The symptoms of genital herpes in women are essentially the same as in men. Because genital herpes affects the private parts, people often wrongly assume that the virus looks different in men and women.
Infection with the herpes simplex virus, commonly known as herpes, can be due to either herpes simplex virus type 1 (HSV-1) or herpes simplex virus type 2 (HSV-2). HSV-1 is mainly transmitted by oral to oral contact to cause infection in or around the mouth (oral herpes). HSV-2 is almost exclusively sexually transmitted, causing infection in the genital or anal area (genital herpes). However, HSV-1 can also be transmitted to the genital area through contact to cause genital herpes.
Treatment. At the present time there is no cure for genital herpes. (A vaccine to prevent the development of herpes is under active development.) Antivirals such as acyclovir and valacyclovir help shorten episodes during the initial phase of infection, but do not cure it. Palliative treatment consists of measures to keep lesions clean and dry, to control pain with an analgesic, to promote healing with frequent sitz baths, and to prevent secondary bacterial infections.
In 17 countries in North America, Latin America and Europe, researchers gave questionnaires to individuals visiting clinics who were infected with herpes simplex virus type 2, reported having had symptoms and had partners who had never had symptomatic genital herpes.
Patients with genital herpes have reported that outbreaks or episodes typically diminish through the years. Early prodromal symptoms, or warning signals, that are followed by outbreaks. These prodromal symptoms often include mild tingling or shooting pains in the legs, hips and buttocks, and can last from 2 hours to 2 days. After the prodromal symptoms occur the blisters develop into painful red spots, which then evolve into yellowish, clear fluid-filled blisters after a day or two. These blisters burst or break and leave ulcers that usually heal in about 10 days. In women, blisters can develop inside the vagina and cause painful urination.
Worldwide rates of either HSV-1 or HSV-2 are between 60% and 95% in adults. HSV-1 is usually acquired during childhood. Rates of both increase as people age. Rates of HSV-1 are between 70% and 80% in populations of low socioeconomic status and 40% to 60% in populations of improved socioeconomic status. An estimated 536 million people worldwide (16% of the population) were infected with HSV-2 as of 2003 with greater rates among women and those in the developing world. Most people with HSV-2 do not realize that they are infected. The name is from Greek: ἕρπης herpēs which means “creeping” or “latent”.
^ Jump up to: a b GBD 2015 Disease and Injury Incidence and Prevalence, Collaborators. (8 October 2016). “Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015”. Lancet. 388 (10053): 1545–1602. doi:10.1016/S0140-6736(16)31678-6. PMC 5055577 . PMID 27733282.
Another possible place for treatment with acyclovir is following unintended exposure to herpes. While this has not yet been proven to be of benefit, it could be considered in certain situations, in the same way that anti-retroviral drugs are being used in instances of HIV exposure such as rape.
Jump up ^ Sidwell RW, Huffman JH, Khare GP, Allen LB, Witkowski JT, Robins RK (August 1972). “Broad-spectrum antiviral activity of Virazole: 1-beta-D-ribofuranosyl-1,2,4-triazole-3-carboxamide”. Science. 177 (4050): 705–06. Bibcode:1972Sci…177..705S. doi:10.1126/science.177.4050.705. PMID 4340949.
A persistent, recurring eruption of the genital or anorectal skin or mucous membranes, caused by herpes simplex virus (usually herpes simplex virus type II). It usually affects adolescents and young adults, is spread by intimate contact, and is classified as a sexually transmitted disease. Worldwide about 85 to 90 million people are infected. See: illustration
It started with what looked and felt like a burning spider bite, “in a spot that was too awkward even for mirror self-examination”, says Pumi, a 31-year-old personal assistant living in Sandton. It turned out to be genital herpes, one of South Africa’s most common sexually transmitted diseases.
