Sexually Transmitted Infections: Genital Herpes

Genital Herpes is a Sexually Transmitted Infection (STI) cause by herpes simplex virus (HSV). It can be passed on via contact through vaginal, anal or oral sex. The symptom usually clears up on its own. The virus will then stay quiescent in your body’s nerve system. Triggers such as UV light, low immune system, unwell, lack of sleep, stress, menses, genital area friction by tight clothing, can cause flare up of the virus, and manifestation of recurrent symptoms.

Genital herpes can be caused by HSV type 1 and 2. In the past, genital herpes are associated with HSV type 2 and oral herpes are associated with HSV type 1. In view of human evolution and change of sexual orientation, the type of HSV no longer determine the location of lesion.

Symptoms of Genital Herpes

  • Small blisters (water bubble) and sores that are red and painful over your genitals, anus, inner thigh region
  • Tingling, burning sensation over the genital region
  • Painful urination
  • In female, abnormal vaginal discharge

Symptoms may not appear for weeks, months or even years after you are exposed to the herpes virus.

What do I expect when I consult my doctor?

Your doctor will enquire history in particular on your symptoms and sexual history. Your blisters or sores will be examined as part of the physical examination. Depending on the lesion, your doctor may offer a swab test to obtain a fluid sample from your lesions. You may be offered blood tests (serological tests) to see whether you have been exposed before by the virus or any recent viral activity.

What are the treatment options for Genital Herpes?

There is no cure for herpes. However, medical treatment is still offered to reduce the severity and duration of the infection. Having said that medical therapy does not alter the natural course of genital herpes infection.

Treatment for Genital Herpes for the First Time

  • Oral antiviral medication (such as Acyclovir, Famciclovir, Valaciclovir).
    This is advisable to be taken within 5 days of onset of lesions. If your lesion is more than 5 days of duration, your doctor will discuss with you the pros and cons of medication and efficacy of oral medication in your individual case.
  • Cream to apply to ease the pain

Treatment for Recurring Genital Herpes

Recurring episodes of genital herpes tend to be milder in comparison to the first episode. Over time, one will slowly have less breakouts. The lucky ones, may even no longer have any herpes breakouts.

Antiviral medication may help shorten the outbreak by 1-2 days if you start taking as soon as possible when the symptoms occur.

If you notice you have more than 6 breakouts per year and it is affecting your quality of life, speak to your doctor for longer-term antiviral medication to suppress the virus. This typically involves taking the medication for a course of 6-12 months.

What can I do if I have Genital Herpes?

  • Keep the affected area clean, avoid the blisters getting infected
  • Consider Vaseline or numbing cream such as lidocaine gel to reduce pain over affected area
  • Wash your hands before and after contact with the affected area
  • Avoid tight and non-airy cloths over affected area
  • Avoid touching or picking on affected area
  • Abstain from sexual intercourse until lesions have resolved
  • Avoid sharing sex toys with someone who has herpes

Living with Herpes and other medical conditions such as HIV, pregnancy

People with HIV may have a more severe form of genital herpes in view of low immune system. Speak to your doctor about treatment options.

Female who are pregnant and have genital herpes should inform their obstetrician and sought treatment as there is a risk of passing herpes to the baby leading to a condition known as neonatal herpes that may be fatal.

Your doctor may offer antiviral treatment

  • during outbreaks in pregnancy,
  • from 36 weeks onwards to reduce chance of outbreak during birth,
  • from time of diagnosis until labor if your first herpes outbreak is after 28 weeks of pregnancy.

In cases of high risk, or your outbreak is close to delivery, your obstetrician may offer you a cesarean surgery to reduce risks of transmission to the baby.

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