What are the triggers for genital herpes outbreaks. How can symptoms be relieved at home. What medications are available for treating genital herpes. How can future outbreaks be reduced. What precautions should be taken to prevent spreading herpes.

Understanding Genital Herpes: Causes and Outbreak Patterns

Genital herpes is a common sexually transmitted infection caused by the herpes simplex virus (HSV). There are two types of HSV: HSV-1 and HSV-2. While HSV-1 typically causes oral herpes, it can also cause genital herpes. HSV-2 is primarily responsible for genital herpes infections.

The herpes virus has a unique ability to remain dormant in the body for extended periods. It hides within nerve cells, lying in wait until certain triggers cause it to reactivate. This characteristic explains why people with genital herpes experience recurrent outbreaks throughout their lives.

What triggers genital herpes outbreaks?

Several factors can trigger a herpes outbreak, including:

• Fatigue
• Genital irritation
• Menstruation
• Physical or emotional stress
• Injury to the affected area

It’s important to note that outbreak patterns vary widely among individuals with herpes. Some people may carry the virus without ever experiencing symptoms, while others may have frequent outbreaks occurring every 1 to 4 weeks. Many fall somewhere in between, with occasional outbreaks happening sporadically.

Self-Care Strategies for Managing Genital Herpes Symptoms

When experiencing a genital herpes outbreak, several self-care measures can help alleviate discomfort and promote healing:

How can pain and itching be relieved during an outbreak?

• Take over-the-counter pain relievers such as acetaminophen, ibuprofen, or aspirin
• Apply cool compresses to sores several times a day
• For women with sores on the vaginal lips (labia), urinating in a tub of water can help reduce pain

What steps can be taken to promote healing of herpes sores?

1. Gently wash sores with soap and water, then pat dry
2. Allow sores to air dry instead of bandaging them
3. Avoid picking at sores to prevent infection and slow healing
4. Refrain from applying ointments or lotions unless prescribed by a healthcare provider
5. Wear loose-fitting cotton underwear and avoid tight-fitting pants
6. Steer clear of nylon or synthetic underwear and pantyhose

Medical Treatments for Genital Herpes

While there is no cure for genital herpes, antiviral medications can effectively manage symptoms and reduce outbreak frequency.

What medications are used to treat genital herpes?

The primary medications used to treat genital herpes are antiviral drugs, including acyclovir and related compounds. These medications can relieve pain and discomfort, accelerate outbreak resolution, and decrease the frequency of future outbreaks.

How are antiviral medications administered for genital herpes?

There are two main approaches to taking antiviral medication for genital herpes:

1. Episodic therapy: Taking the medication for 7 to 10 days when symptoms occur to shorten the duration of the outbreak
2. Suppressive therapy: Taking the medication daily to prevent outbreaks from occurring

Both methods can be effective, and the choice between them often depends on the frequency of outbreaks and personal preference.

Are there any side effects associated with genital herpes medications?

Generally, antiviral medications for genital herpes have few side effects. However, when they do occur, potential side effects may include:

• Fatigue
• Headache
• Nausea and vomiting
• Rash
• Seizures (rare)
• Tremor

Strategies for Reducing Future Herpes Outbreaks

While it’s not always possible to prevent herpes outbreaks entirely, several strategies can help minimize their frequency and severity:

How can lifestyle changes help reduce herpes outbreaks?

• Get adequate sleep to maintain a strong immune system
• Eat a balanced, nutritious diet to support overall health
• Manage stress through relaxation techniques, exercise, or counseling
• Protect yourself from environmental stressors like extreme temperatures, sun exposure, and wind

Can daily antiviral medication prevent herpes outbreaks?

Yes, taking antiviral medication daily (suppressive therapy) can significantly reduce the frequency of outbreaks for many individuals. This approach can be particularly beneficial for those who experience frequent recurrences or wish to minimize the risk of transmission to sexual partners.