A genital rash and mild itching usually are the earliest signs of infection. Eventually vesicles on the surface of the skin form, and then enlarge, break open, and ulcerate. The lesions are painful, especially during coitus, and can cause intense itching, and, if the urethra is involved, painful urination. The disease affects both sexes. In the male, vesicles are found principally on the glans penis, shaft of the penis, and prepuce, and may extend to the scrotum and inner thighs. In the female, vesicular eruptions usually involve the vulva, vagina, and cervix, and may extend to the perineum, inner thighs, and buttocks. Lesions of the cervix can vary from small superficial ulcers with diffuse inflammation to a single, large, necrotic ulcer. Other symptoms include malaise, fever, and anorexia. There also can be involvement of neural structures and the manifestation of neurologic symptoms. The characteristic lesions usually last from one to three weeks in either the initial stage or during periodic outbreaks.
Jump up ^ Foley, James A. (21 Oct 2013). “Hitchhiking Herpes Virus Aligns with Spread of Human Civilization”. NatureWorldNews.com. Archived from the original on 22 October 2013. Retrieved 22 October 2013.
Robert Belshe, director of the Saint Louis University Center for Vaccine Development, said the vaccine was partially effective at preventing herpes simplex virus type 1, but did not protect women from herpes simplex virus type 2.
The first (primary) outbreak of herpes simplex is often the worst. Not all first outbreaks are severe, though. Some are so mild that a person does not notice. When the first outbreak of genital herpes is mild and another outbreak happens years later, the person can mistake it for a first outbreak.
Herpes simplex 1 can cause eye infections. This can happen if you are infected by another person or if you have a cold sore and rub the virus into your eye. During a herpes episode, take care not to touch your sores and always wash your hands after you have touched a sore.
Herpes simplex viruses spread from person to person through close contact. You can get a herpes simplex virus from touching a herpes sore. Most people, however, get herpes simplex from an infected person who does not have sores. Doctors call this “asymptomatic viral shedding.”
Your doctor will do a physical exam and look at the sores. He or she can do a culture of the fluid from a sore and test it for herpes. Blood tests or other tests on the fluid from a blister can also be done.
Famciclovir is another antiviral drug that belongs to the same class. Famciclovir is a prodrug that is converted to penciclovir in the body. The latter is the one active against the viruses. It has a longer duration of action than acyclovir and it only comes in tablets.
The incubation period for HSV-2 infection is usually four to five days but may be as short as 24 hours or as long as two weeks. The first symptoms may be pain or itching at the site of infection. This is followed within a day or two by the appearance of blisterlike lesions that may occur singly or in groups. In males the common sites of infection include the foreskin, the glans, and the shaft of the penis. In females the blister may occur on the labia, the clitoris, the opening of the vagina, or, occasionally, the uterine cervix. Within a few days the blisters rupture and merge to form large areas of denuded tissue surrounded by swollen, inflamed skin. At this stage the lesions may become acutely painful with intense burning and irritation. In females especially, urination may cause great discomfort. Generalized symptoms such as fever and malaise may develop, and lymph nodes in the groin may enlarge. Lesions may persist in this stage for a week or more, and complete healing may take four to six weeks. Genital herpes is generally more severe in females and may become so uncomfortable and disabling as to require hospitalization. Recurrences are not uncommon and may be associated with emotional stress, trauma, sexual intercourse, other infections, or menstruation. Symptoms may not be as severe in recurrent infections as in the initial one.
^ Jump up to: a b Chow AW, Roland A, Fiala M, et al. (March 1973). “Cytosine Arabinoside Therapy for Herpes Simplex Encephalitis – Clinical Experience with Six Patients”. Antimicrob. Agents Chemother. 3 (3): 412–17. doi:10.1128/aac.3.3.412. PMC 444424 . PMID 4790599.
The incidence of active genital herpes is difficult to determine precisely because many cases present mild symptoms, are self-limiting, and are not called to the attention of health care personnel. However, it is clear that the disease has reached epidemic proportions in the United States. It is highly contagious and is transmitted by direct person-to-person contact (not limited to sexual contact). Autoinoculation via the hands is possible; for example, from a lip ulcer to the genital area or from the lip or genitals to the eye. Once the virus gains access to the body it enters the nervous system and invades nerve cells located near the site of infection, such as in the sacral ganglia. The virus lies dormant in nerve cells and can remain there indefinitely, predisposing the person to recurrent outbreaks. Factors contributing to recurrent genital herpes are not well understood. Some infected persons experience no recurrences while others have frequent and severe outbreaks. Many patients are aware of a correlation between the appearance of lesions and precipitating factors such as exposure to sunlight, local trauma, fever, or emotional stress. Hormonal changes preceding menses have been associated with recurrences in women.
