Genital herpes: is there a cure? See symptoms and treatments

What is genital herpes?

Genital herpes is a sexually transmitted disease (STD), caused by the Herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2). This infection is responsible for attacking the skin or mucous membranes of the genitals of men and women.

Thus, it causes signs and symptoms such as wounds, pain, itching and great discomfort in the region.

Generally, genital herpes is transmitted during periods of active disease, that is, when there are visible lesions in the genital region.

However, even in periods of remission of the infection, when there are no visible ulcers or blisters, there may be viruses in the genital secretions of men and women, which increases the chances of contagion.

Therefore, even without symptoms or signs, the patient continues to eliminate the virus intermittently, being able to transmit genital herpes to his partner, especially in unprotected sex. 70% of genital herpes transmissions occur in the asymptomatic phase, since during crises the patient usually avoids having sex.

The use of condoms reduces the risk of transmission, but does not eliminate it completely. The disease also has no cure, but it has treatment.

The virus has an incubation period (interval between infection and the onset of the first symptoms) that varies from 10 to 15 days after sexual intercourse, taking into account the existence of patients in a state of latency (without manifestations) who can, at any time, manifest the disease.

The likelihood of transmission of the virus becomes less as the years pass in relation to the first appearance of herpes. Elimination out of seizures is greatest in the first three months after primary infection (the first time lesions appear).

After 10 years of infection, transmission outside of crises is becoming less and less common.

Patients with the HIV virus who also have genital herpes may be more likely to transmit the disease during the asymptomatic phase.

According to the World Health Organization (WHO), it is estimated that 417 million people aged 15 to 49 years are carriers of the infection caused by the HSV-2 virus.

When it comes to genital herpes caused by HSV-1, the numbers are also significant. In 2012, the WHO analyzed that the prevalence of cases of the disease in the world was 140 million infected people, in the same age group of 15 to 49 years.

For the Herpes simplex virus type 1, the majority of cases occur in the Americas, Europe and Western Pacific. In Africa, on the other hand, infections of genital herpes by this virus occur, mostly, during childhood, before the beginning of sexual life.

In the case of the HSV-2 virus, the prevalence of the disease is higher in Africa (31.5%), and it is also quite common in the Americas (14.4%).

In the International Classification of Diseases (ICD-10), genital herpes (types 1 and 2) is found by code A60.0.

Oral herpes and genital herpes: what is the relationship?

Oral herpes is caused mainly by the herpes simplex virus type 1, characterized by the presence of symptoms such as redness, small bubbles with liquid and burning in the region of the lips or inside the mouth.

In 90% of cases, this virus installs in the patient’s body causing an asymptomatic infection, the diagnosis being possible only when specific antibodies are identified.

When a symptomatic manifestation of the infection occurs, usually the first symptom to appear is gingivostomatitis (inflammation of the oral mucosa) or herpetic stomatitis , a condition that occurs when the organism comes into contact with the virus.

Herpetic stomatitis manifests itself with the appearance of red spots on the mucosal surface of the mouth and throat, which can spread to the cheeks, tongue, tonsils and lips.

The herpes simplex virus type 1 usually causes damage to the mouth only, but it can be transmitted to the genitals in the case of oral sex. Once infected, patients with genital herpes by type 1 transmit the disease in the same way as patients infected by type 2.

The difference is that type 1 attacks are usually milder and less frequent, and transmission outside of attacks is less common, as HSV-1 has less virulence (ability to multiply within the body).

Causes

Genital herpes is usually caused by infection with the Herpes simplex virus type 2, known as HSV-2. It can also be caused by the Herpes simplex virus type 1 (HSV-1), which usually causes cold sores . Transmission can occur during seizures or during periods of remission.

The virus can enter the person’s body through its mucous membranes, usually through the mouth, nose and genitals.

These two viruses belong to the same family, Herpesviridae . Within this group there are eight different types, called herpesviruses.

The name Herpesviridae originates from the Greek word herpein, which means to crawl. It is a reference to the behavior of the virus and the infections it causes, due to the fact that they are recurrent and have a latency characteristic.

