Genital Herpes Simplex

What is genital herpes?

• Genital herpes is a sexually transmitted disease (STD) also known as genital herpes simplex virus (HSV) infection. An STD is an infection that is spread though sexual contact, including sexual intercourse (sex). Genital herpes causes blisters in your genital area. If you are female, your genital area includes your vagina and the area around it. It also includes your cervix (the bottom part of your womb). If you are male, your genital area includes your penis, testicles, and the area around them. Your genital area also includes your urethra (the tube that carries urine out of your body) and your anus.
  
  
• There are two types of genital herpes. Genital herpes is often caused by HSV type 2. HSV type 1 may also infect your genitals. Genital herpes is recurrent, which means you may get it many times in your lifetime. After you have been infected with genital herpes, the virus will travel to the cells under your skin. If the virus becomes active, it will return to your skin and cause a breakout of blisters. A recurrent infection is usually milder than the first infection. Although HSV remains in your body throughout your lifetime, having your infection treated will help relieve your symptoms.

How does genital herpes spread?

• You can get or give someone genital herpes during sexual contact. Sexual contact may include sexual intercourse. It may also include touching a partner's genital area with parts of your body that have the infection. If your HSV is active, then you will have blisters on your genital area. These blisters have the virus in them. During sexual contact, these blisters may touch your partner's genitals and infect your partner with HSV. This is probably the way you were infected with HSV.
  
  
• If you are female and pregnant, you may infect your baby. Your baby may get the infection while he is still in your womb. Your baby may also get it as he passes through your vagina during birth.

What increases my risk of getting genital herpes?

• Sex as a teenager: You may be at higher risk if you started to have sex as a teenager.
  
  
• Drug use: You may increase your risk for HSV if you use drugs, such as cocaine.
  
  
• Many partners: Having sex with many people increases your risk for genital herpes. This includes having more than one sex partner or changing partners frequently. It also includes having a sexual partner who has other sexual partners.
  
  
• Unprotected sex: You may increase your chances of getting genital herpes if you do not use a latex condom during sex.

What are the signs and symptoms of genital herpes?

You may or may not have symptoms when your HSV is active. Symptoms may last as long as a few weeks during your first infection. It usually takes less time for the blisters to go away when your infection happens again. The most common symptoms are blisters or sores that may appear in groups. Blisters may appear in your genital area, thighs or buttocks (rear end). The skin around these sores will become red. The blisters will open up, leak out fluid, and dry up (crust over). Usually these sores will go away without leaving a scar. Other symptoms may include:

• Burning, itching, or a tingling feeling in your genital area.
  
  
• Fever (high body temperature) or chills.
  
  
• Headache, body weakness, or muscle pains.
  
  
• Sore throat.
  
  
• Loss of appetite.
  
  
• Fluid or blood leaking from your vagina.
  
  
• Trouble urinating.
  
  
• Bigger lymph nodes. Lymph nodes are small organs that contain special cells to fight off germs. You may have bigger (enlarged) lymph nodes in the area where your leg meets your genital area.

How are genital herpes simplex virus infections diagnosed?

Your caregiver will ask you questions about your health and sexual history. He will need to know when your symptoms started. Tell your caregiver if you have other medical conditions, are taking any medicine, or have had any surgeries. Tell him about any STDs you (or your partners) may have. Your caregiver may also ask about the health of your current or past partners. You will have a physical exam where your caregiver will look closely at the area with blisters. In women, caregivers may need to do a pelvic exam to check the vagina and internal sex organs. You may also have any of the following:

• Blood tests: You may need blood taken for tests. The blood can be taken from a vein in your hand, arm, or the bend in your elbow. This test checks if your blood contains HSV. This test can help confirm if your blisters are caused by HSV. You may also have this test if you have no symptoms but have a partner with genital herpes.
  
  
• Culture: This test may help find out what germ is causing your infection. Your caregiver will take a sample of your blisters and send it to a lab for testing. He may get the sample by rubbing a cotton swab on or around the blisters. The sample will be mixed with a special solution to see if it grows out HSV.
  
  
• Spinal fluid test: Your caregiver may get fluid from your spine to do a polymerase chain reaction (PCR) test. This test can detect whether your infection is caused by HSV type 1 or type 2.
  
  
• Smear test: Your caregiver will take a sample of your blisters and send it to a lab for testing. This test is called a smear test. Samples are checked under a microscope. This will help caregivers learn what is causing your condition.

How are genital herpes simplex virus infections treated?

There is no cure for genital herpes. Your caregiver may treat your symptoms with medicine. This medicine may help relieve your symptoms and shorten the time that you have them. Your caregiver may give you any of the following medicines:

• Antivirals: This medicine helps stop the virus from getting worse. It may also shorten the time you have the blisters. Your caregiver will tell you when to use this medicine. Your caregiver may also give you this medicine to help stop blisters from happening again. In this case, you may take it every day for a long time.
  
  
• Anesthesia: Your caregiver may give you medicine to put on top of the blisters called topical anesthesia. This medicine will help numb the area and help your pain.
  
  
• Pain medicine: You may need medicine to take away or decrease pain.
  
