased the risk of transmission of the virus to the infant included the presence of HSV in the mother’s cervix, the use of invasive monitoring devices during labor and delivery, and premature delivery (before 38 weeks). Mothers who were under the age of 21 or were experiencing their first episode of HSV infection were also more likely to pass the virus along to their child.

Symptoms of oral herpes include cold sores or fever blisters near the mouth, and genital herpes can cause lesions in the genital area.

The risk of acquiring either type of HSV can be reduced by using a latex condom during sex and avoiding sexual contact with visibly infected areas of the mouth and genitals. But a person infected with HSV-2, the form that generally causes genital herpes, may still be contagious even if they do not have visible symptoms.