This group of viruses is quite common among humans. It is estimated that 90% of people have had contact with at least one of the viruses in the group.

What happens when the virus enters the body?

There are some characteristics of the herpes virus that differentiate it from other types of viruses, such as its aspect known as latency.

This is said to refer to how Herpes Simplex and other herpesviruses manage to create a small, but permanent, colony in the body of the infected person.

This colony, in some cases, remains completely asleep (inactive), without causing symptoms, and human beings are the only hosts in which herpesviruses remain with the infectious aspect throughout their lives.

As we know, it is not in all infected patients that the virus exhibits this inactive behavior, becoming symptomatic from time to time.

Upon entering the organism, the HSV fixes itself in a certain space and begins to create copies of itself, that is, it starts to spread. When moving, it can end up causing everything from subtle unrecognizable signs to more serious symptoms.

To contain these symptoms, the immune system arms itself and tries to inhibit the spread of the virus. In a way, what happens is a game of hide and seek, in which the virus wins. That’s because it is able to hide from the defense system by retreating along the nerve pathways, in a region called a ganglion.

In genital herpes, the virus remains inactive in the sacral ganglion, located at the base of the spine. In the case of oral or labial herpes, the virus seeks to lodge in the trigeminal ganglion, at the top of the spine.

In these hiding places, he remains asleep and the patient returns to an asymptomatic condition. How long it will remain inactive is not possible to determine.

For this behavior, this characteristic known as latency is often compared to the sleep cycle.

However, unlike sleep, in which we are sure to wake up every day, it is not easy to know when the virus will wake up again, which can take days, months or years.

A common consensus among outbreaks was that all were marked by the presence of irregularities in the skin, considering signs even as pimples or itching, for example.

More recently, researchers found that the virus could become active without causing visible symptoms, a feature called asymptomatic shedding, asymptomatic reactivation or subclinical shedding.

For the condition to be considered an asymptomatic spill it is necessary that the following characteristics have occurred:

  • When injuries are neglected because they appear in more hidden or underreported locations;
  • When the signals are confused with other conditions, such as an ingrown hair;
  • When the signs are not noticeable to the naked eye.

Thus, we can say that the virus does not have a standard behavior in all people, and can go unnoticed even when activated.

Even in people who are aware of the symptoms and signs of the disease, it can be difficult in some outbreaks to realize that it is the virus waking up.

How does the transmission happen?

The main form of transmission of genital herpes occurs through contact in unprotected sex, as the HSV-1 or HSV-2 viruses can be present in the body fluids of the infected person, such as in saliva, semen and vaginal secretions.

When it comes to genital herpes caused by the HSV-1 virus, transmission can happen during oral sex. This way, people can be infected by the virus in vaginal, oral and anal sex.

The most common form of transmission occurs when someone who is not infected has direct contact with the skin of an infected person who has visible lesions, such as blisters or rashes, that is, during a symptomatic crisis.

However, it is also possible to contract herpes from contact with an infected person when he has no visible lesions, as in most cases people have no symptoms and are unaware that they are infected. 70% of transmissions happen in this asymptomatic period.

Thus, the main forms of transmission happen as follows:

  • By direct contact with wounds during herpes attacks;
  • Through saliva, if your partner has oral (active) herpes;
  • For genital secretions, if the partner has genital herpes (especially with lesions).

The chances of transmission are increased in every episode in which the patient has a crisis.

How to prevent transmission?

In addition to the use of condoms, other precautions must be taken so that the transmission of the virus does not occur, such as greater attention with the use of personal objects and hygiene.

It is recommended that cups, lipsticks or any lip balm, razors or shaving blades and bath towels should not be shared, especially in the case of visible injuries.

In some situations the genital herpes virus is not considered a transmission risk, such as when using toilets, by contact with someone’s bedding and pools.

Groups of risk

Anyone is at risk of being infected with the herpes virus, regardless of gender or age. In the case of genital herpes, the risk is greater for those who have a sex life without the use of protection.

