Genital herpes: definition, symptoms, causes and treatment

By Cristiano Antonino On May 26, 2023

When we talk about herpes, we almost always think of herpes of the lips. However, there is also genital herpes, a common sexually transmitted infection caused by the herpes simplex virus (HSV)

As the name suggests, the main way the virus spreads is sexual

After the initial infection, the virus lies dormant in the body and can reactivate several times during a lifetime.

Genital herpes can cause pain, itching and sores in the genital area, but it could also be silent and therefore even more subtle.

Genital herpes, causes

Genital herpes can be caused by two types of herpes simplex:

-Herpes simplex virus 1- HSV-1: it is the virus that usually causes cold sores. In most cases, HSV-1 is transmitted through skin-to-skin contact: It can spread to the genital area during oral sex. Relapses are much less frequent than with HSV-2 infection.

-Herpes simplex virus 2-HSV-2: This is the type of virus that most commonly causes genital herpes. The virus is spread through sexual contact and skin-to-skin contact. HSV-2 is very common and highly contagious, whether or not you have an open wound.

Because the virus dies quickly outside the body, it is nearly impossible to become infected through contact with toilets, towels, or other items used by an infected person.

Vaginal herpes: It is more common

There are two factors that increase the risk of contracting genital herpes:

female: women are more vulnerable from this point of view because the virus is transmitted more easily from men to women than vice versa;
Having multiple sexual partners: Each additional sexual partner increases the risk of being exposed to the virus that causes genital herpes.

Symptoms of genital herpes

Most infected people do not know they have HSV because they have no signs or symptoms or because they have very mild signs and symptoms.

When present, symptoms can begin two to 12 days after exposure to the virus.

Here are the most common manifestations of genital herpes:

pain or itching: you may feel pain and/or itching in the genital area until the infection clears;
small red bumps or tiny white blisters: these lesions can appear on the genital area a few days to a few weeks after infection;
Ulcers: Ulcers can form when blisters burst and ooze or bleed. Ulcers can make it painful to urinate;
Scabs: The skin may scab as the ulcers heal.

During the initial outbreak, the person might also have flu-like signs and symptoms such as swollen lymph nodes in the groin, headache, body aches, and fever.

Male genital herpes

Men can develop sores on the penis and/or scrotum.

Women, on the other hand, may have lesions in the vaginal area, on the external genitalia, on the cervix.

Both, then, can have sores on: buttocks; thighs; anus; mouth; urethra (the tube that allows urine to flow out of the bladder).

Sores tend to appear where the infection has entered the body.

You can spread the infection by touching a sore and then rubbing or scratching another area of the body, including the eyes.

Genital herpes and recurrences

Genital herpes, once it enters the body, remains there: it lurks in the cells and can “wake up” at any time, especially in times of stress and low immune defenses.

The disorder manifests itself differently from person to person. In some cases, the signs and symptoms may recur, off and on, for years.

Other people, on the other hand, experience numerous episodes every year. Often, however, outbreaks tend to become less frequent over time.

During a relapse, just before the sores appear, they may be felt

burning, tingling and itching where the infection first entered the body;
pain in the lower back, buttocks and legs. However, recurrences are usually less painful than the original disease and the sores usually heal more quickly.

The complications of genital herpes

Complications associated with genital herpes can include:

other sexually transmitted infections: having genital sores increases the risk of transmitting or contracting other sexually transmitted infections, including AIDS;
neonatal infection: Babies born to infected mothers can be exposed to the virus during birth. This can result in brain damage, blindness or death for the newborn;
Bladder problems: In some cases, sores associated with genital herpes can cause inflammation around the urethra (the tube that carries urine from the bladder to the outside). The swelling can close off the urethra for several days, requiring insertion of a catheter to drain the bladder;
meningitis. In rare cases, HSV infection leads to inflammation of the membranes and cerebrospinal fluid that surround the brain and spinal cord;
Rectal inflammation (proctitis): Genital herpes can lead to inflammation of the lining of the rectum, particularly in men who have sex with men.

Genital herpes, the diagnosis

If you suspect symptoms or are unsure, see your doctor. Doctors usually diagnose genital herpes based on a physical exam and the results of certain laboratory tests, such as:

viral culture: this test involves taking a tissue sample or scraping the sores for later examination in the laboratory;
polymerase chain reaction (PCR) test: PCR is used to copy DNA from a sample of blood, tissue from a wound, or spinal fluid. The DNA can then be tested to establish the presence of HSV and determine what type of HSV the patient has;
blood test: this test analyzes a blood sample to detect the presence of HSV antibodies and thus detect a previous herpes infection.

What not to do with genital herpes

People who have genital herpes should abstain from sexual activity if they have blisters or other symptoms because they can transmit the infection to their partner.

Genital herpes, the cures

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There is no specific cure for this disease.

Your doctor may prescribe antiviral drugs to achieve the following benefits:

during an initial outbreak, help sores heal sooner;
reduce the severity and duration of symptoms in recurrent infections;
decrease the frequency of relapses;
reduce the chance of passing the herpes virus on to other people.

Antiviral drugs used for genital herpes include acyclovir and valacyclovir

Your doctor may advise you to take the medicine only when you have symptoms or to take a certain medicine every day.

These drugs are generally well tolerated, with few side effects.

How to prevent genital herpes

The tips for preventing genital herpes are the same as those for preventing other sexually transmitted infections, namely:

limit sexual contact to only one person who does not have infections;
ask the partner to use a latex condom during each sexual contact;
avoid intercourse if either partner has a herpes outbreak in the genital area or elsewhere.

If you are expecting a baby and you know or suspect you have genital herpes, tell your doctor.

Your doctor may recommend that you start taking herpes antiviral medications late in your pregnancy to try and prevent an outbreak around the time of delivery.

If the woman has an outbreak when she goes into labor, she will probably be advised to have a caesarean section to reduce the risk of passing the virus to the baby.

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