What is genital herpes?
Genital herpes is a sexually transmitted disease, or STD. (This means it spreads from person to person during vaginal, anal, or oral sexual contact). It is caused by a virus. Genital herpes is one of the most common STDs in Canada.
Once a person gets genital herpes, it stays in the body for life. In some people, symptoms come and go. When symptoms appear, it is called a "herpes outbreak".
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What causes genital herpes?
Genital herpes is spread by having vaginal, anal, or oral sex with a person who has the herpes simplex virus, or HSV. There are 2 types of HSV:
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Type 2, known as HSV-2. It is the main cause of genital herpes. |
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Type 1, known as HSV-1. It is the main cause of oral herpes lesions, often called fever blisters or cold sores. HSV-1 is a less frequent cause of genital herpes, but it is becoming more common. |
Most cases of genital herpes are caused by HSV-2, which is transmitted primarily during vaginal or anal sex. In recent years, however, HSV-1 has been causing more and more genital herpes cases. Genital HSV-1 is spread mainly through oral sex with a partner who has a sore on the mouth or lips, but some cases may result from vaginal or anal sex. HSV-1 is much less likely to cause repeat outbreaks of genital herpes than HSV-2. Almost all people who have recurrent genital herpes are infected with HSV-2.
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Who is more likely to get genital herpes?
Anyone who has vaginal, oral, or anal sex with an infected partner can get genital herpes, but women get it more often than men do.
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What are the signs and symptoms of the first outbreak of genital herpes?
Some people experience very mild symptoms or no symptoms at all, so they don't even know they are infected. However, for many people the first herpes outbreak is often the worst, and symptoms can be quite painful.
The main signs of genital herpes are sores around the vagina, on the penis, or near the anus. Sometimes sores appear on the scrotum, buttocks, or thighs. The sores may appear about 4 to 7 days after infection. They usually begin as a rash of red bumps. The bumps then turn into blisters. It is common for the blisters to open up, sometimes causing severe pain. In time, the sores will scab over and heal. The first outbreak of genital herpes usually lasts 10 to 20 days until healing is complete.
During the first outbreak, many people have other symptoms:
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Swollen glands in the groin |
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Discharge from the vagina or penis |
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Painful or difficult urination |
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Fever |
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Headache |
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Muscle ache |
More women than men report severe symptoms, especially during the first genital herpes outbreak.
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What are the signs and symptoms of repeated genital herpes outbreaks?
The signs of repeated outbreaks of genital herpes are similar to the signs of the first outbreak, but they may not be as severe. Some people may have no symptoms, but they can still spread the virus.
Repeated outbreaks are usually shorter than the first outbreak, typically 7 to 10 days from onset to healing. Some people with recurrent outbreaks have warning signs, called a prodrome. These signs can appear a few hours or up to a day before an outbreak. The most common prodrome is tingling in the area where the rash will appear.
After the prodromal signs pass, sores may develop. Sores generally develop in stages:
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Small red areas appear and may be sensitive, itchy, or painful. |
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These areas may swell slightly |
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Next, small blisters filled with fluid form in the same area as the rash. |
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The blisters can open up and form open sores, which may be quite painful. |
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As the sores start to heal, they crust over. New skin grows beneath the scab. |
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When the crust falls off, the sore is healed. |
During repeated outbreaks with symptoms, the sores usually appear on the same side of the body each time.
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How is genital herpes diagnosed?
If you think you have genital herpes, it is very important to see your healthcare provider for a diagnosis. Knowing that you have the virus is the first step to managing the condition and getting treatment.
Because some people with genital herpes do not have symptoms, your healthcare provider may have to do lab tests to check for HSV. Even the best herpes experts often cannot be certain of the diagnosis just by looking at the rash. A blood test will also tell if an infection is due to HSV-1 or HSV-2. If you have sores or blisters, your provider may also take a swab of the sore, which can then be tested for HSV.