However, some groups and behaviors are considered more likely to contract genital herpes:

  • People with multiple sexual partners who do not have sex with protection (male or female condoms);
  • Most needy populations and those with less access to basic health and hygiene principles;
  • People who are starting their sex lives and who do not have an STD prevention sex education;
  • People who have other sexually transmitted infections;
  • People with weakened immune systems;
  • Women.

A study published in 2009 in the New England Journal of Medicine found that circumcised men are less at risk of contracting the genital herpes virus. However, circumcision does not guarantee full protection against the virus and does not replace the use of condoms during sexual intercourse.

Another survey, carried out by the Carlos Chagas Institute with the Department of Pediatrics at the Federal University of São Paulo, observed that the prevalence of HSV-2 increases significantly in people who are beginning their sexual life, which can be attributed to the lack of a sex education that encourages the use of condoms

Therefore, it is extremely important that there is greater counseling by health professionals so that adolescents have more information about the virus and to learn about risky behaviors.

In this way, it would be possible to avoid transmission and complications caused by the disease, as well as simultaneous infections by HSV-1, as well as neonatal herpes (transmitted from the infected mother to the baby).

According to the WHO, genital herpes is also more recurrent in women. In 2012, it is estimated that the number of infected women was 267 million, while 150 million men were living with the virus.

Genital herpes in pregnancy

The virus behaves similarly in pregnant and non-pregnant women. The major problem with herpes in pregnancy is the risk of transmission to the baby. When this happens it is called neonatal herpes , a condition that can be serious and even lethal for the child.

This transmission, called vertical transmission, occurs during delivery when the baby has contact with contaminated secretions in the vaginal canal or maternal blood. Even when the pregnant woman has no symptoms, the risk of transmission exists.

The greatest risk occurs when the woman becomes infected near the date of delivery, that is, when the primary infection appears in the last weeks of pregnancy.

Rarely, herpes can be transmitted inside the uterus during pregnancy, and it is not an infection that usually causes malformation problems for the fetus.

However, when it comes to a severe case of genital herpes, during the first months of pregnancy there is a risk, even if small, of the woman having a miscarriage.

However, when the baby is infected at the time of delivery, the virus can affect the central nervous system and cause more serious problems to the child’s health.

When the woman is infected with the virus before pregnancy, the chances of transmission to the baby are reduced, since her body is already capable of producing antibodies to the viruses that are temporarily transmitted to the baby when it is inside the mother’s womb. .

So, even if the woman has a genital herpes attack at the time of delivery, the antibodies passed on to her will help her at that time.

Caesarean section greatly reduces the risk of transmission of herpes, being the most suitable form of delivery for infected women, especially in crises. However, it does not eliminate 100% the chances of contagion of the baby.

For this reason, the best way to prevent neonatal herpes is the appropriate treatment of pregnant women (prenatal), whose use of antiviral drugs should be done. The most used medication is Acyclovir , which can be administered regardless of the week of pregnancy the woman is in.

Genital herpes is not hereditary and the virus does not affect fertility nor is it transmitted by a man’s sperm or a woman’s egg. Women with genital herpes can have a safe pregnancy and a normal vaginal delivery, except:

  • When it comes to an initial episode of severe genital herpes during the first 3 months of pregnancy, it can cause a miscarriage, which is very rare, but can occur with other types of viral infection;
  • When it is an initial episode in the last 3 months of pregnancy, due to the large number of viruses present and insufficient time for the mother to produce antibodies to protect the fetus, the disease being able to be transmitted to the fetus, causing neonatal herpes.

Pregnant women with no history of genital herpes whose partner has the disease, must use condoms throughout pregnancy to avoid acquiring the disease during this period. Care must be maintained during pregnancy or not.

If the partner has a history of herpes on the face area, oral sex should also be avoided. Genital herpes, in either parent, generally does not affect children and there is little risk of transmission as long as you have normal hygiene habits.

However, parents should be aware that the herpes virus can be transmitted by oral lesions through kissing, which can cause severe and widespread infection in the newborn.

