Overview

What is herpes?

Herpes is the name of a group of viruses that cause painful blisters and sores. One kind of herpes (herpes simplex virus or HSV) causes both cold sores around the mouth and genital herpes (herpes around the sexual organs). Herpes zoster is another kind of herpes, and it causes chickenpox and shingles.

What about how I feel about having herpes?

It’s common to feel guilty or ashamed when you are diagnosed with herpes. You may feel that your sex life is ruined or that someone you thought you could trust has hurt you. You may feel sad or upset.

Keep in mind that you are one of millions of people who have herpes. Herpes may get less severe as time goes by, and you can help protect your sex partner by not having sex during outbreaks and by using condoms at other times. Talk to your family doctor about how you’re feeling.

Symptoms

What are the symptoms of genital herpes?

Symptoms can include painful sores in the genital area, itching, painful urination, vaginal discharge and tender lumps in the groin. During the first outbreak (called primary herpes), some people experience flu-like symptoms such as body aches, fever and headache. Most people who have herpes infection will have outbreaks of sores and symptoms from time to time. Some women have herpes only on the cervix. In this case, there may be few or no symptoms with an outbreak.

What happens once someone is infected?

Once you have been infected with the virus, you’ll go through different stages of infection. Each stage is explained in the following sections.

Primary stage

This stage usually starts 2 to 8 days after you’re infected, but it can take much longer to begin. Usually, the infection causes groups of small, painful blisters. The fluid in the blisters may be clear or cloudy. The area under the blisters will be red. The blisters break open so easily that they quickly become open sores. You may not ever notice the blisters.

Besides having tender blisters or sores in your genital area, it may hurt to urinate. You may run a fever, feel achy and have other flu-like symptoms.

While most people have a painful primary stage of infection, some don’t have any symptoms at all, and may not even know they’re infected.

Latent stage

During this stage, there are no blisters, sores or other symptoms. At this time, the virus is traveling from your skin into the nerves near your spine.

Shedding stage

In the shedding stage, the virus starts multiplying in the nerve endings. If the affected nerve endings are in areas of the body that make or are in contact with body fluids, the virus can get into those body fluids (such as saliva, semen or vaginal fluids). There are no symptoms during this stage, but the virus can be spread during this time.

Causes

How is genital herpes spread?

Genital herpes is usually spread from one person to another by having sex, including oral sex, with an infected person. The virus can enter your body through a break in your skin or through the skin of your mouth, penis or vagina, urinary tract opening, cervix or anus. Herpes is most easily spread when blisters or sores can be seen on the infected person. But it can be spread at any time, even when the person who has herpes isn’t experiencing any symptoms.

Herpes can also be spread from one place on your body to another, such as from your genitals to your fingers, then to your eyes or to other parts of your body.

Can a pregnant woman pass herpes on to her unborn baby?

Yes. A pregnant woman should let her doctor know if she has genital herpes, or if she has ever had sex with someone who had it. Babies born to mothers who have an active genital herpes infection at or near the time of delivery can become infected. This can cause brain damage, blindness of even death in newborns.

The baby is usually safe in the uterus. When the baby passes through the birth canal, it may come in contact with sores and become infected with the herpes virus. If you have herpes or if you have had sex with someone who has it, your doctor may do a cesarean section (C-section) if you have an outbreak at the time you go into labor, so the baby won’t have to go through the birth canal.

Prevention

Is there a safe time to have sex and not spread herpes?

No time is completely safe because it’s hard to know for sure when you can spread herpes. You must tell your sex partner that you have herpes.

You should avoid having sex if you have any sores. Herpes can spread from one person to another very easily when sores are present. Another reason to avoid sex when sores are present is that sores make it easier to become infected with human immunodeficiency virus (HIV), the virus that causes AIDS.

You should use condoms every time you have sex. Condoms can only help reduce the risk of spreading herpes if they cover all the infected skin.

Treatment

What should I do if I think I have herpes?

See your doctor as soon as possible. Herpes is easier to diagnose when there are sores. You can start treatment sooner and perhaps have less pain with the infection.

Is there a cure for herpes?

No. But medicines can help. The medicine acyclovir can speed up healing and can lessen the pain of herpes for many people.

Acyclovir pills can treat primary or recurrent herpes and can stop or lessen the number of recurrences. Acyclovir also comes in a cream to put on sores during the primary stage or during recurrences.

Famciclovir and valacyclovir are other medicines used to treat recurrent genital herpes and for prevention of recurrences.

What if I have herpes and become pregnant?

If you have genital herpes and are considering pregnancy or are pregnant, be sure to tell your doctor. He or she may give you an antiviral medicine so you will be less likely to have a herpes outbreak at or near the time you deliver your baby. If you do have an outbreak of genital herpes at the time of delivery, your doctor will most likely deliver your baby by cesarean section. With a cesarean section, the risk of giving herpes to your baby is small.

What if I get herpes during pregnancy?

If you have your first genital herpes outbreak during pregnancy, you should tell your doctor. Your doctor may want to treat you with an antiviral medicine. The risk of your baby getting herpes is much higher if you have your first genital herpes outbreak near the time of delivery.

It is important to avoid getting herpes during pregnancy. If your partner has herpes and you do not have it, be sure to use condoms during sexual intercourse at all times. Your partner could pass the infection to you even if he is not currently experiencing an outbreak. If there are visible sores, avoid having sex completely until the sores have healed.

Everyday Life

Tips on dealing with herpes

  • Talk to your doctor if you think you may have herpes.
  • Remember that you’re not alone. Millions of people have herpes.
  • Keep yourself healthy and limit your stress.
  • Don’t touch your sores.
  • Tell your sex partner and use condoms.

Tips to soothe the pain

  • Take aspirin, acetaminophen (one brand name: Tylenol) or ibuprofen (some brand names: Advil, Motrin, Nuprin).
  • Place lukewarm or cool cloths on the sore place.
  • Take lukewarm baths. (A woman may urinate in the tub at the end of the bath if she is having pain urinating — this may help dilute the urine so it doesn’t burn the sores so badly.)
  • Keep the area dry and clean.
  • Wear cotton underwear.
  • Wear loose-fitting clothes.

Complications

Recurrences

Many people have blisters and sores that come back after the first herpes attack goes away. This is called a recurrence. Usually, the symptoms aren’t as bad as they were during the first attack.

Stress, being sick or being tired may start a recurrence. Being in the sun or having your menstrual period may also cause a recurrence. You may know when a recurrence is about to happen because you may feel itching, tingling or pain in the places where you were first infected.

Questions to Ask Your Doctor

  • What is the best treatment for me?
  • Is it safe to have unprotected sex if I don’t have any sores?
  • Can I give myself genital herpes if I also have oral herpes?
  • What is the best way to prevent herpes outbreaks?
  • If I give my baby herpes, is there any treatment?
  • Are there any side effects to my treatment?
  • Can I live a normal life with herpes?
  • Am I at risk of developing any other diseases?
  • Are there any support groups in my area?
  • Can I give someone else herpes even if I’m not having an outbreak?

Citations

  • Neonatal Herpes Simplex Virus Infections by Caroline M. Rudnick, M.D., PH.D., and Grant S. Hoekzema, M.D.( 03/15/02, http://www.aafp.org/afp/20020315/1138.html)