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GENITAL HERPES

Genital herpes is a sexually transmitted disease that infects men and women alike. It can spread through vaginal, anal or oral sex with an infected person. Genital herpes has no cure, although it is not life-threatening, unlike other sexually transmitted diseases (STDs). Like most other STDs, genital herpes spreads silently without showing any obvious symptoms. The primary mode of transmission of genital herpes is through direct contact.

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Types

Types of genital herpes not found.

Stages

Stages of genital herpes not found.

Symptoms

One might not see any visible symptoms soon after being infected with the herpes virus. But, as the infection grows and spreads, it starts to show some mild symptoms.


  • The initial symptoms could be ‘pimples’ or ‘zits’ appearing on the infected person’s genital areas. Sometimes such signs are seen around the mouth area too (owing to oral sex).

  • Many times, people with herpes mistake these initial symptoms for a skin condition or an allergy.

  • As the infection progresses, the sores grow and start resembling blisters on the infected areas (genitals, rectum and around the mouth). There can be one or more blisters at one spot at any time. If left untreated, the sores can break open and can cause pain. This outbreak is usually followed by flu-like symptoms such as fever, body aches and swelling in the lymphatic glands. Usually, the first attack of herpes is the worst and can take a toll on the person infected with it. These outbreaks can take up to several weeks to heal even with treatment.

  • Once infected, the virus stays in the body for the rest of their life despite treatment and care. In such a scenario, one can face episodes of repeated outbreaks. However, the outbreaks after the first one are usually shorter in duration and less painful. Also, the number of outbreaks tends to decrease over the years.

  • Other symptoms associated with Genital Herpes include smelly discharge, a burning sensation during urination and painful intercourse. Apart from this, unusual vaginal bleeding between periods among women is also noticed.

Causes And Risk Factors

Causes

Genital herpes can be caused by two types of viruses, viz., herpes simplex type 1(HSV-1) and herpes simplex type 2(HSV-2). Initial infection of HSV-1 often happens during childhood following the disappearance of maternal antibodies during the first year of life. Herpes simplex virus type 2 is generally associated with Genital Herpes. The virus can be transmitted through skin contact during sexual intercourse with one’s partner. Transmission can also occur due to sharing of sex toys. Herpes genitalis virus is a surface virus and cannot survive for an extended period if not present in the skin. Hence, this virus's transmission is mainly through sharing of bed sheets, toilet seats, and towel. It is most common in people in the age group of 14 to 49, but can also be seen in older adults. With herpes infection, sores or blisters are usually seen on the genitals of the infected person. These sores are filled with fluids that carry the virus. If a healthy person comes into contact with these fluids, the disease can be transmitted. Even if the symptoms of the disease are not prominent, i.e., the sores aren’t present (asymptomatic shedding) in the infected person, it can still be transmitted during sexual intercourse.

Risk Factors

Risk factors for the development of genital herpes are:


  • Having sexual intercourse with an infected partner

  • Practising sexual intercourse with multiple partners.

  • If an individual already is diagnosed with a sexually transmitted infection.

Prevention

To prevent getting an infection of genital herpes:


  • Always practise safe sex. Use latex condoms during sexual intercourse and dental dams during oral sex.

  • Avoid having sex with multiple partners and practise monogamy. This can save you from getting infected with any type of STD.

  • If the infection is already present:

  • Talk to your partner about your health and the potential risks involved. Remember, even if the signs of the disease are suppressed, you can still pass the infection to your partner.

  • Condoms and dams can only cover the sores that are present in the genital areas and the mouth. But the blisters can also appear elsewhere in the body. Coming in contact with the fluids of the sores in case of an outbreak can also contribute to transmitting the disease. Hence, using condoms isn’t protection enough to limit the transmission of the disease.

  • Maintain proper hygiene. Always wash hands thoroughly to prevent herpes from spreading to other parts of the body, in case there are open sores.

  • Herpes is not curable; always talk to your partner and keep your doctor in the loop to know how you can prevent the disease from coming in the way of good health and happy sex life.

Diagnosis

Following methods can be used for the diagnosis of genital herpes-


  • The diagnosis of genital herpes can be made symptomatically.

  • Viral culture of the herpes simplex virus should be done by taking a swab from the genital lesions within five days. This is detected using enzyme immunoassay for immunofluorescence assay.

  • Polymerase chain reaction: The polymerase chain reaction is four times more sensitive than the viral culture test.

  • Serotyping: This method is used to detect the presence of herpes simplex virus antibodies. It differs from the other tests because it can be used to differentiate between herpes simplex virus 1(HSV-1) and herpes simplex virus 2 (HSV-2).

  • Tzanck Smear test.

Treatment

Sadly, genital herpes has no cure. However, it can be managed efficiently with treatment. Treatment with antivirals can keep the symptoms in check, reduce the episode severity & make it less painful.

In the case of women who are pregnant and infected with herpes, special prenatal care is necessary. Sometimes the infection can also lead to a miscarriage or premature delivery. A herpes infection can spread from mother to child. Medications are given to a pregnant woman during the last trimester to prevent transmitting the disease to the baby. Usually, a C-section is performed on a mother suffering from herpes to save the baby from getting infected while birthing.

Lifestyle Management

Lifestyle management for Genital Herpes is as follows-


  • Keep your genitals dry.

  • Avoid tight-fitting clothes.

  • Soak in a warm bath.

Prognosis And Complications

Prognosis

The prognosis of HSV-2 is worse than HSV-1.

Complications

Complications due to genital herpes infection can be as follows:


  • Bladder problems and having trouble with urinating

  • Vaginal yeast infections

  • MeningitisOther complications may include:

  • Urethritis (inflammation of the urethra, the urinary outflow tract), which results in ulceration. There may be no tell-tale blisters so that the presentation is identical to gonorrhoea or chlamydia urethritis.

  • Proctitis (rectal infection), which can occur without external lesions. Symptoms include fever, rectal pain, watery discharge, and autonomic nerve dysfunction that may result in difficulty while passing urine.

  • Neurogenic (nerve) pain indicates leg and thigh pain, which often results in recurrence.

  • Meningitis is rare.

  • Widespread infection is seen in debilitated or immune-suppressed patients.

Alternative Treatments

No alternative treatment found.

References


  1. Geburtshilfe und Frauenheilkunde. Herpes Genitalitis. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5177552/. Accessed on March 25, 2021

  2. Informedhealth.org. Genital Herpes: Overview [Internet] Available at https://www.ncbi.nlm.nih.gov/books/NBK525769/. Accessed on March 25, 2021


3.] Microbial cell. Genital Herpes: Insights into sexually transmitted infectious diseases. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5354570/. Accessed on March 25, 2021.

 

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