Although neonatal herpes is a very serious condition for the baby, it is also considered rare. According to the American Sexual Health Association (ASHA), in the USA, less than 0.01% of babies born are infected with the virus at birth. However, 25% to 35% of pregnant women carry the virus.

This is an important data to understand that, despite the risk that the baby runs, it is possible to have a healthy and uncomplicated delivery.

Symptoms and phases

Most of the time, the individual does not know that he was infected by the genital herpes virus, because it is common that the disease does not show signs or symptoms. In fact, most people who become infected with the Herpes simplex virus do not develop the disease, remaining asymptomatic and unaware of the infection.

There are studies that suggest that up to 90% of infected patients do not develop symptoms. In some cases, the signs go unnoticed or are mistaken for other diseases or conditions, such as insect bites, yeast infection ( candidiasis , for example), ringworm, acne, pimples and ingrown hairs.

Bearing in mind that the signs of genital herpes can vary greatly from person to person, it is important that each individual seeks to consult with the doctor to investigate them. Thus, it will be possible to remove the doubt and start treatment as soon as possible, regardless of the clinical condition.

The time that symptoms can take to appear is also different for each patient. It may take a few days after contact with the virus, months or years, as well as it may never wake up.

The most well-known symptoms of this disease are the sores that appear in the genital region. These wounds, also called vesicles or ulcers, cause irregularities in the patient’s skin.

The appearance of these lesions resembles small pimples or blisters on the skin, which sometimes have a liquid inside. They can take 2 to 4 weeks to heal completely.

Some characteristics that may be present in these herpes outbreak periods include:

  • Peels that form when the ulcers heal;
  • Pains and irritation that appear 2 to 10 days after contagion;
  • Red spots and small whitish blisters that usually appear days after infection;
  • Ulcers in the genital region, which can bleed and cause pain when urinating;
  • Small clusters of blisters and wounds;
    Tingling, itching and burning around the genitals (they are common slightly before an outbreak);
  • Burning when urinating if the blisters are close to the urethra;
  • Burning and pain when defecating, if the lesions are close to the anus;
  • Groin languages.

These symptoms can happen in the penis, scrotum, thighs and urethra, in addition to the vagina, vulva and cervix. They can also appear in the mouth, buttocks and anus.

In the first days after the infection, the infected person may show symptoms very similar to those of the flu – as it is also a viral infection – such as:

  • Reduced appetite;
  • Fever;
  • General malaise;
  • Muscle pains in the lower back, buttocks, thighs or knees;
  • Tiredness.

Primary genital herpes

Primary infection is the name given the first time that genital herpes lesions appear after the patient has been infected . It can last from 2 to 3 weeks, being, generally, the most difficult and painful phase of the infection.

The symptoms of genital herpes tend to develop within 3 to 7 days after intercourse responsible for the infection, but in some cases it can take up to 2 weeks.

Normally, blisters appear on the genitals, which then rupture, forming ulcers. In primary infection, these lesions tend to be very painful, and there may also be itching (itching) in the area.

In addition to the typical herpes lesion, the primary infection usually comes with other symptoms, such as fever , malaise and body aches.

Lymph nodes (lymph nodes) may appear in the groin area and, if the ulcers are close to the exit of the urethra, there may be severe pain when urinating.

In men, genital herpes sores usually appear on or near the penis. In women, lesions may be visible outside the vagina, but they usually occur inside the vagina, such as the cervix, where they are hidden.

As for internal injuries, the only signs of illness may be vaginal discharge and / or discomfort during sexual intercourse.

Lesions of genital herpes can also appear anywhere in the perineum and around the anus of patients who have anal sex.

Recurrent genital herpes

After primary infection, the genital herpes lesions disappear, remaining silent for several months or years. In most patients, the infection recurs from time to time and, in some cases, more than once a year, due to changes in the immune system.

Once in the body, following through a nerve in the affected area, the genital herpes virus installs itself in a nervous ganglion, close to the spine, where it remains in a latent state.

Reactivation occurs when the virus multiplies in the neural ganglion and the viral particles migrate through the nerve to the site of the primary infection on the skin or mucous membranes (oral or genital).