Preventing the Spread of Genital Herpes

Individuals with genital herpes have a responsibility to take precautions to avoid transmitting the virus to others. It’s crucial to understand that the virus can be shed even when no visible symptoms are present.

What precautions should be taken to prevent spreading genital herpes?

1. Disclose your herpes status to sexual partners before engaging in sexual activity
2. Use latex or polyurethane condoms during sexual intercourse
3. Avoid sexual contact during symptomatic outbreaks
4. Refrain from oral sex when experiencing oral herpes symptoms
5. Do not share personal items such as towels, toothbrushes, or lipstick
6. Wash hands thoroughly with soap and water after touching a sore
7. Consider daily antiviral medication to reduce viral shedding and transmission risk

Living with Genital Herpes: Emotional and Psychological Aspects

A genital herpes diagnosis can have significant emotional and psychological impacts. It’s essential to address these aspects of living with the condition for overall well-being.

How can individuals cope with the emotional impact of a genital herpes diagnosis?

• Seek support from trusted friends, family members, or support groups
• Consider counseling or therapy to work through feelings of shame, anxiety, or depression
• Educate yourself about the condition to dispel myths and reduce fears
• Practice self-compassion and remember that herpes is a common condition that doesn’t define your worth

How can open communication about genital herpes improve relationships?

Open and honest communication about genital herpes can strengthen relationships by:

• Building trust and intimacy
• Reducing anxiety about transmission
• Allowing partners to make informed decisions about sexual health
• Promoting shared responsibility for sexual health in the relationship

Advances in Genital Herpes Research and Future Treatment Prospects

While current treatments for genital herpes focus on managing symptoms and reducing outbreaks, ongoing research aims to develop more effective therapies and potential cures.

What are some promising areas of research in genital herpes treatment?

• Development of therapeutic vaccines to boost the immune system’s response to the virus
• Gene editing techniques to remove the virus from infected cells
• Novel antiviral compounds that target different stages of the viral life cycle
• Immunotherapy approaches to enhance the body’s natural defenses against the virus

While these research areas show promise, it’s important to note that developing new treatments and potential cures for genital herpes is a complex and time-consuming process. In the meantime, individuals with genital herpes can effectively manage their condition through a combination of medical treatments, self-care strategies, and lifestyle modifications.

Navigating Sexual Health with Genital Herpes

Living with genital herpes doesn’t mean giving up on a fulfilling sex life. With proper precautions and open communication, individuals with herpes can maintain healthy sexual relationships.

How can individuals with genital herpes maintain a healthy sex life?

• Practice safe sex by using condoms and dental dams
• Communicate openly with partners about herpes status and risks
• Consider suppressive antiviral therapy to reduce transmission risk
• Explore non-penetrative forms of sexual intimacy during outbreaks
• Stay informed about the latest research on herpes transmission and prevention

What role do regular check-ups play in managing genital herpes?

Regular medical check-ups are crucial for individuals with genital herpes. These appointments allow healthcare providers to:

1. Monitor the frequency and severity of outbreaks
2. Adjust treatment plans as needed
3. Address any complications or concerns
4. Provide updates on new treatment options or research developments
5. Offer guidance on sexual health and relationship issues

By maintaining open lines of communication with healthcare providers, individuals with genital herpes can ensure they receive the most appropriate and up-to-date care for their condition.

Complementary and Alternative Approaches to Herpes Management

While conventional medical treatments remain the cornerstone of genital herpes management, some individuals explore complementary and alternative approaches to support their overall well-being and potentially reduce outbreak frequency or severity.

What complementary therapies show promise in managing genital herpes?

