Genital Herpes

In most cases, the bothersome blisters go away on their own after a while. However, the person affected remains contagious. The symptoms often return after a while. Medications cannot cure genital herpes simplex; they can only reduce the symptoms and prevent those affected from passing the virus on to others.

Overview: What Is Genital Herpes Simplex?

Genital herpes is a viral infection. There are two different types of herpes viruses that cause genital herpes:

• Herpes simplex virus type 1 (HSV-1) is primarily responsible for cold sores, but it can also cause genital herpes. They are very common in Europe. Many people become infected with this virus as toddlers.
• Herpes simplex virus type 2 (HSV-2) causes genital herpes. They are usually transmitted through sexual contact.

In addition, there are other types of herpes viruses; herpes zoster, for example, causes shingles.

Infection with herpes simplex often occurs well before the first symptoms appear. Type 2 viruses usually enter the body through the mucous membranes during sexual intercourse. They travel along the nerve pathways (axons) to the nerve ganglia and infect them as well. Although the immune system can eliminate many of these viruses, the genetic material (DNA) of herpes viruses hides in the cell nuclei of nerve cells. There, it can remain undetected for a lifetime and continue to produce new herpes viruses. Once the immune system is weakened, the virus’s DNA reactivates and produces countless new viruses. This causes a secondary infection—often accompanied by the typical blisters on the mucous membranes or skin.

How can I get genital herpes?

Genital herpes simplex viruses can be transmitted in various ways:

• from the mother to the infant at birth
• as a toddler who puts a lot of things in his mouth (especially HSV-1)
• during petting and kissing
• during sexual intercourse in all forms

The virus is transmitted through vaginal and prostate secretions, as well as through saliva and semen. The risk of infection is particularly high from the fluid inside the herpes blisters. The viruses are then absorbed through the mucous membranes or through tiny breaks in the skin. During oral sex, herpes viruses are transmitted from the lips to the genitals and vice versa. The incubation period for the virus is three to seven days.

Genital Herpes: Prevalence and Age

Genital herpes affects men and women equally and is found all over the world. In Switzerland, about 70 percent of all adults are infected with the herpes simplex virus type 1 (HSV-1). Herpes simplex type 2 viruses can be detected in one out of every five people. Experts estimate that one in every 25 Swiss people experiences symptoms of genital herpes, and three have genital herpes without knowing it. The prevalence of genital herpes caused by HSV-1 has increased significantly in recent years. Medical professionals attribute this, among other things, to changes in sexual practices. In people who have been infected with HSV-1 for some time, symptoms on the genitals are less severe or may not appear at all after infection with HSV-2. However, even without symptoms, such a person is contagious. Diseases caused by HSV-2 occur more frequently with advancing age and an increasing number of sexual partners.

Genital Herpes: Causes and Risk Factors

Genital herpes is caused by a viral infection. The risk of transmission from a man to a woman is about five times higher than the other way around. If you use a condom during sexual intercourse, you can significantly reduce the risk of transmission. However, the viruses may still be transmitted despite this protection, as they often spread to the surrounding skin as well. However, the viruses are often already present in the body for a long time before the disease becomes apparent with the characteristic blisters. A herpes infection cannot be reversed. The more frequently a person changes sexual partners, the higher the risk of infection. Unprotected sexual contact significantly increases the risk compared to using condoms.

The following factors may trigger symptoms or cause the virus to reactivate:

• Stress
• Skin Irritations/Injuries
• Fever
• Sunburn
• Hormonal fluctuations (such as those associated with the menstrual cycle)
• Pneumonia
• Cancer
• Irritation of the infected nerve node (such as from inflammation or dental treatment)

Symptoms: Genital herpes manifests as painful blisters

There are people who never realize they have genital herpes. Her symptoms are so mild that she doesn’t even notice them. In many cases, the infection is completely asymptomatic. Nevertheless, these people can still spread the virus. Other people affected suffer greatly from the symptoms:

• The skin becomes red, burns, and itches.
• Blisters form with pus-filled, crusty coatings. They are often very painful.
• The inguinal lymph nodes are swollen.
• You are having trouble urinating.
• Fever
• Headaches, Muscle Aches, Back Pain

In most cases, the blisters heal within two to three weeks. However, the condition can flare up again at any time later on—for example, during times of stress. In most cases, such a recurrence is accompanied by milder symptoms.

Clinical Presentation: Diagnosis by a Doctor

Of course, we’ll take a look at the affected area first. In the early stages, the typical blisters may not yet be present. The mucous membrane is usually reddened and tender. As a result, the viral infection can easily be mistaken for a fungal infection in its early stages. The situation is clear when there are inflamed blisters on the genitals. Then we’ll take a swab of the mucous membrane, preferably from an area with a newly ruptured blister. We’ll send this swab to the lab. There, DNA testing is used to determine whether a person has a genital herpes simplex infection and which of the two viral strains is responsible.

Genital Herpes: Prevention, Early Detection, Prognosis

There is currently no vaccine against herpes viruses. You can only prevent it by exercising caution during sexual contact. Condoms offer some protection against herpes infection, but not complete protection. If you are already infected, you should inform your sexual partners. If you notice any blisters on yourself, you should touch them as little as possible and wash your hands thoroughly after touching them. As soon as symptoms appear, you should consult a specialist. The frequency with which the unpleasant symptoms of genital herpes subsequently reappear varies greatly from case to case. Some people are never bothered by it again, while others take medication repeatedly to manage the condition.

Complications Associated with Genital Herpes

In some cases, complications may arise: If the immune system is weakened, genital herpes can spread to the brain and become life-threatening. It is relatively common for fungi or bacteria to enter the body through the resulting wound after the blisters burst, leading to a secondary infection (superinfection). In contrast, infections of the central nervous system, the lungs, or the liver caused by HSV-2 are very rare. However, HSVsepsis can be life-threatening.

Infections caused by genital herpes are extremely dangerous for newborns. In these individuals, herpes viruses easily trigger encephalitis (herpes encephalitis). For this reason, many experts recommend a cesarean section for women with genital herpes. Pregnant women should therefore be sure to inform their doctor if they have a genital herpes infection. Visitors with an HSV infection should also avoid direct contact with newborns.

Course and Prognosis of Genital Herpes

After treatment with an antiviral ointment or pills, the blisters usually heal within two to three weeks. However, the virus itself remains in the body and cannot be eliminated. That is why the disease can flare up again at any time, especially when the immune system is weakened. For genital herpes simplex, the risk of a recurrence is 60 to 70 percent. This means that about two out of three people affected will experience a recurrence of the disease at some point in the future, either once or multiple times.

Genital Herpes: Treatment with Ointments and Tablets

If you have genital herpes, you should avoid sexual contact until your symptoms subside. Your sexual partner should also get tested for herpes simplex viruses if they have symptoms and seek treatment if necessary. After all, there is a high risk that he or she has already been infected.