After the initial outbreak, the person affected by the disease may develop antibodies that keep the infection inactive indefinitely and thus never get to reactivate.

Other people, at certain times, have new outbreaks of the infection, which represent a viral reactivation, with milder symptoms than those of the initial infection.

The factors that trigger this reactivation vary from person to person. Among them are physical exhaustion, other infectious processes, menstruation, excessive alcohol intake, intense sun exposure, conditions that weaken the immune system and emotional stress .

Friction or repeated trauma at the injury site, such as during sexual intercourse, can also lead to reactivations in some people.

However, there are cases of recurrences in which it is not possible to identify any triggering factor.

90% of patients experience their first recurrence within 18 months of primary infection, with some having more than 10 recurrences within one year.

Crisis returns are frequent in those who have had a prolonged primary infection, with initial herpes lesions lasting more than 1 month. Over the years, crises become weaker and less frequent.

A few days before the lesions appear, the patient may experience some alarm symptoms, such as itching of the labia majora, tingling, burning, numbness in the penis and tingling in the genital region.

In this way, many patients are able to identify that a new outbreak of genital herpes is on the way and thus are able to prepare for the treatment and care of the lesions.

In other cases, the patient may not develop symptoms of primary infection soon after the contamination, only presenting ulcers years later, after some event that reduces his immunity.

In these cases, despite being the first appearance of wounds, the disease behaves more like a recurrence than as a primary infection, being shorter and less painful. Symptoms such as fever and malaise are also not common.

In these situations it is very difficult to establish precisely when the patient was infected and who infected him.

How is the diagnosis made?

The diagnosis of herpes is usually made by a general practitioner, urologist or gynecologist . From a consultation with these specialists, there are two main ways to identify genital herpes: by physical exams (when there are active lesions) or laboratory tests.

The physical examination takes place by assessing the symptoms and wounds, when they appear.

Usually, a physical examination is sufficient for the diagnosis, but the doctor may order some tests for confirmation, such as when the injuries are not very typical.

In these cases, the doctor can take samples of the ulcers to identify the virus through laboratory tests such as cell culture, blood test, serology, PCR and the Tzanck method.

In addition to the use for the diagnosis of the patient, serology is also important for diagnosing the partners of the infected patients, being an exam capable of identifying infection by the HSV-1 and HSV-2 virus.

The detection of antibodies against herpes through a blood test, however, is not as efficient, as it is not able to define the location of the infection by the virus, helping only when the infection is suspected.

If the blood test is positive, the doctor may request the collection of material when new lesions appear to confirm the diagnosis. Other tests may be ordered, depending on the patient, if the doctor suspects an infection with other sexually transmitted diseases.

In addition, it is worth mentioning that the tests are able to identify the virus, but do not provide information about when the patient was infected.

Anyway, if the diagnosis for genital herpes is positive, the partner must be informed by the patient, so that he can also perform the tests. In these cases, there is medical confidentiality and it is up to the bearer of the infection the decision to inform the partner.

Exams

When the diagnosis of genital herpes is not possible only through physical examination, some laboratory tests can be carried out to confirm whether it is really this disease and by which virus it was caused. The exams performed are as follows:

Tzanck method

This is a widely used method for diagnosing herpes infection, although it is not so precise in distinguishing the two types of the virus. Therefore, it is more recommended for patients who have atypical cases or in immunocompromised patients.

Basically, the exam consists of scraping the base of the lesion on the skin to collect a sample of cells. The test result usually takes 7 to 10 days.

Viral Culture

Viral culture takes place following the Tzanck method, as it is in this situation that the collected material is sown in a culture medium.

This process in which the virus is placed with other cells aims to provide a multiplication of these microorganisms, so that they can be identified and differentiated for the diagnosis of the disease in particular.

In the case of genital herpes, from this procedure, it is possible to visualize the cytopathic changes, that is, the damage that the virus caused in the cells. This process takes between 24 to 48 hours of incubation so that it is possible to observe the changes through microscopy.

This is a much more sensitive test in relation to the accuracy of the result, as it allows it to be possible to identify the type of strain, that is, to reveal whether genital herpes was caused by HSV-1 or HSV-2.