• Stress-reduction techniques such as meditation, yoga, or tai chi
• Dietary supplements like lysine, zinc, or vitamin C (consult with a healthcare provider before use)
• Topical applications of natural substances like aloe vera or tea tree oil (use with caution and under medical guidance)
• Acupuncture for potential immune system support and stress reduction

It’s important to note that while some individuals report benefits from these approaches, scientific evidence supporting their effectiveness is often limited. Always consult with a healthcare provider before incorporating complementary therapies into your herpes management plan, especially to ensure they don’t interact with any prescribed medications.

How can a holistic approach benefit individuals with genital herpes?

A holistic approach to managing genital herpes considers not just the physical symptoms but also the emotional, psychological, and social aspects of living with the condition. This comprehensive strategy may include:

1. Conventional medical treatments
2. Lifestyle modifications for overall health
3. Stress management techniques
4. Emotional support and counseling
5. Nutritional guidance
6. Safe sexual practices and relationship support

By addressing all facets of well-being, individuals with genital herpes can often achieve better overall health outcomes and improved quality of life.

In conclusion, while genital herpes presents challenges, it is a manageable condition with proper care, treatment, and support. By staying informed, working closely with healthcare providers, and adopting a comprehensive approach to health, individuals with genital herpes can lead fulfilling lives and maintain healthy relationships. As research continues to advance, there is hope for even more effective treatments and management strategies in the future.

Genital herpes – self-care Information | Mount Sinai

Herpes – genital – self-care; Herpes simplex – genital – self-care; Herpesvirus 2 – self-care; HSV-2 – self-care

Future Outbreaks

One type of herpes virus stays in the body by hiding within nerve cells. It can remain “asleep” (dormant) for a long time. The virus can “wake up” (reactivate) at any time. This can be triggered by:

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

The pattern of outbreaks varies widely in people with herpes. Some people carry the virus even though they’ve never had symptoms. Others may have only one outbreak or outbreaks that occur rarely. Some people have regular outbreaks that occur every 1 to 4 weeks.

Self-care

To ease symptoms:

• Take acetaminophen, ibuprofen, or aspirin to relieve pain.
• Apply cool compresses to sores several times a day to relieve pain and itching.
• Women with sores on the vaginal lips (labia) can try urinating in a tub of water to avoid pain.

Doing the following may help sores heal:

• Wash sores gently with soap and water. Then pat dry.
• Do not bandage sores. Air speeds healing.
• Do not pick at sores. They can get infected, which slows healing.
• Do not use ointment or lotion on sores unless your provider prescribes it.

Wear loose-fitting cotton underwear. Do not wear nylon or other synthetic pantyhose or underwear. Also, do not wear tight-fitting pants.

Medicine

Genital herpes cannot be cured. Antiviral medicine (acyclovir and related drugs) may relieve pain and discomfort and help the outbreak go away faster. It may also reduce the number of outbreaks. Follow your provider’s instructions about how to take this medicine if it has been prescribed. There are two ways to take it:

• One way is to take it for about 7 to 10 days only when symptoms occur. This typically shortens the time it takes for symptoms to clear up.
• The other is to take it daily to prevent outbreaks.

Generally, there are very few if any side effects from this medicine. If they occur, side effects may include:

• Fatigue
• Headache
• Nausea and vomiting
• Rash
• Seizures
• Tremor

Reducing Outbreaks

Consider taking antiviral medicine daily to keep outbreaks from developing.

Taking steps to keep yourself healthy can also minimize the risk for future outbreaks. Things you can do include:

• Get plenty of sleep. This helps keep your immune system strong.
• Eat healthy foods. Good nutrition also helps your immune system stay strong.
• Keep stress low. Constant stress can weaken your immune system.
• Protect yourself from the sun, wind, and extreme cold and heat. Use sunscreen, especially on your lips. On windy, cold, or hot days, stay indoors or take steps to guard against the weather.

