What is genital herpes?

Genital herpes is a viral infection. It is caused by the herpes simplex virus, which is called HSV for short. One form of the herpes virus causes "cold sores" around the mouth or lips. This kind can be passed around if someone touches the cold sore and then touches another person.

Genital herpes is caused by another form of the virus. It causes sores in the genital area and can be spread from person to person by direct skin contact (often during sex) with a person who has the infection.

What do genital herpes sores look like?

Herpes sores usually look like blisters or cold sores. In women, the sores can be inside the vagina and on the cervix, or on the skin outside the vagina. In men, the sores are on the penis and scrotum, and the skin around the genital area. The sores start off as itchy places and then change to blisters or ulcers. Ulcers are red sores that are filled with pus. Sometimes, blisters pop up and change to ulcers before you even notice you have them. Over a period of days, the sores change to crusted spots before they finally heal.

How common is genital herpes?

Genital herpes is very common. One of every five people in this country has genital herpes. People who have sex with many partners are most likely to get it. When women with genital herpes get pregnant, they can pass the infection to their baby during delivery. New babies can get really sick from herpes. If the infection is bad, the infant may even die.

What are genital herpes infections like?

The first herpes infection is usually the worst one. Genital herpes infections come back over and over again. The first time, you may have one sore or many sores. The sores are painful. Some may be hidden inside the urethra. The urethra is the tube that carries urine from your bladder. The sores make urination painful. Some people also have a fever, a sore throat, deep tiredness and body aches. These problems might last three weeks.

After the first infection, HSV sores can come back any time. They often come back when you are sick with something else and when your immune system isn't strong enough. Genital herpes might come back 4 to 6 times a year at first. After a few years, the herpes sores hurt less. They come back less often.

Is genital herpes contagious?

Yes. When blisters or crusts are present, the virus can be passed by direct contact to others. But the virus can be just as contagious even when you cannot see any sores. Using condoms helps to prevent the spread of infection--but condoms cannot protect you completely. Because HSV also causes cold sores on the mouth, a person with cold sores can spread HSV through mouth contact with the genital area of another person. The virus can also be carried on hands from the mouth to another area. You can even spread the virus to yourself by touching cold sores on your mouth and then touching other areas of your body.

Will it ever go away?

No, genital herpes can't be "cured." You will have genital herpes for the rest of your life. As time goes by, many people have fewer and milder herpes sores.

Is there a treatment?

Yes, several medicines are used to treat HSV infection. Acyclovir (brand name: Zovirax), famciclovir (brand name: Famvir) and valacyclovir (brand name: Valtrex) are all used for genital herpes. Your doctor can prescribe one of these medicines for you. They don't have many side effects, but they can be a little expensive.

How can I avoid getting genital herpes?

No vaccine can protect you from HSV infection, but you can do some things to prevent getting infected:

* Limit the number of sexual partners you have in your lifetime.

* Make sure that you and your sexual partner use condoms every time you have sex.

* Consider sexual abstinence (not having sex until you're in a deeply committed relationship).

* Don't have any kind of sex with someone who has herpes sores, itching or scabs, and remember that genital herpes can be spread even when there is no sign of a sore.

* Always wash your hands after touching a cold sore.

COPYRIGHT 2000 American Academy of Family Physicians
COPYRIGHT 2000 Gale Group

Q I'm a 23-year-old college-educated woman with herpes who practices safe sex. I've developed feelings for my new lover and want to share my secret, but I'm too scared. Should I tell him?

A Yes. There are ethical and medical reasons for disclosing your condition to your new lover. Telling him limits the likelihood of your spreading the virus to him: He needs to know he has to use condoms at all times.

Genital herpes is caused by the herpes simplex virus type 2 (HSV-2). When the virus is active it causes contagious lesions, or sores, to appear on the genitals, but it can also be active and cause no recognizable symptoms. The American Social Health Association (ASHA) in North Carolina says the safest sex is always with a condom, even when there are no breakouts. For information and advice, read the book Managing Herpes: How to Live and Love With a Chronic STD by Charles Ebel (ASHA, $19.95 plus $5 shipping and handling). To order, write to P.O. Box 13827, Research Triangle Park NC 27709, or call (800) 230-6039. You can visit wwww.ashastd.org; you might also contact the National Herpes Hotline, (919) 361-8488, 9:00 A.M. to 7:00 P.M. EST, to talk to a trained counselor. This will bolster your self-esteem and prepare you for discussing the matter with your lover.

Pick a quiet afternoon or evening to have your conversation. Bring a copy of Ebel's book for reference in case you need it. You can begin by saying "We get along so well and I think we owe it to each other to be totally honest about our sexual histories. I want to tell you something very personal. A while back I discovered I had contracted herpes. I'm sorry I didn't tell you earlier, but I thought you should know."

Try to be calm and confident, but be prepared if he gets angry or feels betrayed. If this is the case, say something like "I understand your being upset. Tell me your thoughts and feelings so we can work through this together." Gently explain to him that this is an important health issue for both of you, and that you two need open dialogue to help you decide how to proceed in your relationship. You might also say to your man "I've read a lot about herpes and know how to minimize the risk of infection. But I want to be sure you're comfortable with this. Do you have any questions?"

If your lover decides to terminate the relationship, you know you did the right thing. Furthermore, you have the information you need for your next relationship.

Gwendolyn Goldsby Grant, Ed.D., psychologist, certified sex counselor, lecturer and consultant for Fortune 500 companies, is also author of The Best Kind of Loving: A Black Woman's Guide to Finding Intimacy.

COPYRIGHT 1999 Essence Communications, Inc.
COPYRIGHT 2000 Gale Group

What is a genital herpes infection?

Genital herpes infections are sexually transmitted diseases. Symptoms can include painful sores in the genital area, itching, painful urination, vaginal discharge and tender lumps in the groin. With the first episode, many people have a fever and general aches, like the flu. Most people with herpes infection will have outbreaks of sores and symptoms from time to time. Some women have herpes only on the cervix. In this case, there may be few or no symptoms with an outbreak.

About 25 percent of adults in the United States are infected with genital herpes infections. The virus is not curable. Babies born to mothers who have an active genital herpes infection at or near the time of delivery can become infected. This can be serious and sometimes fatal for newborns.

What if I have herpes and become pregnant?

If you have had genital herpes and are considering pregnancy or are pregnant, be sure to tell your doctor. He or she may give you antiviral medicines so you will be less likely to have an outbreak of herpes at or near the time you have your baby. If you do have an outbreak of genital herpes at the time of delivery, your doctor will want to deliver your baby by cesarean section so your baby will be less likely to get herpes infection. Using casarean section, the risk of giving herpes to your baby is small.

What if I get herpes during pregnancy?

If you have your first episode of genital herpes during pregnancy, you should tell your doctor. Your doctor may want to treat you with antiviral medicine. The risk of your baby getting herpes is much higher if you have your first episode of genital herpes near the time of delivery.

It is important to avoid getting herpes during pregnancy. If your partner has a history of herpes and you do not have it, be sure to use condoms during sexual intercourse at all times during pregnancy. Your partner could pass the infection to you even if there are no painful sores. If there are painful sores, you must not have sex until the sores heal.