What is herpes?
Herpes is a common and usually mild recurrent skin condition; most infections are unrecognized and undiagnosed.
Herpes is caused by a virus: the herpes simplex virus (HSV).
HSV is in a family of viruses called herpesviruses. This family includes Epstein-Barr virus (the cause of mono) and the varicella zoster virus (the cause of chicken pox and shingles).
Although there are several viruses in the herpesvirus family, each is a separate virus and different. Having one virus does not mean you will have another.
HSV can cause oral herpes (cold sores or fever blisters on the mouth or facial area) as well as genital herpes (similar symptoms in the genital region).
There are two types of herpes simplex: herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2).
The majority of oral herpes cases are caused by HSV-1 and the majority of genital herpes cases are caused by HSV-2; however, type-1 or type-2 can occur in either the genital or oral area.
What is my risk as a woman of transmitting genital herpes to my male partner?
The risk of infection is based on several factors, but the best estimate is that approximately four percent of men will become infected in a monogamous relationship with an HSV-positive woman over the course of a year. This contrasts with approximately 17 percent of women in a monogamous relationship with an HSV-positive male becoming infected.
Does having oral herpes protect me from genital herpes?
No. Some experts have speculated that having oral herpes reduces the chances of acquiring genital herpes but most authorities believe there is no significant cross-protection between the two types.
If I have no symptoms, doesn’t that mean I am less likely to transmit the virus?
Yes and no. The amount of virus produced is greatest at the time someone is having an outbreak. Yet many outbreaks occur without the person realizing it. Lesions can be so small or hidden from view that only special tests can prove one is having an outbreak. It is estimated that 80 percent or more of persons without visible symptoms are infectious at some point in their lives.
How effective are condoms for preventing infection?
They are highly effective. The virus cannot penetrate through latex barriers. However, it is possible, although rare, to acquire infection during skin-to-skin contact if a lesion is present and not covered by a condom.
How is genital herpes diagnosed?
Visual inspection is the most common way of making a diagnosis. Viral cultures are also commonly used, but only when a sore is present. Recently, blood tests have become available that can accurately determine infection. and can accurately distinguish between the two types of HSV even when no symptoms are present, i.e., the lesion is on the scrotum.
How safe are the drugs used for treating genital herpes?
All of the commonly used prescription medications are well-tolerated and have few short-term side effects. Acyclovir has been studied the longest and its long-term safety is good, both in pregnant women and in children. However, its long-term effect on fetuses is not known.
What causes recurrent outbreaks of genital herpes?
This is an important question and hard to answer definitively. Some factors that have been studied include stress, poor diet, menstruation and irritation from vigorous sex. However, there is no way of accurately predicting when the next outbreak will come. Keeping one’s immune system strong is important. (Persons with weakened immune systems, such as HIV-positive individuals, have more frequent and severe outbreaks than HIV-negative persons.) Experts also recommend getting emotional support, as the psychological impact of genital herpes often is more upsetting than the physical symptoms.