Genital Herpes: Overview

Genital herpes, a sexually transmitted disease (STD), affects millions of people. Whether you have been diagnosed with genital herpes or are interested in preventing it, the following overview should help you better understand the disease.

Why should you be concerned about genital herpes? It might be more common than you think. The Centers for Disease Control and Prevention (CDC) estimates that 45 million people ages 12 and older in the United States (one out of five adolescents and adults) have been infected with genital herpes.

Genital herpes is an infection of the genitals, buttocks or anal area caused by the herpes simplex virus (HSV). There are two types of herpes simplex viruses: herpes simplex virus 1 (HSV-1) and herpes simplex virus 2 (HSV-2).

Although genital herpes can be uncomfortable, the disease is not considered a dangerous condition in adults. However, it does increase the risk of acquiring and transmitting human immunodeficiency virus (HIV) by providing a point of entry or exit for the virus.

How is genital herpes transmitted?

HSV-1 most commonly causes cold sores or fever blisters to appear on or around your mouth, lips or nose, but the virus can also cause genital herpes. HSV-1 can infect your genitals during oral sex or genital-to-genital contact with a person who has the virus. Between 5 and 10 percent of genital herpes is caused by HSV-1, according to the National Institutes of Health (NIH).

Genital herpes is more commonly caused by HSV-2. The virus is passed from person to person when bodily fluids are exchanged during vaginal, oral or anal sex.

You can contract the herpes virus regardless of your sexual orientation. For instance, the virus can be transmitted from woman to woman if a sore from one woman comes into contact with the oral or genital mucosa (moist tissue that lines certain organs and body cavities) of her female partner.

Genital herpes is most easily spread through having vaginal, oral or anal sex with another person who is infected with the HSV-2 virus and showing sores. However, the disease can also be transmitted during the few days prior to the appearance of sores. This period, known as prodrome, is characterized by the appearance of early symptoms (such as itching or burning in the genital or anal area, fever or muscle aches).

Experts used to believe that transmission of genital herpes could occur only if the virus was active and causing symptoms, but this has since been proven false. There are several days each year during which you can transmit the virus without the presence of sores or other symptoms. This is known as asymptomatic reaction or asymptomatic shedding.

HSV-1 and HSV-2 live in the nerve cells. After the virus infects your body, it travels to the sacral ganglion (a sensory nerve root at the base of the spinal column). It can remain there in an inactive state indefinitely. In some people, the virus reactivates and travels back to the skin, where it multiplies until it erupts at the surface in the form of a sore. This is called an outbreak. Because the nerves in your genitals, upper thighs and buttocks are connected, you can experience outbreaks in any of these areas.

Between outbreaks, the virus retreats back to the sacral ganglion, where it is protected from your body's immune system. Although you develop antibodies in response to infection, the antibodies can't completely protect you against different strains of the virus or reactivation of the virus.

Scientists do not know what causes the virus to become active. You may develop an outbreak when you are sick, under stress or have been exposed to the sun. You may also have outbreaks during your menstrual period. In addition, poor diet, fatigue, friction, surgical trauma and steroid medications (such as asthma medications) also trigger outbreaks.

Genital herpes and pregnancy

Although rare, you can pass genital herpes to your baby during childbirth as the baby goes through the vaginal canal. This occurrence is uncommon because mothers pass antibodies (proteins used by the immune system to identify and neutralize substances foreign to the body such as bacteria and viruses) to their babies during pregnancy. However, if you acquire genital herpes during your third trimester of pregnancy, you are more likely to transmit the virus. This is because your body has not had enough time to build up antibodies to the infection.

Transmission of HSV to an unborn baby can lead to a number of complications, including premature birth. A baby born with herpes can also experience serious health problems, such as encephalitis (inflammation of the brain), severe rashes and eye problems. Herpes can also be life threatening to an infant. According to the National Institute of Allergy and Infectious Diseases (NIAID), half of all babies infected with herpes either die or suffer from nerve damage.

Herpes treatment and prevention

There is no cure for herpes. Once you have been infected with the virus, it will always remain in your body. That is why taking preventive measures is the best way to avoid contracting herpes and other sexually transmitted diseases. Abstaining from sex or being in a long-term monogamous relationship with an uninfected partner is the surest way to prevent the disease. If you are sexually active, use a condom every time you have vaginal, anal or oral sex. Also, limiting the number of sexual partners and having sex with people who are not infected with the virus can help you reduce your chances of catching the disease.

If you do have genital herpes, medication can reduce the severity of your symptoms and the number of outbreaks you experience. Recently, the U.S. Food and Drug Administration (FDA) approved a new drug that prevents the transmission of genital herpes. In addition, there are a number of self-care measures that you can take to speed healing and prevent the spread of the infection to other parts of the body and to other people.

Although genital herpes is a common and manageable condition, living with herpes can be distressing, inconvenient and, in some cases, painful. The period after diagnosis may be an especially emotional time, with many people experiencing feelings of shame and fear. You may be reluctant to tell your sexual partners about your condition, but remember that by telling them and by practicing safe sex measures, you are helping reduce the spread of the disease. It may be helpful to seek emotional support such as counseling or a support group as a way of dealing with your condition. This can help to remind you that you are not the only person with genital herpes. There are millions of people experiencing the same symptoms and emotions.