Knowing Causes of Genital Herpes May Save You from a Lifelong Herpes Infection

One of the distressing realities of modern lifestyles is that couples don't always know that they have sexually transmitted diseases. Nearly 50 per cent of all adults in the United States, for example, have antibodies for the herpesvirus, either HSV-1 or HSV-2, either of which can be causes of genital herpes.

Most people who have been exposed to one or both of these viruses did not get them during sex. Most commonly, North Americans get the virus as infants and toddlers from the saliva of other infants and toddlers who are infected. But the virus stays in the body indefinitely, and it can be spread in sexual intercourse even when there are no sores.

Here are some facts every sexually active person needs to know about herpes and related viral infections.

  • By age 50, about 25 per cent of American men who are not in a relationship have a history with HSV-2, the kind of herpes that causes more severe symptoms (both orally and genitally).
  • By age 50, about 50 per cent of American women who are not in a relationship have a history with HSV-2.
  • Doing random blood samples, the American Centers for Disease Control found that 81.1 per cent of adults who had had an HSV-2 infection had never been diagnosed by a doctor as having the disease.
  • One survey found that about 21 per cent of heterosexual couples who "always" used condoms or who only "made out" rather than having vaginal intercourse than nonetheless transmitted the herpesvirus.
  • Infection with HSV-2 increases risk of infection with HIV.

Herpes is very common, and most people who have it don't know they have it. So, aside from monogamous relationships, how can people keep from getting the disease? It turns out the condoms are not the only way to prevent transmission of the virus.

  • Among the most important genital herpes causes are various stresses on the immune system. Avoiding sex after getting a flu shot, avoiding unprotected sex if you use an asthma inhaler every day, and avoiding sex after you know you have been exposed to toxic fumes (such as stripping paint, cleaning silverware, and steam cleaning synthetic carpets) might keep you from transmitting, or receiving, the herpesvirus.
  • Getting enough beta-carotene and vitamin A in your diet may also help prevent transmission of the virus. One study found that female sex workers who took a vitamin A capsule every day (don't take more than 5,000 IU a day) were 47 times less likely to transmit viruses during unprotected sex.
  • Researchers in India have found that wearing cotton underwear, bathing daily, and keeping the crotch dry seem to reduce the frequency of herpes outbreaks and also reduce transmission.

Antiviral drugs are usually recommended for suppressing outbreaks in infected individuals. Drugs and dosages are typically used all the time in people who have six or more outbreaks a year, but only at the beginning of an outbreak by people who have fewer that six outbreaks a year. But that leads to a very important question:

How can you know you are at risk of transmitting herpes?

If you have a tingly feeling in your genitals, in your mouth, or on your lips, it could be a sign of the virus activating itself. This is a time to avoid unprotected contact, the most important cause of genital herpes.

The problem is that it is possible to shed the virus even when you don't have the tingly, itchy, burning feeling that precedes outbreaks of genital herpes. Causes of outbreaks don't matter as much as using protection every time you have sex.

Selected References:

Freeman EE, Weiss HA, Glynn JR, Cross PL, Whitworth JA, Hayes RJ. Herpes simplex virus 2 infection increases HIV acquisition in men and women: systematic review and meta-analysis of longitudinal studies. AIDS 2006;20:73-83.

Xu F, Sternberg MR, Kottiri BJ, et al. Trends in herpes simplex virus type 1 and type 2 seroprevalence in the United States. JAMA 2006;296:964-73.

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