Genital Herpes Facts – How to Know Whether You Have an STD or Some Other Problem

Nearly one out of every five adults in the United States has been infected with genital herpes-and half those infected don't know it. Since your sexual partner may not be able to protect you, it's up to you to protect yourself. Here are the ten genital herpes facts every sexually active person has to know.

  1. The herpesvirus does not distinguish between "oral" and "genital" sites for infection.

    2. There are two common kinds of herpes virus, herpes simplex virus 1, also known as HSV-1, and herpes simplex virus 2, also known as HSV-2. HSV-1 is commonly passed from toddler to toddler through shared saliva. HSV-2 is more commonly passed from adult to adult through sexual intercourse. HSV-1 usually causes cold sores. HSV-2 usually causes genital herpes lesions.

    But just because the virus usually infects one part of the body doesn't mean it can't infect the other. Oral sex can pass either form of herpes to either location of the body. If you have a pre-existing oral infection with HSV-1, however, you are less likely to catch HSV-2.

  2. The first bout of genital herpes is usually the worst.

    3. People who are newly infected with herpes after sexual intercourse don't have antibodies to the virus. That is why three to five days after exposure to herpes, the worst symptoms may set in. Different people, however, have different severity of symptoms.

    Some women develop oozing lesions in the cervix, sores on either side of the vagina, and blisters on the hips, anus, and thighs. Some men develop blisters on the penis from tip back along the shaft and also sores on the anus and hips.

    Some people, however, just have a headache, a mild fever, a little itching, and no other symptoms at all, ever. They can still pass the virus on to their sexual partners.

  3. You don't have to have a visible sore to pass the virus on to a sex partner.

    4. The herpes virus is passed by direct contact with infected skin, saliva, or sexual secretions. The blistering that goes along with herpes outbreaks is not actually caused by the virus. It's caused by the immune system's reaction to the virus. Even before the immune system tries to destroy infected tissue, the virus can build up to levels that can infect another person.

    There are rare occasions in which the herpes virus does not infect either the mouth or the genitals. Wrestlers, for example, may develop herpes infections of the skin anywhere they are in prolonged contact with an infected wrestler. Children sometimes develop herpes infections of the fingers caused by picking at scabs caused by fever blisters. The virus can lodge in the eyes, nose, and throat, waiting to be activated by immune deficiency conditions. You can't know you are safe just by looking at your sex partner.

  4. All genital sores are not caused by herpes.

    5. There are many other kinds of genital sores that are not caused by herpes. Chancroid sores, for instance, are transmitted almost exclusively through penile-vaginal intercourse, and they are caused by bacteria. These sores can cause scars on the genitals and lower abdomen, and they can also cause permanent swelling of the lymph glands, but the infection eventually passes.

    Yeast infections cause an itch similar to the very earliest stages of herpes, but they begin with a white, crusty area that later forms a rash, rather than blisters. Yeast infections can also be passed from partner to partner during sexual intercourse, but they are much easier to treat than herpes.

    In rare instances, shingles (herpes zoster) can cause blistering on the genitals, but this close relative of the herpesviruses that can genital herpes is more likely to break out in lines following nerves on the trunk or face. People get shingles after they are infected with chicken pox, sometimes as long as 60 to 70 years after they are infected with this common childhood virus. Most people do not catch chicken pox by touching shingles outbreaks on another person, but it is possible in people who have severely weakened immune systems.

    Syphilis causes large, circular lesions on the glans penis (tip of the penis) in men and vulva in women. These skin lesions do not hurt unless they get infected with some other kind of microorganism. After the appearance of the first skin lesions, a rash may develop symmetrically on both sides of the body.

    Genital sores can also be caused by mites ("crabs"), allergies to the synthetic fibers in underwear, allergies to latex condoms and latex bands in clothing, contact dermatitis caused by laundry soap not removed in the rinse cycle for washing clothes, and heat rash. These other causes of genital sores are usually one-time events that resolve in a few days after the offending agent (latex, soap, tight clothing) is no longer in contact with skin.

  5. The best way to find out whether you have genital herpes is a lab test.

    6. The procedure for finding out to a medical certainty whether you have herpes is similar to having a Pap smear. The doctor removes a scraping from a sore. The technician places it on a slide, stains it, and looks for giant cells with multiple nuclei under a microscope. If cells are changed in this way, then you are diagnosed as having herpes. Accurate blood tests for herpes have not yet been developed.

References:

[Best Evidence] Sheffield JS, Hill JB, Hollier LM, Laibl VR, Roberts SW, Sanchez PJ. Valacyclovir prophylaxis to prevent recurrent herpes at delivery: a randomized clinical trial. Obstet Gynecol. Jul 2006;108(1):141-7.

Fleming DT, McQuillan GM, Johnson RE, et al. Herpes simplex virus type 2 in the United States, 1976 to 1994. N Engl J Med. Oct 16 1997;337(16):1105-11.

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