PCR

The PCR, or polymerase chain reaction test, sketches the patient’s DNA by analyzing a small sample of the wound present in the genitalia. From this DNA, the doctor will be able to tell if there is a virus that causes herpes or not.

Serology

Serology is an examination of the study of blood serum, specific to discover the presence of antibodies in the blood, with the antibodies being sought for Immunoglobulin M (IgM) and Immunoglobulin G (IgG).

It is done through a common blood collection. Antibodies can be identified by blood or serum, obtained after coagulation and centrifugation.

This test is especially indicated for people who do not have injuries, but have discomfort in the genital or labial region.

Blood test

The results of this test show whether antibodies against genital herpes viruses are present or not, indicating whether there has been infection in the past. It is not the most suitable for not identifying which type of virus caused the infection.

Tem care of genital herpes?

No, genital (or oral) herpes has no cure. However, patients diagnosed with the disease can receive treatment using drugs that help prevent and reduce outbreaks.

There are anti-herpes medications that must be taken daily, which reduces the chances of transmission of the virus during sexual intercourse.

What is the treatment?

Genital herpes is a disease that has no cure, but that has treatment to prevent the occurrence of outbreaks, alleviate symptoms and to reduce the chances of transmission and complications.

In general, any doctor can monitor these patients, but the most suitable specialists are the gynecologist, urologist and infectologist.

Certain local care can be taken to treat injuries. For this, some medications are applied directly to the wounds, to help with healing and prevent self-contamination.

This must be done because contact with the liquid from the wounds can cause injuries in other parts of the body, such as when the patient touches the hand and ends up, unintentionally, “transferring” the virus to another region of his body.

Who should prescribe ointments or specific products for this care is the doctor, as self-medication can end up worsening the situation of the injury or prolonging its healing time.

The treatment is basically done by means of antiviral medications (in tablets or ointments), which relieve the pain and discomfort caused during a crisis, curing the lesions more quickly, preventing complications and reducing the risk of transmission to others.

People who have a lot of seizures can take these medications daily for a while – after medical evaluation. This can help prevent seizures and shorten their duration.

For recurrent seizures, the patient should take the medication as soon as the tingling, burning or itching begins, or as soon as blisters start to appear.

The doctor may also recommend the use of anesthetic ointments or gels to be applied to the genital region during the appearance of blisters and other symptoms.

Antivirals

The first episode of genital herpes is usually treated for 7 to 10 days by oral medications. If there is no improvement in the ulcers, the treatment can be extended for another week.

Treatment works best if started within the first 72 hours of symptoms. In the event of other crises, the treatment time is reduced and can be done for an average of 5 days.

When it comes to patients with a history of frequent seizures, it is advisable to keep antiviral drugs at home as a precaution. Thus, they can start treatment as soon as the first signs of the disease.

If the patient rarely has seizures or few symptoms, there may be no need for treatment with antivirals, especially if the individual does not have a sexual partner at the time that he or she may be infected.

Episodic therapy

This type of treatment is done with the use of antiviral drugs when a patient has the first sign of an outbreak. It is a strategy used for a few days, in which the patient receives the medication to speed up the healing of wounds or to prevent the outbreak from occurring entirely.

However, it is necessary to understand that each patient will have a different manifestation of symptoms and outbreaks, so episodic therapy may not be necessary in all cases.

It is most suitable for patients who have outbreaks over a long period of days and with more intense symptoms. This treatment can shorten between 1 to 2 days of the outbreak, on average.

It is most effective when started at the first sign of the disease or outbreak. When lesions are already present, episodic treatment may offer little benefit to the patient.

Daily suppressive therapy

Patients diagnosed with genital herpes can check with the specialist doctor about the need for daily suppressive therapy, which is basically the administration of antiviral medication daily.

Like treatment with medications in an episodic manner, this therapy also seeks to reduce the chances of an outbreak and leave the disease under control, making the risk of symptoms less.

