Genital Herpes: Symptoms, Cause, Complication, Diagnosis, Management, Prevention and How to Cope with Herpes

Genital herpes is a common STD (Sexually Transmitted Disease) that can occur to men and women and caused by HSV (herpes simplex virus). It commonly manifests as sore, pain and itching in genital area. However, one may have no symptom at all and once infected with genital herpes, he/she may be contagious anytime after infection, even if there are no visible sore or other symptoms. After infection, the virus may remain dormant and may lead to flare-up (appearance of symptoms) several times a year. Unfortunately, there is no cure for herpes simplex virus infection (genital herpes). However, medications are available for reducing severity of symptoms and for reducing risk of transmission. Use of barrier method during sexual intercourse is the only effective way to prevent genital herpes.

What are the symptoms of genital herpes?

In many patients, genital herpes may have no symptoms and the infected person may not be aware of the infection. Symptoms include,

  • Sore, pain or itching: this usually appear within 10 days (2 days to 10 days) of infection from a sexual partner. Common locations of itching, pain or sore include, penis, urethra, scrotums, and thigh in men; cervix, vaginal area and external genital area in women; anus, mouth and buttocks in men as well as women.
  • In the areas mentioned above, there may appear small white blisters or small red bumps. The blisters may bursts and ulcer formation occurs. There may be watery discharge or bloody discharge from ulcer. Scab formation in ulcer when it heals.
  • Recurrence of signs and symptoms is common after they disappear on its own or after treatment. Recurrence may occur several times a year and accompanied by pain in lower back, buttocks or legs. Consult your doctor if you suspect you may have genital herpes.

What is the cause of genital herpes?

Genital herpes is caused by two types of HSV (herpes simplex virus), HSV-1 and HSV-2. HSV-2 is responsible for genital herpes and can spread by sexual contact and also by skin to skin contact and it is highly contagious, can spread even if you have no abrasions in skin. Recurrences are common with HSV-2.

HSV-1 is responsible for fever blisters, cold sores around mouth and can spread to genital areas during oral sex. Recurrence is less frequent.

Herpes simplex virus cannot survive outside in the environment and cannot be spread by using same toilet or towel and utensils.

Who are at risk of genital herpes?

Women generally have higher risk of getting genital herpes, because the virus (HSV) is more easily transmitted from men to women in compare to, from women to men. If you have multiple sex partners you are at higher risk of genital herpes.

What are possible complications associated with genital herpes?

Possible complications of genital herpes include,

  • Other STDs (sexually transmitted diseases): presence of genital sores increase risk of transmission of other STDs such as HIV infection.
  • Proctitis (inflammation of rectum) can be seen among male homosexuals suffering from genital herpes.
  • Meningitis: rarely genital herpes can lead to meningitis.
  • Babies born to infected mothers may develop the disease/infection and may lead to blindness, brain damage and even death of newborn.
  • Bladder problem may arise in persons infected with genital herpes.

What tests are done to diagnose genital herpes?

Following tests help in diagnosis and confirmation of genital herpes:

  • PCR (plymerase chain reaction): this test can confirm diagnosis of genital herpes and presence of HSV.
  • Viral culture: this can be done from collection of samples from genital sore or other spots and cultured for virus.
  • Blood test to detect antibodies against HSV.

Treatment/management of genital herpes:

There is no cure for genital herpes, because there are curative anti-viral drugs available at present for any viral disease. However, some antiviral drugs are useful in management of genital herpes and reduce risk of transmission, such as acyclovir (brand name Zovirax), valacyclovir (brand name Valtrax), famciclovir (brand name Famvir) etc. These can be useful when taken during flare-up of genital herpes. These antiviral drugs can reduce frequency of recurrence/flare-ups, reduce duration of symptoms, faster healing of sores, and reduce risk of transmission.

Medications may also be required to treat the pain associated with genital herpes. For pain of genital herpes, commonly used pain medications (such as NSAIDs) are not much useful and may require drugs for neuropathic pain such as gabapentin, pregabalin etc.

Prevention of genital herpes:

Prevention of genital herpes is same as for other STDs. Use of condom during sexual intercourse and have sexual intercourse with your partner only to prevent genital herpes and other STDs. Avoid intercourse during flare-up or recurrence of genital herpes.

Genital herpes during pregnancy:

If you have genital herpes during pregnancy it is important you inform this to your doctor and get tests done to confirm it. If you have outbreak/recurrence/flare-up around the time of delivery the risk of infection of your baby is very high. The only safe way is to have caesarean delivery of your baby to prevent genital herpes infection of your baby.

How to cope with genital herpes?

If you find that you are suffering from genital herpes, you may be ashamed, embarrassed, or angry and coping with the problem may be difficult. You may blame your partner for transmitting the disease to you. Your partner may also reject you. However, blame game is not the solution to your problem.

You have to learn more about the disease and learn how to deal with genital herpes. You need to learn how to reduce risk of transmitting the disease to others. You also need to know how to manage flare-ups and recurrences.

Talk to your partner and discuss the problem openly and do not hide anything. Do not blame your partner, because genital herpes can remain dormant for many years and it is very difficult to find out when infection occurred. Also you can join a support group in your locality or join internet forum and share your experience and learn from other how they are coping with the problem.

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