Genital Herpes - Causes, Symptoms, Diagnosis and Treatment

Medically Reviewed by Dr Sravya, MBBS, MS

Introduction

A typical and contagious viral infection, genital herpes is typically spread through sexual contact. It can affect both sexes and is brought on by the herpes simplex virus (HSV). During the early outbreak, the infection also exhibits uncomfortable sores or blisters in the vaginal or anal areas, as well as flu-like symptoms. HSV-1 and HSV-2 are the two varieties of the herpes simplex virus.

While HSV-1 frequently causes oral herpes, HSV-2 is typically to blame for genital herpes. But both can spread genital diseases through sexual activity or oral-genital contact.

Antiviral drugs can help manage symptoms, lessen the frequency and intensity of outbreaks, and limit the risk of transmission to sexual partners even though genital herpes is a chronic disorder with no known cure. Genital herpes can be controlled by prevention measures including safe sex practices and open communication with partners.

Table of Contents

Symptoms

A sexually transmitted infection (STI) known as genital herpes is brought on by the herpes simplex virus (HSV), which has two main strains: HSV-1 and HSV-2. Genital herpes symptoms might differ from person to person and can alter over time. The specifics of typical genital herpes symptoms are as follows:

1.Primary Outbreak

The first genital herpes outbreak is frequently the worst.
2 to 12 days after the virus has been exposed, symptoms usually start to show.
On or around the genitals, anus, thighs, or buttocks, painful, little, red pimples or tiny blisters may develop.
These blisters have the potential to burst, causing painful, shallow ulcers or sores.
Itching, burning, and discomfort in the affected area are additional typical symptoms.
Genital and anal areas frequently experience swelling and redness.

2. Flu-Like Symptoms

During the initial outbreak, some people with genital herpes may exhibit flu-like symptoms like a high temperature, headache, muscle pain, and swollen lymph nodes in the groyne area.

3. Recurrence

The virus may sometimes reactivate in the nerve cells of the body after the initial infection.
Tingling, itching, or burning feelings in the vaginal region may be symptoms of a close-to-crisis.
A genital herpes recurrence is indicated by the formation of new, tiny, painful blisters or sores that can last for two to ten days.

4. Asymptomatic Shedding

Many genital herpes sufferers may be asymptomatic, or their symptoms may be so mild that they are not obvious.

The virus can still spread to sexual partners even when no visible signs are present because it is secreted from the skin and mucous membranes.

5. Complications

While genital herpes is mostly not life-threatening, it sometimes results in difficulties.

If the sores are close to the urethra, complications could include painful urination, discomfort urinating, and subsequent bacterial infections of the sores.

Rarely, the virus can cause encephalitis or meningitis, especially in those with compromised immune systems.

Causes

The herpes simplex virus (HSV), which has two main strains: HSV-1 and HSV-2, is the principal cause of genital herpes. These viruses are extremely infectious and can spread via a variety of channels, frequently via direct skin-to-skin contact. The main points regarding the causes of genital herpes are as follows:

1. Herpes Simplex Virus (HSV):

1. HSV-1: This strain frequently results in cold sores or blisters with a fever around the mouth and on the face and is linked to oral herpes. When spread through oral-genital contact, it might, nevertheless, result in genital herpes.
2. HSV-2: The more frequent cause of genital herpes is HSV-2. It spreads through sexual contact, including vaginal, anal, and oral intercourse, and mostly affects the genitalia and anal regions.

2. Transmission

Direct Skin-to-Skin Contact: Contact with an infected person’s mucous membranes or skin is the most frequent method of transmission. This might happen during oral, anal, or vaginal sex as well as during sexual contact.

Asymptomatic Shedding: Individuals with genital herpes can still shed the virus and spread it to their partners even if no outward signs are present. It is difficult to completely stop the transmission because of this.

3. Risk Factors:

Sexual Activity: Having sex with a partner who has genital herpes increases your risk of getting it.

Several Sexual Partners: Having several partners might raise the chance of exposure, particularly if they have undiagnosed or untreated herpes infections.

Use of Condoms is Low: Condoms can lessen the danger, but they do not offer full protection because the virus can spread to places that are not covered by the condom

4. Vertical Transmission:

During childbirth, pregnant mothers with genital herpes might pass the virus on to their unborn children. The term “vertical gearbox” refers to this. To lessen the danger of transmission to the unborn child, a caesarean section (C-section) delivery may be suggested in such circumstances.

5. Autoinoculation:

Having oral herpes (HSV-1) makes it feasible for the virus to spread from the mouth to the genitalia during oral intercourse, for example. This may result in an HSV-1-related genital herpes infection.

6. The immune system includes

Herpes outbreaks can be prevented and controlled by strengthening the immune system. The frequency and intensity of outbreaks can be increased by stress, disease, or a compromised immune system.

