Genital Herpes

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Genital Herpes, How it is Transmitted, Symptoms and Treatment.

Genital herpes
Genital herpes, also known as herpes simplex genitalis, is considered as the most common infectious genital ulceration in the United States. Each year, genital herpes is estimated to affect 1 million individuals. Researchers believe that at least 45 million people ages 12 and older have recurrent genital herpes infections annually, making it an epidemic sexually transmitted disease. Although the total number of Americans with genital herpes has decreased over the past decade, one out of five adolescents and adults continue to suffer from the negative effects of this STD.

Genital herpes is more common in women than men. Approximately one out four women are afflicted with this disease, while one out of eight men have the infection. The incidence is highest in teens and in young adults. Furthermore, studies also show that nonwhite lower socioeconomic populations are at risk for genital herpes. It is important to emphasize that women are at greater risk for more severe complications. Women with genital herpes could transmit the virus to their newborns during delivery.

Almost 80% of infected individuals are asymptomatic. Others experience frequent painful recurrences, which can significantly result in physical and emotional difficulties. Genital herpes is a lifelong medical condition without a cure; therefore, appropriate preventive measures must be done to control the spread of the disease. Prompt recognition and early initiation of treatment are essential in the management of the disease.

Cause and Transmission of Genital Herpes
Genital herpes is caused by herpes simplex viruses, either by herpes simplex virus type 1 or herpes simplex virus type 2. HSV - 1 is usually associated with cold sores on the outside of mouth, lips, cheeks, chin, and nostrils, whereas, HSV - 2 is closely associated to genital disease. HSV - 2 causes 80% of initial genital herpes infections and 95% of recurrent infections. Genital herpes is transmitted through vaginal, anal or oral - genital contact.

Genital Herpes Episodes and Manifestations
The signs and symptoms of genital herpes vary. The manifestations largely depend whether you are experiencing an initial outbreak or a recurrent infection. Bear in mind that around 80% of infected individuals do not demonstrate any sign or symptom associated to genital herpes; thus, it is of utmost importance to practice safe sex at all times.

First Episode or Outbreak of Herpes

After 3 to 7 days of exposure to the virus, painful red lesions begin appear in the genital area. Both men and women are susceptible to genital herpes; however, symptoms tend to be more apparent and severe in women. The sites most frequently affected by genital herpes in women are the vagina, cervix and labia. In men, the lesions occur on the shaft of the penis and scrotum. Anal intercourse results in appearance of lesions in and around the anus.

Right after the lesions appear, they form small painful fluid – filled blisters that contain the virus particles. As the blisters break, they shed the highly infectious virus into the surrounding skin. After five to seven days, development of new patches of painful ulcers occurs, lasting for 1 to 2 weeks or more, if infected. The infection is spread to other parts of the body by touching the blisters and later, rubbing your hand in another area. Some individuals get blisters on the mouth, lips, cheeks, nostrils and chin.

The first outbreak of the lesions is the usually the most severe. The first episode has an average duration of 12 days.

Latent Stage of Herpes
HSV - 2 is incurable. Although the signs and symptoms disappear, the virus continues to stay inside your body. After the first outbreak, the virus travels through the nerve paths and hides at the base of the nerves, where it remains dormant unless activated by certain factors. The stage where no signs or symptoms are manifested is called the latent stage.

Recurrent Episode Herpes
Subsequent occurrences, termed recurrent infections, are less severe than the initial episode. Recurrent infections have an average duration of 4 to 5 days. Recurrent genital herpes infections occur when the virus travels from the nerves back into the skin's surface, causing the outbreak of ulcers. The virus is activated during stress, exposure to the sun, fevers and infections. A weakened immune system, and menstrual periods could also set off an outbreak.

Almost half of individuals with recurrent outbreaks report that before the ulcers appear, they experience mild symptoms, which are termed prodromal symptoms. Burning, itching, tingling or throbbing at areas where the lesions usually appear may be reported. Pain in the buttocks, groin and legs may also accompany these sensations. Researchers believe the prodromal symptoms indicate increased levels of infectiousness; thus, sexual contact must be avoided. It is also possible to have recurrence in areas other than the initial infection sites. Body parts with no direct contact to the infection may be involved during recurrence.

Diagnosis
A thorough medical history, careful physical assessment and laboratory examinations are done to diagnose genital herpes. It is important to distinguish genital herpes from other sexually transmitted diseases in order to create a right treatment plan for your medical condition.

A culture test may be done to detect the virus; however, it is estimated that only 50% of infected individuals tested positive for HSV infection using this laboratory test. Consult your physician within 48 hours of the initial symptoms as the virus is more likely detected during the early stages of infection. For asymptomatic individuals or for those individuals who believe they have been infected in the past, a blood test may be indicated to detect HSV antibodies to determine HSV infection. The antibodies are not detected during the initial episode since it may take some time for your body to form them. However, once the antibodies are synthesized, they are detected throughout life, even during the latent or dormant stage.

Treatment
Treatment of genital herpes is mainly achieved through drug therapy. Three antiviral medications are usually prescribed to alleviate the symptoms of HSV - 2 virus: acyclovir, famciclovir and valacyclovir. These antivirals are taken by mouth. Acyclovir is the treatment of choice for genital herpes. It is believed that this drug is the most effective medication to reduce the length and severity of the first episode.

For infected individuals having fewer than six outbreaks each year, an episodic therapy is usually prescribed. Using any of the three antivirals, episodic therapy decreases the duration and severity of the genital herpes. It does not reduce the frequency of the outbreaks. Suppressive therapy is the treatment approach for individuals having six or more recurrences each year. This is also recommended for infected individuals with weakened immune system, such as those HIVs.

Sitz baths may temporarily relieve the pain. Analgesics, such as acetaminophen or ibuprofen may be taken to alleviate the pain of genital ulcers. Application of topical xylocaine jelly works wonders.

Preventions
The best way to prevent genital herpes is to abstain from any form sexual contact. If this is not possible, it is of utmost importance to use a latex condom every time you have sex. Condoms can reduce viral transmission but it is not 100% - guaranteed. Partners of infected individuals must be seen by a health care provider for proper treatment and management.

If you have recurrent infections, it is best to keep your stress level to a minimum. Eat healthier and follow a healthier lifestyle to strengthen your immune system and fight off the outbreak of the lesions.

Read About other Women's Health Concerns
Read About Chlamydia Infections
Read About Human Papillomavirus or HPV Vaccines
Read About Genital Warts caused by HPV Infection