Genital Herpes

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    AHealthyWomen answered
    Review the following questions about herpes so you're prepared to discuss this important health issue with your healthcare professional.
    • How, what and when should I tell my partner about my infection?
    • Does my partner need to be tested?
    • Does having genital herpes mean I can't or shouldn't get pregnant?
    • How will I be monitored for outbreaks once I am pregnant?
    • Do I have to be careful about passing the virus to my children through casual contact?
    • How can I predict when I'm going to have another outbreak?
    • When am I at greatest risk for transmitting the virus to my partner?
    • Is there a cure for herpes? How can drug treatments help me?
    • How do I decide whether I need drugs to control recurrences?
    • How do I choose among the drugs available for treating herpes and preventing recurrences?
    • What can I do to make herpes outbreaks less painful?
    • Are there any support groups for people with herpes?
    • Where can I find someone to talk to who understands how I'm feeling?
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    AHealthyWomen answered
    Various vaccines are being developed and tested for herpes simplex virus 2 (HSV-2), which causes genital herpes. The Herpevac Trial for Women, an eight-year clinical trial involving 50 trial sites and more than 8,000 women, investigated a vaccine to protect women against genital herpes disease. The trial, which wrapped up in 2010, found the vaccine to be ineffective. The study did, however, produce important scientific information to help guide future research toward a vaccine that will prevent genital herpes.
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    AHealthyWomen answered
    The risk of transmitting genital herpes to a fetus varies greatly, depending on when a woman is infected. A pregnant woman who develops a first episode of genital herpes during her pregnancy is at highest risk of passing the virus to her fetus and may be at higher risk for premature delivery.

    If a mother has her first outbreak near or at the time of a vaginal birth, the baby's risk of infection is high. If the outbreak is a recurrence -- meaning the mother was infected before she was pregnant -- the baby's risk is much lower. Overall, studies show that less than 2% of pregnant women with herpes simplex virus (HSV) acquired the virus during pregnancy.

    Before much was known about how HSV is transmitted from mother to baby during birth, many pregnant women with the virus were given cesarean sections, regardless of when they became infected. Today, cesarean sections are limited to women who have detected sores in or near the birth canal at the time of labor. Women whose virus is active late in pregnancy may be put on suppressive therapy to help prevent transmission to the infant.
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    AHealthyWomen answered
    The drug acyclovir appears to be safe for treating genital herpes in pregnancy, but it should only be used when the benefits of taking the drug outweigh the risks. At this time, there isn't as much information on the safety of valacyclovir and famciclovir; both are classified as class B agents by the U.S. Food and Drug Administration (FDA), meaning there is no evidence of risk in humans, which is similar to the risk of acyclovir.

    If an infant is infected with genital herpes, the antiviral medication acyclovir can greatly improve the outcome, particularly if treatment starts immediately. With early detection and treatment, most of the serious complications of neonatal herpes can be lessened. 
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    AHealthyWomen answered
    Treatment for genital herpes involving medication can be taken in different ways. Episodic therapy is taken at the first appearance of symptoms. This therapy involves taking daily dosages of a drug until symptoms subside, usually for a course of one to five days. These antiviral drugs are safe, have few side effects, shorten the length of first episodes and reduce the severity of recurring outbreaks, especially if taken within 24 hours of the onset of prodromal symptoms. Episodic therapy will not prevent transmission between episodes, however.

    If you have frequent recurrences of genital herpes, suppressive therapy can keep the virus in check indefinitely. This treatment involves daily medication, even when you have no symptoms. It can reduce the number of recurrences significantly. Suppressive therapy also reduces the chances that an infected person will transmit the virus to a sexual partner primarily because it reduces asymptomatic shedding of the virus.
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    AHealthyWomen answered
    Most people who have had an initial primary outbreak of genital herpes will experience periodic outbreaks, or recurrences. For many, symptoms will reappear an average of four or five times a year lasting about five to 10 days.

    Between outbreaks, the virus retreats to the sacral ganglion in the spine where it is protected from the body's immune system. Infected people develop antibodies in response to genital herpes infection but, unfortunately, herpes simplex virus (HSV) antibodies cannot completely protect a person against different HSV types or against reactivation of the dormant virus. Periodic outbreaks tend to become less frequent and less severe over time. Eventually outbreaks may disappear altogether.

    Not all outbreaks have symptoms, and the virus may continue to be transmitted from a variety of sites in the genital area or in genital secretions or from lesions that are hidden or too small to notice.
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    AHealthyWomen answered
    Almost immediately after the herpes simplex virus (HSV) infects your body and before symptoms appear, the virus travels to a sensory nerve root at the base of the spinal column called the sacral ganglion. It remains there in a latent or dormant stage 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. An itching, tingling or burning sensation in the genital area or buttocks often signals an upcoming episode. These warning symptoms are called the prodrome.

    The trigger for these recurrences is not known. Stress, menstruation, infections and emotional distress may contribute. However, research has shown that episodes can recur when these factors are absent.

    Keeping one's immune system strong is important. For instance, persons with weakened immune systems, such as human immunodeficiency virus (HIV)-positive individuals, have more frequent and severe outbreaks than HIV-negative persons. Experts also recommend getting emotional support, as the psychological impact of genital herpes often is more upsetting than the physical symptoms.
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    AHealthyWomen answered
    Genital herpes is not always easy to diagnose because signs and symptoms vary greatly. Some studies show that as many as two-thirds of all people infected with genital herpes will experience either no symptoms or will have symptoms so mild or atypical that they will not notice them or will mistake them for something else, like a yeast infection.

    Research has shown that after receiving health education about symptoms of genital herpes, many people who were thought to have asymptomatic infection (infection with no symptoms) were able to recognize symptoms.
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    AHealthyWomen answered
    One of the most bewildering and frustrating aspects of genital herpes is the periodic outbreak of sores that infected people often experience. The herpes simplex virus (HSV) remains dormant in certain nerve cells of the body for life, causing periodic symptoms in some people while remaining dormant for life in others.

    Recurrences of genital herpes can be upsetting and sometimes painful. Moreover, the emotional stress over transmitting the disease to others and disrupting sexual relations during outbreaks, as well as informing your sexual partner of your infection status, can take a toll on personal relationships. With proper counseling, improved treatments and prevenation measures, however, couples can cope with and manage the disease effectively.

    Like other genital ulcer diseases, genital herpes increases both the risk of acquiring and transmitting human immunodeficiency virus (HIV), the virus that causes acquired immune deficiency syndrome (AIDS), by providing a point of entry or exit for HIV.
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    AHealthyWomen answered
    For reasons not entirely clear, many people with genital herpes either have no visible symptoms or don't recognize the symptoms. The virus can be transmitted with or without symptoms being present. But the major concern with both oral and genital herpes is that you remain infected for life and there is no cure.

    When it does cause symptoms, genital herpes can produce sores in and around the vaginal area, on the penis, around the anal opening and on the buttocks or thighs. Occasionally, sores also appear on other parts of the body where broken skin has come into contact with the virus.

    The amount of virus produced is greatest at the time someone is having an outbreak. Yet many outbreaks occur without the person realizing it. Lesions can be so small or hidden from view that only special tests can prove one is having an outbreak. It is estimated that most people with herpes are infectious at some point in their lives when they don't have visible symptoms.