The diagnosis isn't always easy because symptoms vary from person to person. Also, symptoms come and go, and might not be there when you visit your healthcare provider. To help with diagnosis, try to answer your provider's questions about your symptoms and your sexual history as openly as you can. Your provider is there to help you, not to judge you.
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What are the treatment choices for genital herpes?
There is no cure for herpes, but 3 prescription drugs (called antivirals) are available that can speed healing for some patients in the event of an outbreak. They can also be taken on a regular basis to help prevent recurrent outbreaks. Talk with your healthcare provider about which treatment approach may be right for you. Together you can decide based on your symptoms and whether this is your first outbreak or a recurrent outbreak.
The 3 antiviral medications available for treating genital herpes are acyclovir, famciclovir, and valacyclovir. These medications can help to lessen your symptoms and how long they last. For many patients they can also help reduce the number of outbreaks you have.
They can be taken in 2 ways:
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As each outbreak occurs. This is called episodic treatment |
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Continuous daily treatment to help prevent outbreaks. This is called suppressive treatment. |
Your healthcare provider will prescribe the treatment that is right for you based on your symptoms and oth er relevant information.
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What else can I do when I have an outbreak besides taking medicine?
During an outbreak when you have sores or blisters, these steps may help provide comfort.
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Keep the affected areas clean and dry. |
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Loose-fitting clothing may help |
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If you have especially painful sores, you may want to dry yourself after a bath or shower with a hair dryer (on low power) instead of a towel. |
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Try not to touch the sores or break open the blisters. |
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If you do touch the sores, wash your hands afterward. It is especially important to avoid touching your face and eyes after you touch your sores. |
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Do not use feminine sprays, feminine deodorants, or douches during a herpes outbreak. |
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Don't use any creams or ointments on sores unless prescribed by your healthcare provider. |
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Soothe the affected areas with a cool cloth. |
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Soak in a warm bath. |
Ask your healthcare provider which of these steps may be helpful for you.
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How can I help make sure I don't spread genital herpes to others?
Talking openly about genital herpes can be difficult. However, there is no need for you to feel embarrassed or ashamed about having genital herpes. In the long run, it is best to be honest with your partner. Telling your partner that you have genital herpes is an important step in protecting him or her from getting the infection.
Genital herpes can still be spread to a sex partner even when you have no symptoms. Most new cases of genital herpes are caught from someone who has an active herpes infection with no symptoms. So, if you've ever had genital herpes, it is important to always practice safer sex.
This means you should not have vaginal, oral, or anal sex with uninfected partners when you have active symptoms, such as sores. You should wait until they are completely healed. Between outbreaks, use a condom during sex. Neither of these methods is perfect, but they will help prevent the spread of herpes.
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If I think I have genital herpes, do I have to treat it?
If you think you have herpes, it's important to see your healthcare provider. Some of the risks of herpes are:
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It causes repeated outbreaks that may be painful. |
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It can be spread to sex partners. |
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A pregnant woman can pass it to her unborn baby during vaginal delivery. This is called neonatal herpes and can be serious or even fatal to the infant. |
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Fear of outbreaks or of spreading the disease to a partner or your baby can cause stress, anxiety, or depression. |
The symptoms of herpes can be treated, but it can't be cured. In most healthy people, herpes doesn't usually cause other health problems. Yet, many people choose to treat their herpes to help make outbreaks shorter and less severe. This can help many feel more comfortable.
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What questions might I ask my healthcare provider about treating genital herpes?
Preparing a list of questions before your visit with your healthcare provider can help you get the most out of your time together. You may want to include the following questions on your list:
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Is medicine appropriate for me? |
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What can I expect this medicine to do? |
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Will the medicine relieve my herpes symptoms? |
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Will it prevent future outbreaks? |
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What side effects can I expect from my medicine? |
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How will I know it's really working? |
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What could happen if I stop taking it? |
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Should my partners be treated? |
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Should I continue the medicine if I become pregnant? |
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