For patients who have recurrent outbreaks, between 6 or more per year, this treatment helps to reduce the chances of seizures by up to 75% when compared to patients who do not receive the medication daily, and can totally avoid outbreaks in some cases.

It is unclear how long suppressive therapy should be maintained. Some experts recommend taking a break from treatment periodically (every few years) to determine whether suppressive therapy is still needed. If the outbreaks return, suppressive therapy can be restarted.

Suppressive therapy can also be indicated in cases of sexual partners with discordant serologies, that is, one of them infected with herpes and the other not.

This method reduces the risk of transmission by more than 50%. When associated with the use of condoms, the risk of transmission of genital herpes becomes small.

Home treatment

In addition to antiviral medications, some home treatments can be used to relieve the symptoms of an outbreak of genital herpes.

What should be done is to keep the area always clean and dry, if possible, allowing the genital region to receive air, which helps to prevent the region from becoming stuffy and proliferating infectious agents.

Therefore, it is important that clothes and underwear are not too tight, as friction with injuries can prevent better ventilation from happening, in addition to causing greater discomfort and pain in the region. Prefer pieces made of cotton, as they allow ventilation and hinder the proliferation of fungi, viruses and bacteria

However, before risking any homemade prescription it is necessary to check the possibility with a doctor, to avoid complications . Knowing that there are no risks, it is possible to move on with home treatments and care. Some tips are:

  • Take a sitz bath with cold water, to temporarily reduce the pain caused by the wounds;
  • Use the sitz bath or take a shower with warm water to be able to urinate, especially in the case of women who experience pain or discomfort when urinating;
  • Avoid using soap in the genital area or bubble baths during crises;
  • Keep the genital area well sanitized and dry;
  • Avoid underwear, pants and shorts that are too tight;
  • Avoid the use of creams and ointments that were not prescribed by the doctor;
  • Check the possibility of using analgesic and anti-inflammatory drugs to reduce pain.

Medicines

According to the Ministry of Health and the Food and Drug Administration (FDA), there are three main antivirals used to treat genital herpes , namely Acyclovir , Valacyclovir and Fanciclovir .

These antiviral drugs are usually prescribed when the patient has the first episode (or crisis) of genital herpes or in episodic and suppressive therapy.

Medications such as Lidocaine or Xylocaina can also be indicated to relieve pain and moisturize the skin, thus reducing the discomfort caused by the disease when it is symptomatic.

Learn a little more about antiviral drugs:

Aciclovir

This is the oldest antiviral drug used to treat herpes, available since 1982. Initially, it was marketed only in the form of an ointment, for direct application to the skin. In 1985, the sale was also made as a medicine in pill form. It is currently available in both presentations.

It is a drug considered safe for patients, even for those who undergo suppressive therapy for up to 10 years in a row.

In addition to being used to treat infections caused by the herpes simplex virus, Acyclovir can also be used in some cases of herpes zoster.

Some of the trade names of Aciclovir are:

  • Acyclofar Tablet ;
  • Hervirax Creme ;
  • Hervirax Ophthalmic Ointment ;
  • Zovirax Tablet ;
  • Zovirax Injectable ;
  • Zovirax Ophthalmic Oil ;
  • Acyclomed Creams ;
  • Hervirax ;
  • Herpesil Creme;
  • Aciclofar Creme;
  • Aciclomed Tablet ;
  • Aciclor;
  • Aciveral ;
  • Acivirax ;
  • Anclomax ;
  • Antivirax ;
  • Ciclavix ;
  • Clovir;
  • Ezopen ;
  • Heclivir;
  • Herpesil Tablet ;
  • Herpfar;
  • Hervirax Tablet ;
  • Zelnin .

Valaciclovir

Valaciclovir is a medicine used to treat infections of the skin and mucosa caused by the herpes simplex virus, including the initial and recurrent genital herpes. After ingesting the pill, the drug is converted into the substance acyclovir, which acts to combat the action of the virus in the body.

It can be more efficient in the treatment, because the body is able to absorb a large part of the medication, which reduces the need to take several doses a day.