Preventing the Spread of Herpes

Even when you do not have sores, you can pass (shed) the virus to someone during sexual or other close contact. To protect others:

• Let any sexual partner know that you have herpes before having sex. Allow them to decide what to do.
• Use latex or polyurethane condoms, and avoid sex during symptomatic outbreaks.
• Do not have vaginal, anal, or oral sex when you have sores on or near the genitals, anus, or mouth.
• Do not kiss or have oral sex when you have a sore on the lips or inside the mouth.
• Do not share your towels, toothbrush, or lipstick. Make sure dishes and utensils you use are washed well with detergent before others use them.
• Wash your hands well with soap and water after touching a sore.
• Consider using daily antiviral medicine to limit viral shedding and reduce the risk of passing the virus to your partner.
• You may also want to consider getting your partner tested even if they have never had an outbreak. If you both have the herpes virus, there is no risk for transmission.

When to Call the Doctor

Contact your provider if you have any of the following:

• Symptoms of an outbreak that worsen despite medicine and self-care
• Symptoms that include severe pain and sores that do not heal
• Frequent outbreaks
• Outbreaks during pregnancy

Eckert LO, Lentz GM. Genital tract infections: vulva, vagina, cervix, toxic shock syndrome, endometritis, and salpingitis. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 23.

Whitley RJ, Gnann JW. Herpes simplex virus infections. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 350.

Workowski KA, Bachmann LH, Chan PA, et al. Sexually transmitted infections treatment guidelines, 2021. MMWR Recomm Rep. 2021;70(4):1-187. PMID: 34292926 pubmed.ncbi.nlm.nih.gov/34292926/.

Last reviewed on: 11/10/2022

Reviewed by: John D. Jacobson, MD, Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Genital herpes – Better Health Channel

About genital herpes

Genital herpes is a common sexually transmissible infection (STI) caused by the herpes simplex virus (HSV). There are two forms of HSV – HSV1 and HSV2. HSV1 occurs more commonly around the mouth, but it can also occur on the genitals. HSV2 occurs mainly in and around the genital area.

It is estimated that about one in eight people have HSV 2 and about 80% of those infected may be unaware that they have HSV2. It’s often not possible to tell when a person first acquired the HSV infection as the first symptoms may appear weeks to years later, if at all.

There is no cure for genital herpes, but medication can help manage and reduce the severity of symptoms, and also reduce the frequency of recurrences and reduce the risk of spread.

Many people are anxious about herpes, but it’s important to remember that it only affects the skin for relatively short periods of time, and most people only have a few recurrences.

Pregnant women with genital herpes should discuss this with their antenatal care provider, as herpes infection can be transmitted to the baby during pregnancy and delivery, leading to serious illness.

Genital herpes is spread by skin-to-skin contact

The herpes virus is spread by skin-to-skin contact and can be transmitted during vaginal, oral or anal sex. The infection can occur anywhere on the genitals, in areas around the groin or pubic area, and in or around the anus. Cold sores on the mouth can cause genital infection during oral sex for those who do not already have the cold sore virus.

The virus can be spread when someone with HSV has an ‘episode’ or an outbreak – characterised by having a sore, blister, ulcer or skin split (this is known as viral shedding). It can also be spread between episodes, when there is no sore, blister, ulcer or skin split present – called asymptomatic viral shedding.

During viral shedding the virus is on the skin surface and can be spread through genital skin-to-skin contact, or from the mouth or face to genital skin during contact.

Symptoms of genital herpes

Many people who have genital herpes may not be aware they have the infection, because they may not have any symptoms.

The first episode of herpes can cause considerable pain and distress. Symptoms of the first episode may include:

• flu-like symptoms – such as feeling unwell, headaches and pains in the back and legs, with or without enlarged glands in the groin
• small blisters around the genitals – these break open to form shallow, painful ulcers, which scab over and heal after one to two weeks
• small cracks in the skin with or without an itch or tingling
• redness or a distinct rash
• some people also have considerable pain and swelling in the genital area, and hence may have additional pain and difficulty passing urine.

