Genital herpes Health Article

Definition

Genital herpes is a sexually transmitted viral infection affecting the skin or mucous membranes of the genitals.

Alternative Names

Herpes - genital; Herpes simplex - genital; Herpesvirus 2; HSV-2

Causes, incidence, and risk factors

Genital herpes is caused by two viruses:

• Herpes simplex virus type 2 (HSV-2)
• Herpes simplex virus type 1 (HSV-1)

Herpes simplex virus type 2 (HSV-2) causes most cases of genital herpes. HSV-2 can be spread through secretions from the mouth or genitals.

Herpes simplex virus type 1 (HSV-1) most often causes herpes infections of the mouth and lips (commonly called cold sores or fever blisters). HSV-1 can spread from the mouth to the genitals during oral sex.

Herpes simplex virus (HSV) is spread from one person to another during sexual contact. You may be infected with herpes when your skin, vagina, penis, or mouth comes into contact with someone who already has herpes.

Herpes is most likely to be transmitted by contact with the skin of an infected person who has visible sores, blisters, or a rash (an active outbreak), but you can also catch herpes from an infected person's skin when they have NO visible sores present (and the person may not even know that he or she is infected), or from an infected persons mouth (saliva) or vaginal fluids.

Because the virus can be spread even when there are no symptoms or sores present, a sexual partner who has been infected with herpes in the past but has no active herpes sores can still pass the infection on to others.

Genital HSV-2 infections is more common in women (approximately 1 of every 4 women is infected) than it is in men (nearly 1 of every 8 men is infected).

Symptoms

Many people with HSV-2 infection never have sores, or they have very mild symptoms that they do not even notice or mistake for insect bites or another skin condition.

If signs and symptoms do occur during the first outbreak, they can be quite severe. This first outbreak usually happens within 2 weeks of being infected.

Generalized or whole-body (systemic) symptoms may include:

• Decreased appetite
• Fever
• General sick feeling (Malaise)
• Muscle aches in the lower back, buttocks, thighs, or knees

Genital symptoms include the appearance of small, painful blisters filled with clear or straw-colored fluid. They are usually found:

• In women: on the outer vaginal lips (labia), vagina, cervix, around the anus, and on the thighs or buttocks
• In men: on the penis, scrotum, around the anus, on the thighs or buttocks
• In both sexes: on the tongue, mouth, eyes, gums, lips, fingers, and other parts of the body
• Before the blisters appear, the person may feel the skin tingling, burning, itching, or have pain at the site where the blisters will appear
• When the blisters break, they leave shallow ulcers that are very painful. These ulcers eventually crust over and slowly heal over 7 - 14 days or more

Other symptoms that may occur include:

• Enlarged and tender lymph nodes in the groin during an outbreak
• Painful urination
• Women may have vaginal discharge or, occasionally, be unable to empty the bladder and require a urinary catheter

A second outbreak can appear weeks or months after the first. It is almost always less severe and shorter than the first outbreak. Over time, the number of outbreaks tends to decrease.

Once a person is infected, however, the virus hides within nerve cells and remains in the body. The virus can remain "asleep" (dormant) for a long period of time (this is called latency).

The infection can flare-up or reactivate at any time. Events that can trigger latent infection to become active and bring on an outbreak include:

• Fatigue
• Genital irritation
• Menstruation
• Physical or emotional stress
• Trauma

Attacks can recur as seldom as once per year, or so often that the symptoms seem continuous. Recurrent infections in men are generally milder and shorter than those in women.