Genital herpes is one of the most contagious and common sexually transmitted diseases or STDs. However, because in most cases there are no symptoms, many people are unaware that they are infected, increasing the likelihood of transmitting the disease. The disease is caused by two types of virus: HSV-1, the herpes simplex virus type 1, which affects the mouth and lips but can be transmitted to the genitals, and HSV-2, the herpes simplex virus type 2, that typically causes genital herpes and is transmitted by skin contact or through oral and genital secretions.
Anyone who has sexual intercourse or is sexually active can contract genital herpes. Herpes is transmitted through direct skin-to-skin contact. The transmission occurs when the infected zone is in contact with a mucous membrane, such as the mouth and genitals. Most of the skin on the body is too thick for the virus to penetrate. If a person with oral herpes has oral sex, it is possible to pass herpes to a partner. If someone who has genital herpes, has sex, he or she will likely pass genital herpes to his or her partner.
Even without any symptoms, herpes can be transmitted from person to person. There are several days a year (called asymptomatic reactivation, i.e., a period of asymptomatic infection or a period of subclinical infection) when a person is in a contagious stage without having symptoms. At the onset of infection, the herpes simplex virus escapes immune defenses as it enters through nerve endings into the nerve ganglion. In the ganglion, the virus is inactive and does not cause any damage to the nerve fibers from time to time. However, the virus can reactivate. When reactivation happens, the virus begins a journey from the reservory in the nerve to the skin, where it can cause blisters and wounds. It then multiplies and causes another herpes outbreak. Repeat outbreaks usually develop near the site of the first infection but may be located in other areas. For example, some people may have recurrent herpes outbreaks on the genitals and, over a period of months or years, may have outbreaks on the buttocks.
Genital herpes often has no symptoms, or symptoms are so mild that they can be mistaken for bites. The first outbreak usually occurs two days to two weeks after infection, and symptoms include:
The consequences of getting herpes can include:
Systemic antiviral drugs (acyclovir, famciclovir, or valacyclovir) taken by mouth are the treatment of choice. They shorten viral replication, reduce symptoms and the duration of lesions. They are recommended during the first infection and recurrences. Administered prophylactically, they reduce the rate of recurrences but do not eradicate the virus. The doses are acyclovir 400 mg/8 h for 7 to 10 days, famciclovir 250 mg/8 h for 7 to 10 days, and valacyclovir 1g/12 h for 7 to 10 days. In recurrences, the same doses are used for five days. When recurrences are more than 6 per year, a prolonged regimen of 6 to 12 months with one of the above drugs at a lower dose, which varies according to the authors, is recommended.
Although there is no 100% effective method to prevent the spread of genital herpes except sexual abstinence, protecting yourself during sex by using a condom is the most effective way to reduce the risk of infection. The correct use of condoms is key to reduce the chances of infection with this type of disease; however, it only protects the area of the body that it covers, and only latex condoms prevent infection. Those made of other materials do not offer this protection against sexually transmitted diseases. It is important to bear in mind that, in order to reduce the risk, condoms must be used properly, so we invite you to consult our article How to put on a condom step by step so that you can be aware of its proper use.
Similarly, it is important to minimize situations in which the condom could break. If you know you are infected, you should avoid having sex, even if you are using a condom until the affected person has finished treatment and the symptoms have disappeared.
Genital herpes is a sexually transmitted infection (STI) caused by the herpes simplex virus that affects one in six people in the Western world.