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Facts About Genital Herpes

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One of the most commonly occurring sexually transmitted disease is Genital Herpes. Some of the frequently asked questions by people suffering from Genital Herpes are:

Genital herpes is one of the most common venereal diseases. However, an infection with herpes viruses usually does not lead to a disease at all: up to 90 out of 100 people who are infected get no or only very inconspicuous symptoms. Anyone who is infected with herpes viruses once carries them in their body for life.

When symptoms occur, they can be painful and also psychologically stressful. There are, however, treatments that can alleviate the symptoms and shorten an outbreak. Anyone who has had genital herpes once usually has to deal with it again and again. The good news is that the outbreaks become weaker and less frequent over time.

Nevertheless, the diagnosis of genital herpes is very uncomfortable for many people and raises many questions: Where did I get infected? How do I tell my partner – and who should I tell in the first place? Can I pass the infection on to my child if I am pregnant? These are some of the questions that can arise after the diagnosis of genital herpes.

What exactly is Genital Herpes?

Genital herpes are basically clusters of blisters that may appear anywhere in the genital area, buttocks or may even progress to the upper thighs. Most often these blisters are particularly painful and the pain may be combined with redness, numbness and uneasiness. Though, blisters usually appear only once, in some cases, they may reappear in varying frequencies at different sites of the same body area. At times, you may get so sore that you may have difficulty in passing urine.

How can one get Genital Herpes?

The ‘herpes simplex virus‘ is the virus responsible for causing genital herpes. Though, in most cases, these viruses remain dormant within the individual for life, in a few rare cases, they may reappear as cold sores. The usual means by which these viruses get transferred is from mouth to genital area, by hand transfer or during sexual activity. A commonly observed fact is that, in most cases, the person transferring the infection may not even be consciously aware of it.

How to diagnose the infection?

Most often, the skin blisters and ulcers are diagnosed by the doctors, but, in order to be sure about the diagnosis, there are some tests you may do. You can either take a swab from the ulcers and culture the virus in lab or you can take some of the blister fluid and test it under the electron microscope.

What are the possible risks associated with this?

Genital herpes is mostly associated with the development of red skin lesions, but, in more severe cases, it may also result into brain inflammation. Fortunately so, it also responds to the same anti-virus medicine. The one’s who are at maximum risk are the pregnant women and thus, they especially need to be conscious that precautions be taken to prevent the infection from being passed on to their babies.

What are the available treatments?

Although, there are no pre-infection medicines or vaccines available for preventing genital herpes, an effective preventive measure is to use condoms during sexual contact. Also, there are medicines available in the form of ointment or tablets, for treating the skin eruptions. Though, these medicines may not prevent the recurrence of the attacks completely, they definitely help to reduce the frequency of attacks, even after the medicine is stopped.

Symptoms

With genital herpes (also: genital herpes) the skin can become painfully inflamed and small blisters can form. They appear in small groups, can tear and weep. Crusts are often formed as they heal. The skin can also itch and burn, and women often have pain when they urinate.

In men, the penis, foreskin and scrotum are typically affected, while in women the labia, vagina and cervix are affected. However, vesicles can also occur in the anal region, on the bottom or on the inside of the thighs. Some people announce an outbreak by tingling in the genitals or pain in the bottom, hips or legs.

When genital herpes first appears, the symptoms are often particularly severe. In addition to the typical skin symptoms, fever, headaches, general exhaustion and muscle aches, often swollen lymph nodes in the groin can also occur. Further outbreaks are usually milder.

Anyone who already has another herpes pathogen in their body may already have built up a certain defence against herpes viruses. Then the symptoms of the first outbreak are often milder than in people who have not yet had any contact with herpes viruses. In contrast, the symptoms can be more severe and last longer when the immune system is weakened.

Causes

Genital herpes is caused by herpes simplex viruses. There are two different types:

Herpes simplex virus type 1 (HSV-1)
Herpes simplex virus type 2 (HSV-2)
The type 2 virus is mainly responsible for genital herpes, while the type 1 virus typically causes lip herpes. In principle, however, both virus types can cause both lip and genital herpes. Whether one gets genital or lip herpes depends not only on the type of virus, but also on where in the body the viruses are located.

Herpes viruses that have taken up residence in the nerve nodes (ganglia) at the lower end of the spine can cause genital herpes. If they multiply in the nerve nodes and migrate along the nerve cords to the outer layers of the skin, they can cause genital herpes.

Herpes viruses are transmitted through skin contact, especially during sexual intercourse, oral or anal sex. It can also be transmitted through shared sex toys. Without skin contact, herpes viruses do not survive for long. Therefore, it is very unlikely to get infected, for example, through towels, bed linen or toilet lids.

Risk factors

The risk of contracting the disease from a male sexual partner is significantly higher for women than for men from a female sexual partner. Experts assume that the virus is usually passed on by people who do not even know they are carrying it in their bodies.

People who have many changing sexual partners or already have a sexually transmitted disease such as HIV infection are more likely to contract genital herpes. Last but not least, the risk increases if you do not protect yourself with condoms.

Not all people who are infected with herpes viruses will develop the disease. Why some people get genital herpes and others do not is not known exactly.