Diagnosis

Clinical assessment, physical examination, and laboratory tests are often combined to diagnose genital herpes. The specifics of the genital herpes diagnosis procedure are as follows:

1. Clinical Evaluation

A healthcare professional will begin by gathering information about your medical history, including any instances of genital sores in the past, your sexual history, and any possible herpes virus exposure.

Additionally, they will inquire about symptoms, such as when, how frequently, and how severe an epidemic was.

2. Physical Examination:

The healthcare professional will visually examine the vaginal and anal areas during a physical examination to look for any indications of herpes lesions or sores.

Additionally, they might look for other signs like swollen lymph nodes in the groyne.

3. Testing in a laboratory:

Even while a clinical evaluation and physical examination are important diagnostic tools, genital herpes is frequently identified by laboratory testing, particularly in cases when there are no obvious signs or when the symptoms are unusual.

4. Viral Culture:

A viral culture entails obtaining a sample from an open blister or sore from the herpes virus. A laboratory will examine the sample to see if the herpes simplex virus (HSV) is present.

When conducted early in an infection while sores are still apparent, this test is most accurate.

5. PCR (Polymerase Chain Reaction) Test:

PCR testing is a highly sensitive technique that can find the herpes virus’ genetic material even when there are no outward signs of an infection.

It is considered one of the most reliable tests for diagnosing genital herpes.

6. Blood Tests:

Blood tests can find herpes virus antibodies. IgM and IgG blood tests are available for herpes.

IgM tests are generally not advised for the diagnosis of herpes since they are less reliable and can result in false-positive results.

IgG tests are more precise and can reveal whether a person has HSV-1 or HSV-2 infection. They are unable to determine whether the infection is oral or genital, though.

7. Western Blot Test:

The Western blot test is a highly specific blood test that can differentiate between HSV-1 and HSV-2 and confirm a herpes diagnosis. It is commonly employed to verify the outcomes of an IgG test that is positive.

It’s vital to remember that testing time management can have an impact on how accurate the results are. For instance, blood tests may not yield good findings until several weeks after infection, although viral cultures are most accurate when conducted during an active outbreak.

Treatment

Genital herpes treatment tries to control symptoms, lessen the frequency and intensity of outbreaks, and lower the danger of spreading the virus to sexual partners. While there is no known treatment for genital herpes, antiviral drugs can be useful in controlling the infection. The specifics of treating genital herpes are as follows:

1. Antiviral Drugs

Antiviral medications are the main course of treatment for genital herpes. They function by lowering the severity of symptoms, shortening the duration of crisis situations, and inhibiting the herpes virus.

The following antiviral drugs are frequently used for treating genital herpes: –

These drugs come in a variety of dosage forms, such as oral pills, topical creams, and intravenous (IV) formulations for more serious conditions.

2. Episodic Treatment:

Taking antiviral medication during an active outbreak to reduce symptoms and minimise the duration of the outbreak is known as episodic treatment.

Depending on how serious the outbreak is, the drug is normally taken for 5 to 10 days.

3. Suppressive Therapy:

Suppressive therapy entails taking antiviral medications every day to limit the intensity of symptoms, lower the frequency of irritation, and lower the risk of spreading the virus to sexual partners.

This method is advised for people who have frequent or severe outbreaks or for those who are in a discordant relationship with a partner who does not have herpes.

For long-term use, suppressive treatment is typically secure and well-tolerated.

4. Pain Relieving

Over-the-counter analgesics like acetaminophen or ibuprofen can help control the pain and discomfort brought on by genital herpes infections.

5. Topical Creams:

To ease itching and suffering during a crisis, several topical creams as well as ointments containing calming agents, like lidocaine, may be advised.

6. Hygiene and Comfort Measures:

Maintaining a clean, dry environment around the affected area can aid in healing and assist in fighting off additional bacterial infections.

7. Psychological Support:

Receiving a diagnosis of genital herpes can be emotionally taxing. Counselling and support groups can help people cope with the psychological effects of the disease and offer emotional support.

8. Regular Follow-Up:

Patients with genital herpes should schedule routine follow-up visits with their doctor to evaluate the efficacy of treatment, determine whether suppressive therapy is necessary, and address any worries or queries.

Conclusion

In conclusion, the herpes simplex virus, which is common in sexual activity, causes genital herpes. Although there is no cure, antiviral drugs can effectively control the condition by reducing the risk of transmission and treating the symptoms.

Herpes is a chronic infection that might recur despite therapy, so it’s crucial to keep that in mind. It’s essential to practise safe sex, use barrier techniques like condoms or dental dams, and have open conversations about sexual health in order to safeguard both you and your sexual partners.

Avoiding sexual activity while there is an outbreak or while prodromal signs like tingling or itching are present can also help stop transmission. Genital herpes requires constant management as well as emotional support because it can be stressful to live with the condition. People can live happy lives while controlling this widespread viral infection by seeking medical advice, following prescribed medicines, and leading a healthy lifestyle.