Genital Herpes: What You Need to Know
Find out what genital herpes is, how it’s diagnosed, what its complications are, and how you can treat it.
A House Call Doctor podcast listener recently contacted me regarding her recent diagnosis of genital herpes. She told me how the diagnosis made her feel as though she could no longer go on dates or be sexually active since she feared she’d be rejected if she disclosed her health status.
Reading about how she was feeling truly made me so very sad. Because although a genital herpes diagnosis may not be the most welcoming news, there are truly much worse health conditions to have. So that’s why I have decided to devote this article to genital herpes.
How Common Is Genital Herpes?
Over fifty million people in the United States are affected by genital herpes. That’s how common it is. In my clinic I often see men and women of all ages who have a history of genital herpes. And I even have 70- and 80-year-olds coming in asking for antiviral medications…frequently. I tell you all this just to give you perspective on how widespread of an infection it truly is. Additionally, it’s not just an infection for those with multiple partners–all it takes is one time without a condom with a partner who is affected with it in order to contract it. That’s it.
What Is Genital Herpes?
Genital Herpes is transmitted from person to person via sexual intercourse. There are two types: Herpes Simplex Virus (HSV) type 1 and type 2. HSV type 2 is usually the culprit in those with genital herpes, not oral herpes. However, these days type 1 is being increasingly found to cause genital herpes as well, and vice versa.
What Are the Symptoms of Genital Herpes?
Patients with outbreaks of genital herpes report small (often less than one centimeter) inflamed spots in the genital area. These small ulcers are often tender or even painful to the touch.
The very first outbreak is often the worst. Patients may experience fever, overall malaise, headaches, and lymph node enlargement in the groin. However, there are some patients who have a very mild first outbreak with very minimal symptoms.
Once you’ve had that very first outbreak, your immune system produces special proteins called antibodies that help to fight off any future outbreaks. And therefore, recurrent outbreaks tend to be less severe and shorter in duration.
Some patients very rarely get a recurrent outbreak, whereas others may get them as frequently as once a month. Most patients do experience a recurrence at some point.
How Is Genital Herpes Diagnosed?
Genital herpes is really best diagnosed by a physical exam. Your doctor will be able to tell if you have it simply by looking at the affected area. No further testing is typically necessary.
Your doctor may also use a special swab to culture an active herpetic lesion. However, that test is only 50% accurate, so most doctors don’t run it. And even though a blood test is another possible diagnostic tool, these results can often be inaccurate. Many people may have had exposure to a herpes virus but never actually gotten genital herpes—so if the blood test came back positive in those cases, it would be misleading and often meaningless.
How is Genital Herpes Treated?
The reason I think there is so much hoopla over genital herpes is because there is no cure–there is no way to get rid of the virus in your body. It lays dormant and comes out in times of stress, and then it goes back into hiding once again.
However, there is treatment to decrease the duration and discomfort associated with the outbreaks. An anti-viral medication, such as acyclovir, can be prescribed by your doctor and taken several times a day for anywhere between five to ten days during an outbreak. It’s important to note that if the medication is not taken within the first two or three days of the outbreak, it’s not as effective.
[[AdMiddle]In those who get very frequent recurrences of the outbreaks, like once a month or more, one option is to take a daily anti-viral to help prevent outbreaks from occurring in the first place.
I should also mention that some of my patients report using over-the-counter lysine to keep their symptoms at bay. However, that is not FDA regulated, so I don’t know how effective it is, or what if any long term harmful affects it may have. But some of my patients tell me it works for them.
What Are the Potential Complications of Genital Herpes?
The good news is that genital herpes, although quite annoying during outbreaks, will not kill you or hurt your health. Serious complications of this virus are very rare. There have been reported cases of meningitis (infection of the fluid feeding your brain and spine), urinary bladder retention (difficulty voiding), and proctitis (inflammation of the rectum and/or anus). Most people with genital herpes lead normal healthy lives without any complications–other than the annoyance of dealing with these tender ulcers that come and go.
However, it is very important to get tested for other sexually transmitted infections (STI’s), such as HIV, syphilis, gonorrhea and chlamydia when diagnosed with genital herpes. Some studies have shown that those with genital herpes are more predisposed to contract HIV. Please make sure you get tested.
For women with a history of genital herpes who become pregnant, it’s really important to share this information with your obstetrician, because having an outbreak during your delivery time may indicate a need for a c-section, as active herpes can pose a risk to the fetus during delivery.
How to Prevent the Transmission of Genital Herpes
Besides abstinence, of course, the only way to prevent the transmission of genital herpes is by using a condom. I should mention that patients often shed the virus even when there are no ulcers or outbreaks present. That means that you can spread herpes to your partner even if you are symptom free. That’s why it’s also difficult to know if someone has genital herpes by just looking. They can carry and spread the virus without having anything to see.
Hormonal contraceptives do not provide protection against herpes and STI’s. And like I mentioned previously, all it takes is once. So please use a condom every single time to help prevent the transmission of genital herpes, whether you have been diagnosed with herpes or not.
The Bottom Line
Overall, no one should allow herpes to control their life. Yes, it’s true that it may be annoying and there’s no cure–and of course it’s important to prevent contracting or passing it on to someone else in the first place. But it is certainly not the worst STI to contract, and it is not the worst health condition to truly suffer from. And it’s quite common. Don’t let it control you; control it.
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Please note that all content here is strictly for informational purposes only. This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider. Please always seek a licensed physician in your area regarding all health related questions and issues.
Doctor with Condoms image courtesy of Shutterstock
About the Author
Dr. Sanaz Majd is a board-certified Family Medicine physician who graduated from Drexel University College of Medicine in Philadelphia. Her special interests are women’s health and patient education.