Little research has been done on possible triggers for recurrent genital herpes outbreaks. There are indications that permanent psychological stress could promote outbreaks. Other possible triggers include sunlight, colds, physical exertion, rough or tight clothing, skin injuries and, in women, menstruation.

Frequency

Genital herpes is one of the most common venereal diseases. In Germany, it is estimated that 10 to 15 out of every 100 people carry HSV-2 in their bodies. About 10 to 30% of them contract genital herpes.

Women are affected slightly more often than men: they get infected more easily because their mucous membranes are more sensitive.

History

If there is an outbreak of genital herpes, the infection may already have occurred months or years ago. If genital herpes breaks out for the first time, it takes an average of 20 days for the inflammation to heal without treatment. However, subsequent outbreaks are milder and heal within ten days on average. Once you have fallen ill, you usually have to deal with genital herpes again and again.

How Often Genital Herpes Breaks Out Depends on the Type of Virus:

HSV-1 causes an average of 20 to 50% of those affected to have another outbreak within a year.
HSV-2 leads to at least one outbreak in 70 to 90% of those affected within a year, but on average four further outbreaks.
The frequency and severity of the outbreaks often decreases over time.

Consequences

Especially when genital herpes breaks out for the first time, complications can occur. Possible consequences are an infection of the vagina with yeast fungi, a bladder disorder with problems urinating or, rarely, inflammation of the meninges. Complications are very rare with further outbreaks.

People with genital herpes have a higher risk of getting infected with other sexually transmitted diseases like HIV.

Pregnant women can transmit herpes viruses to their babies during birth. But this happens very rarely. If there is an outbreak of genital herpes just before birth, a Caesarean section is often recommended to minimise the risk of infection for the child.

Very rarely, a herpes infection can lead to larger skin rashes on the body or affect the eyes.

Diagnosis

To detect genital herpes, the doctor takes a smear from one of the affected skin areas. This sample is then examined in the laboratory for herpes viruses. Depending on the situation, the virus type can also be determined.

It is often not possible to determine genital herpes with certainty just from skin symptoms and complaints. For one thing, the typical symptoms do not always appear. On the other hand, genital herpes can also occur together with other skin and sexually transmitted diseases. An infection with fungi or chlamydia and other skin diseases such as psoriasis can lead to similar symptoms.

It is more difficult to detect infection with herpes viruses in people without symptoms. In this case, a test for herpes antibodies can be used to see if there are antibodies in the blood. If HSV-2 antibodies are found there, genital herpes could develop. If HSV-1 antibodies are found, it is difficult to predict which part of the body will be affected if symptoms occur.

The tests usually cannot tell you how long you have been infected. However, if you have genital herpes for the first time, but no antibodies have been detected, it is very likely that you have been infected recently.

Prevention

Since many people carry herpes viruses in their bodies, anyone who is sexually active can become infected with these viruses. However, the risk of infection can be significantly reduced.

People with genital herpes are advised not to have sex as soon as there is an outbreak. This is because the risk of infecting someone is highest during an outbreak.

But even people who do not have symptoms can pass on the virus. During the symptom-free period, condoms can significantly reduce the risk of infection. They also protect against other sexually transmitted diseases.

If you have genital herpes, it makes sense to talk about it with your partner. If both partners take a blood test for antibodies, it is possible to assess who carries which types of virus in the body – and whether there is a risk of infection. For example, a partner with HSV-1 can still be infected with HSV-2.

People who have genital herpes and take virus-inhibiting (antiviral) drugs are slightly less infectious. This can be done with drugs called acyclovir, famciclovir or valaciclovir. However, these drugs have to be taken daily and over a longer period of time. It is not clear whether the drugs will reduce the risk of infection if you use condoms anyway.

How Can Infection be Avoided in The Partnership?

A first outbreak of genital herpes can lead to severe symptoms and sometimes to complications. For this reason, it is common to take virus-inhibiting drugs with the active ingredients Aciclovir, Famciclovir or Valaciclovir during an initial outbreak. These tablets can reduce the symptoms and shorten the duration of the illness by a few days. Creams or ointments with virus-inhibiting active ingredients do not help with genital herpes.

If there are further outbreaks, the symptoms are usually less severe. Treatment is then not absolutely necessary. If you treat a subsequent outbreak, it is sufficient to take the drugs for a shorter period of time. It is important to start treatment within the first 24 hours – preferably as soon as the first symptoms appear. This is easier if you always have pills with you at home or when travelling.

If you have severe or very frequent outbreaks, preventive treatment with medication can also be considered. The drugs are then taken over a longer period of time – i.e. also in phases without symptoms. This can significantly reduce the risk of outbreaks.

If genital herpes causes more pain, painkillers can help. Many women who have pain when they urinate also find sitz baths pleasant.

Other treatments, such as laser or localized heat application, have not been researched. So it is not clear whether they can help.

How Can Genital Herpes Be Treated?

Knowing that you have genital herpes can be very stressful psychologically. Many people find it difficult to talk about the disease with their partner. Some are afraid of being seen as unfaithful or rejected. Others wonder whether their partner might have infected them.

Talking openly about the disease can help – because often it is not possible to know for sure when and with whom someone has been infected. After all, many people carry herpes viruses in their bodies and anyone who is sexually active can get infected. The virus can also have been in the body for months or years when genital herpes develops.

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