  
  • Learn how to take your medicine. Ask what medicine and how much you should take. Be sure you know how, when, and how often to take it.
    
    
  • Do not wait until the pain is severe before you take your medicine. Tell caregivers if your pain does not decrease.
    
    
  • Pain medicine can make you dizzy or sleepy. Prevent falls by calling someone when you get out of bed or if you need help.

What can I do to protect myself and others from getting genital herpes?

• Avoid contact with infected skin. Do not have sexual contact if you or your partner have the infection. If you have sex, always use a latex condom. Avoid kissing if you or your partner have blisters in or around the mouth. Do not touch infected skin. Do not breastfeed if you have blisters on your breast. Be sure to carefully wash your hands after any contact with infected skin.
  
  
• Talk to your partners. Tell your partner that you have been diagnosed with genital herpes. Do not have sex with someone until they know that you have genital herpes. Ask your caregiver for ways to tell partners about your infection.
  
  
• Talk to your caregivers. Tell your other caregivers that you have genital herpes. If you are pregnant, your baby may need special monitoring. Inform your caregiver of your condition to avoid spreading the infection to your baby. You may also need to deliver your baby by cesarean section (c-section). A c-section is where your caregiver uses surgery to remove your baby from your body.
  
  
• Learn more about genital herpes. Your caregiver will talk with you about genital herpes. He will explain to you how you got the infection and what happens when you have it. You can learn more about the risks and treatment options. He will give you more information about how to prevent spreading the infection. He may also teach you ways to help cope with genital herpes.

What increases my chances for recurrence?

• Stress and fatigue: Your symptoms may come back if you are very tired (fatigued) or stressed.
  
  
• Illness: If you have another infection, your immune system may get weak. This may cause you to break out into blisters.
  
  
• Menstruation: Women may break out in blisters when they are menstruating (have their period).
  
  
• Trauma: If you get physically or mentally hurt, you may be more likely to have a recurrence of blisters. Other trauma to your body may cause a break out, including surgery.
  
  
• Heat and Cold: You may have an increased chance for blisters if you are exposed to high or low temperatures. Being exposed to a special light called ultraviolet (UV) may also increase your risk.

What problems may occur with genital herpes?

• You may have trouble urinating. You may have very bad pain in your genital area. Medicine for HSV may give you headaches or an upset stomach. You may respond more slowly to treatment, and some medicine may stop working after awhile. If you have genital herpes during pregnancy, your baby is at risk of getting herpes. Your baby may weigh less at birth than it should. The infection may damage his eyes and brain. Having genital herpes may also increase your risk of having a miscarriage (losing your baby while pregnant).
  
  
• Having HSV puts you at risk for having human immunodeficiency virus (HIV). The small openings caused by the blisters on the genitals allow HIV to get into your body. Having a weak immune system may cause you to have severe symptoms. Infection can spread and cause swelling of other organs, such as your brain, lungs, and liver. HSV may also spread to your brain and spinal cord causing serious infections called encephalitis and meningitis.

How do I care for myself at home?

The following are things you can do to be more comfortable when your infection is active:

• Always wash your hands before and after touching the area of your blisters.
  
  
• Keep the blisters clean and dry. Wash them with soap and warm water, and dry gently.
  
  
• Wear loose-fitting clothing.
  
  
• Wear cotton underwear.
  
  
• Putting an ice pack on your blisters may decrease pain. Always follow your caregiver's instructions on how to use an ice pack.
  
  
• Taking a warm bath may help decrease your pain.
  
  
• Avoid touching your blisters.

Where can I find more support and information about genital herpes?

Accepting that you have genital herpes simplex may be hard. It may be difficult for you to tell your partner or partners that you have genital herpes. You may feel very sad (depressed), ashamed, and alone. These feelings are normal. Ask your caregiver how to cope with genital herpes. Talk to your partner, family, or friends about your feelings. Contact the following for more support and information:

• American Social Health Association (ASHA)
  P.O. Box 13827
  Research Triangle Park , NC 27709
  Web Address: http://www.ashastd.org
  

• CDC National Prevention Information Network
  PO Box 6003
  Rockville , MD 20849-6003
  Phone: 1- 800 - 4585231
  Web Address: http://www.cdcnpin.org
  

• Division of STD Prevention, Centers for Disease Control and Prevention
  1600 Clifton Rd.
  Atlanta , GA 30333
  Phone: 1- 800 - 232-4636
  Web Address: http://www.cdc.gov/std
  

When should I call my caregiver?

Call your caregiver if:

• You have chills or a fever.
  
  
• You have painful blisters on your penis, vagina, anus, or mouth.
  
  
• Fluid or blood is coming out of your genitals.
  
  
• You have trouble urinating.
  
  
• You have a headache.
  
  
• Your symptoms stay the same or get worse.
  
  
• You have trouble chewing or swallowing.

When should I seek immediate help?

Seek help immediately of call 911 if:

• You think you are pregnant and you are bleeding from your vagina.
  
  
• You have trouble breathing.
  
  
• You have a seizure (convulsions).
  
  
• Your neck is stiff.
  
  
• You have trouble thinking clearly.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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