Avoiding direct contact with the virus is the only way to prevent infection. Therefore, avoid having sex with someone who has an active genital or oral sore as there is a high risk of transmission at this time. Herpes can, however, be present on the skin without causing any symptoms and be transmitted by someone who has no sores present. Reducing your number of sexual partners and using condoms will reduce the likelihood of coming into contact with herpes.
Shingles may occur in the mouth if the maxillary or mandibular division of the trigeminal nerve is affected, in which the rash may appear on the mucous membrane of the upper jaw (usually the palate, sometimes the gums of the upper teeth) or the lower jaw (tongue or gums of the lower teeth) respectively. Oral involvement may occur alone or in combination with a rash on the skin over the cutaneous distribution of the same trigeminal branch. As with shingles of the skin, the lesions tend to only involve one side, distinguishing it from other oral blistering conditions. In the mouth, shingles appears initially as 1–4 mm opaque blisters (vesicles), which break down quickly to leave ulcers that heal within 10–14 days. The prodromal pain (before the rash) may be confused with toothache. Sometimes this leads to unnecessary dental treatment. Post herpetic neuralgia uncommonly is associated with shingles in the mouth. Unusual complications may occur with intra-oral shingles that are not seen elsewhere. Due to the close relationship of blood vessels to nerves, the virus can spread to involve the blood vessels and compromise the blood supply, sometimes causing ischemic necrosis. Therefore, oral involvement rarely causes complications such as osteonecrosis, tooth loss, periodontitis (gum disease), pulp calcification, pulp necrosis, periapical lesions and tooth developmental anomalies.
HSV-1 is closely related to herpes type 2 that causes genital herpes, a sexually transmitted disease (STD). Both oral and genital herpes can cause sores in the facial area or on and around the genitals, and can be transmitted by vaginal, anal and oral sex. HSV can also spread to the eyes, causing a condition called herpes keratitis that can cause blindness.
HSV-2 can be contracted from infected bodily fluids, including semen, vaginal fluid, saliva or herpes lesions, sores or blister fluid. Genital herpes can be contracted while receiving oral sex with someone who has oral herpes. Upon entering a cell, the infection often does not cause any symptoms. If the virus destroys the host cell during replication, sores or blisters filled with fluid appear. Scabs form over the sores or blisters once the fluid is absorbed, then the scabs disappear without scarring. Once the virus makes its way to the dorsal root ganglia, it becomes inactive for an unknown period of time. The virus becomes active again at unpredictable times, causing shedding and sometimes lesions or sores. Genital herpes is easier to transmit during an active infection when lesions or sores are present, however, it can be transmitted when no symptoms arise. One-third to half of all shedding instances show no symptoms. If symptoms do appear, they are often worse during the initial outbreak than recurring outbreaks.
General good health may help your immune system fight recurrences – get enough sleep, follow a healthy diet, stop smoking, reduce alcohol intake, get regular exercise, practice stress management and relaxation techniques.
^ Jump up to: a b Sakakibara R, Yamanishi T, Uchiyama T, Hattori T (August 2006). “Acute urinary retention due to benign inflammatory nervous diseases”. Journal of neurology. 253 (8): 1103–10. doi:10.1007/s00415-006-0189-9. PMID 16680560.
Because there are 2 different kinds of herpes simplex viruses (HSV-1 and HSV-2) that can live on many body parts, lots of people are confused about what to call these infections. But it’s actually pretty simple:
Several antiviral drugs are effective for treating herpes, including acyclovir, valaciclovir (valacyclovir), famciclovir, and penciclovir. Acyclovir was the first discovered and is now available in generic. Valacyclovir is also available as a generic and is slightly more effective than aciclovir for reducing lesion healing time.
Overall health Genital herpes is essentially a minor, sometimes recurring, skin infection; ‘cold sores’ which occur on the genitals rather than the face. It does not cause long-term ill health or affect longevity of life. People who get genital herpes can and do lead perfectly normal lives.