Recurrent episodes of genital herpes

Recurrences are usually less painful and shorter in duration than the first episode of genital herpes. Over time, episodes usually become less frequent and may eventually stop altogether. Infections caused by HSV1 are less likely to recur in the genital area than infections caused by HSV2.

Recurrences may be triggered by:

• stress
• menstruation
• sexual activity
• general illness
• low immunity (such as during cancer treatment)
• no apparent reason noted.

Diagnosis of genital herpes

If you think you have herpes, your doctor will need to take a swab from the affected area to confirm the diagnosis. On rare occasions, your doctor will also do a blood test to help with the diagnosis. Discuss this with your doctor.

Treatment for genital herpes

There is no medication to cure your body of the herpes virus. Treatment is aimed at easing symptoms, reducing the frequency of recurrences and reducing transmission.

Symptoms can be improved by:

• salt baths
• ice packs to the affected area
• pain-relieving medication – such as paracetamol
• antiviral medication – such as acyclovir, famciclovir and valaciclovir. These can reduce the severity of an episode if taken early enough (preferably as soon as you become aware of any symptoms appearing). Topical antivirals usually used for cold sores on the lips or face are not suitable for use on the genitals.

Preventing recurrences of genital herpes

If you have frequent episodes, antiviral medication may be taken daily to reduce the likelihood of symptoms. You will need a prescription from your GP.

Prevention of genital herpes

The best protection against STIs is to always use barrier protection such as condoms, female condoms and dams (a thin piece of latex placed over the anal or vulvar area during oral sex). Because herpes is spread by skin-to-skin contact, condoms will reduce the risk of transmission, but it will not protect sexual partners completely as condoms do not cover the entire genitals.

Using lubricant with a condom during sex will also reduce the risk of trauma to the genital skin. This has been shown to reduce HSV transmission, especially in the first six months of a sexual relationship. Silicone-based lubricants are recommended.

Remember that herpes transmission can occur when symptoms are present (such as a sore or blister), but may also occur even if there are no genital symptoms through asymptomatic viral shedding.

For people who have frequent episodes of genital herpes, antiviral medication, taken daily, helps to reduce transmission of herpes to a sexual partner.

Pregnancy and genital herpes

Herpes infection may be transmitted to the baby during pregnancy and delivery, leading to serious illness. Although this is not common, let your midwife or obstetrician know if you have ever had a diagnosis of genital herpes, in the past or during your pregnancy.

Support and advice for genital herpes

If you have just found out you have genital herpes, you may feel shocked and may have a lot of questions. It may help you to gather as much information as you can about herpes. This can help you to make fully informed decisions about your treatment, safe sex and preventing further recurrences. Talking to a counsellor about your concerns may also help.

Where to get help

• Your GP (doctor)
• Sexual Health Victoria (SHV)External Link. To book an appointment call SHV Melbourne CBD Clinic: (03) 9660 4700 or call SHV Box Hill Clinic: (03) 9257 0100 or (free call): 1800 013 952. These services are youth friendly.
• Melbourne Sexual Health CentreExternal Link Tel. (03) 9341 6200 or 1800 032 017 or TTY (for the hearing impaired) (03) 9347 8619
• Thorne Harbour HealthExternal Link (formerly Victorian AIDS Council) Tel. (03) 9865 6700 or 1800 134 840
• Ballarat Community Health Sexual Health ClinicExternal Link Tel. (03) 5338 4500
• Bendigo Community Health Sexual Health ClinicExternal Link Tel. (03) 5434 4300 Or (03) 5448 1600
• Gateway Health Clinic 35External Link, Wodonga Tel. (02) 6022 8888 or 1800657 573
• Sunraysia Community Health ServicesExternal Link Tel. (03) 5022 5444
• Barwon Health Sexual Health ClinicExternal Link Tel. (03) 5226 7489
• 1800MyOptionsExternal Link Tel:1800 696784 is a statewide phone service for information about sexual health as well as contraception and pregnancy options

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