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Information from Your Family Doctor
What Should I Know About Genital Herpes?
Am Fam Physician. 2000 Mar 15;61(6):1708-1709.
See related article on herpes simplex virus infections.
What is genital herpes?
Genital herpes is a viral infection. It is caused by the herpes simplex virus, which is called HSV for short. One form of the herpes virus causes “cold sores” around the mouth or lips. This kind can be passed around if someone touches the cold sore and then touches another person.
Genital herpes is caused by another form of the virus. It causes sores in the genital area and can be spread from person to person by direct skin contact (often during sex) with a person who has the infection.
What do genital herpes sores look like?
Herpes sores usually look like blisters or cold sores. In women, the sores can be inside the vagina and on the cervix, or on the skin outside the vagina. In men, the sores are on the penis and scrotum, and the skin around the genital area. The sores start off as itchy places and then change to blisters or ulcers. Ulcers are red sores that are filled with pus. Sometimes, blisters pop up and change to ulcers before you even notice you have them. Over a period of days, the sores change to crusted spots before they finally heal.
How common is genital herpes?
Genital herpes is very common. One of every five people in this country has genital herpes. People who have sex with many partners are most likely to get it. When women with genital herpes get pregnant, they can pass the infection to their baby during delivery. New babies can get really sick from herpes. If the infection is bad, the infant may even die.
What are genital herpes infections like?
The first herpes infection is usually the worst one. Genital herpes infections come back over and over again. The first time, you may have one sore or many sores. The sores are painful. Some may be hidden inside the urethra. The urethra is the tube that carries urine from your bladder. The sores make urination painful. Some people also have a fever, a sore throat, deep tiredness and body aches. These problems might last three weeks.
After the first infection, HSV sores can come back any time. They often come back when you are sick with something else and when your immune system isn't strong enough. Genital herpes might come back 4 to 6 times a year at first. After a few years, the herpes sores hurt less. They come back less often.
Is genital herpes contagious?
Yes. When blisters or crusts are present, the virus can be passed by direct contact to others. But the virus can be just as contagious even when you cannot see any sores. Using condoms helps to prevent the spread of infection—but condoms cannot protect you completely. Because HSV also causes cold sores on the mouth, a person with cold sores can spread HSV through mouth contact with the genital area of another person. The virus can also be carried on hands from the mouth to another area. You can even spread the virus to yourself by touching cold sores on your mouth and then touching other areas of your body.
Will it ever go away?
No, genital herpes can't be “cured.” You will have genital herpes for the rest of your life. As time goes by, many people have fewer and milder herpes sores.
Is there a treatment?
Yes, several medicines are used to treat HSV infection. Acyclovir (brand name: Zovirax), famciclovir (brand name: Famvir) and valacyclovir (brand name: Valtrex) are all used for genital herpes. Your doctor can prescribe one of these medicines for you. They don't have many side effects, but they can be a little expensive.
How can I avoid getting genital herpes?
No vaccine can protect you from HSV infection, but you can do some things to prevent getting infected:
Limit the number of sexual partners you have in your lifetime.
Make sure that you and your sexual partner use condoms every time you have sex.
Consider sexual abstinence (not having sex until you're in a deeply committed relationship).
Don't have any kind of sex with someone who has herpes sores, itching or scabs, and remember that genital herpes can be spread even when there is no sign of a sore.
Always wash your hands after touching a cold sore.
This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at http://familydoctor.org.
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.
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