HERPES, GENITAL

General Information

DEFINITION--A virus infection of the genitals transmitted by sexual relations (intercourse or oral sex).

BODY PARTS INVOLVED--Penis; vagina; cervix; thighs; buttocks (sometimes).

SEX OR AGE MOST AFFECTED--Both sexes and all ages of sexually active persons.

SIGNS & SYMPTOMS

• Painful blisters, preceded by itching and irritation, on the vaginal lips or penis. In women, the blisters may extend into the vagina to the cervix and urethra. After a few days, the blisters rupture and leave painful, shallow ulcers which last 1 to 3 weeks.
• Difficult, painful urination.
• Enlarged lymph glands (sometimes).
• Fever and a general ill feeling (sometimes).

CAUSES

• Herpes type 2 virus (HSV-2). Genital herpes is typically caused by Herpes type 2 virus (HSV-2). Oral herpes is typically caused by Herpes type 1 virus (HSV-1). However, both types can be contracted in either location, and both will look, feel, and act the same.

  Genital herpes is often spread while a partner has an active herpes lesion. Lesions may be on the genitals, hands, lips or mouth. Herpes can also be spread during the beginning phase of an outbreak, when there's a tingling or itching feeling below the skin, or when the virus sheds itself on the skin, and there are no symptoms of the disease at all.

RISK INCREASES WITH

• Serious illness that has lowered resistance.
• Use of immunosuppressive or anticancer drugs.
• Stress may lead to diminished efficiency of the immune responses that usually suppress growth of the virus.
• Other "triggers" that can cause a recurrence include genital trauma, menstruation, sunbathing and infection of some other type.

HOW TO PREVENT

• Avoid sexual intercourse if either partner has blisters or sores.
• Use a latex condom during intercourse if either sex partner has inactive genital herpes.
• Avoid oral sex with a partner who has cold sores on the mouth.
• If you are pregnant, tell your doctor if you have had herpes or any genital lesions in the past. Precautions should be taken to prevent infection of the baby.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and exam by a doctor.
• Laboratory study of fluid from the lesion (sometimes).

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.

POSSIBLE COMPLICATIONS

• Generalized disease and death in persons who must take anticancer drugs or immunosuppressive drugs.
• Transmittal of life-threatening systemic herpes to a newborn infant from an infected mother.
• Secondary bacterial infection.
• Genital herpes may increase the risk of cervical cancer.

PROBABLE OUTCOME--Genital herpes is currently considered incurable, but symptoms can be relieved with treatment. During symptom-free periods, the virus returns to its dormant state. Symptoms recur when the virus is reactivated. Recurrent symptoms are not new infections. The discomfort varies from person to person and from time to time in the same person. The first herpes infection is often much more uncomfortable than following ones.

How To Treat

GENERAL MEASURES--

• Women should wear cotton underpants or pantyhose with a cotton crotch.
• To reduce pain during urination, women may urinate in a shower or through a tubular device, such as a toilet-paper roll or plastic cup with the end cut out or pour a cup of warm water over genitals while urinating.
• Warm baths with a tablespoon of salt added can ease discomfort.
• Women should have an annual Pap smear and physical examination to rule out any complications.

MEDICATION--

• Your doctor may prescribe acyclovir (an antiviral medication) in oral form for treatment of initial episodes and management of recurrent genital herpes. For some patients, it may be prescribed for prevention purposes. A topical form of acyclovir is available but is not as effective.
• You may use mild painkillers, such as acetaminophen.

ACTIVITY--

• Avoid intercourse until symptoms disappear.
• Appropriate rest if symptoms are present.

DIET--No special diet.

Call Your Doctor If

• Symptoms don't improve in 1 week, despite treatment.
• Unusual vaginal bleeding or swelling occurs.
• Fever returns during treatment or you become generally ill.