In addition to contributing to the treatment of genital, labial and herpes zoster herpes, Valacyclovir is used to inhibit the action of several types of herpesvirus, such as cytomegalovirus (CMV), Epstein-Barr virus (EBV) and human herpesvirus type 6 (HVH-6).

This medicine has the trade names Herpstal and Valtrex , available in tablet form.

Fanciclovir

This active ingredient is used to prevent HSV from reproducing. Like Valaciclovir, Fanciclovir is well absorbed, which helps it to persist in the body for a longer time, without the need for high doses.

The trade names are Fanclomax (tablet) and Penvir (cream and tablet).

Attention!

NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained in this website is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.

Living together

Being diagnosed with a disease such as genital herpes can trigger a number of emotional problems in the patient. It is common for them to feel initially ashamed, angry , frustrated or depressed about the situation.

These negative feelings are usually associated with the fact that it is a sexually transmitted disease. In this condition, the patient may also have to face a prejudice attributed to the disease.

However, genital herpes is a very common disease, and in most cases, carriers of the virus do not even know they have it. Therefore, however difficult it is to live with the disease, it is necessary to accept it.

Even if people understand the situation as a bad thing, it is necessary that the patient is not so cruel to himself. The bad feelings experienced in this moment of discovery tend to pass, the symptoms can be controlled and the transmission prevented.

Some basic care can also help the patient to deal better with the disease, heal the lesions more quickly and prevent their recurrence, such as:

  • Do not wear socks, underwear or pants made of nylon or other synthetic materials;
  • Wear comfortable cotton clothes;
  • Wash the area gently with water and mild soap;
  • Take warm baths to relieve the pain (after the bath, keep the bubbles dry).

In addition, other changes and tips that can help in socializing are:

Be informed

After receiving the diagnosis, the patient may find himself in a situation where he feels lost or scared. The lack of information about the disease can help to make this moment even more complicated.

Therefore, it is essential that the patient seeks information about what genital herpes is and how it will be living with the disease from then on.

Talk to your sexual partner

Having a conversation with your partner about herpes can be difficult, but it is inevitable. This dialogue should happen for your health, for his and for the relationship to continue or start in a healthy and honest way.

There is no recipe for how this conversation should be, but it is important for the patient to know that telling their partner about their condition is also a sign of confidence. Just as important, informing your partner about STDs is reducing the chances of transmitting the disease.

In this way, it is also possible to investigate whether the partner has been infected by the virus. If this is not the case, preventive measures must be initiated. If the partner has been infected, or is already infected, he or she should also begin treatment.

The fact that you do not know when you were infected by the virus can be one of the most negative points of the disease, as it can end up causing distrust between the couple. That is why it is so important to have this type of conversation, so that everything is clarified.

As seen, the virus can manifest itself after months or years, sometimes it never manifests itself. This, however, does not eliminate the risk of transmission. Thus, in addition to the conversation, meeting other people and couples who have been through this can help.

Follow the treatment correctly

Following the treatment prescribed by the doctor is essential to avoid complications and to prevent the transmission of the virus.

Therefore, the patient must respect the guidelines regarding medications and care, especially during crises and the appearance of injuries. The use of condoms during sexual intercourse should always be done .

Keep your immune system strengthened

When the body has a weakened immune system, the chances of outbreaks of genital herpes increase. And it is during crises that the risk of transmission becomes even greater.

Therefore, it is recommended that the patient maintain a life with healthy habits, such as balanced diet, exercise, controlled stress and quality of sleep.

Be careful with symptoms during outbreaks

When the patient has injuries, care must be taken. It is important to be careful with the products used, such as intimate soaps and creams, which can end up irritating the wounds and prolonging the healing process. The use of ointments and creams should only be done with medical advice.

In addition, they should pay attention if they run their hand over the wounds, due to the risk of contact with the liquid present in the lesions. Thus, they can end up transferring the virus from place and causing lesions in different parts of the body.

Prognosis

Once an individual is infected, the virus remains in the body for the rest of his life. Some people have only one crisis, and others have frequent crises.

In people with a normal immune system, genital herpes remains a localized and uncomfortable infection, but it is rarely life-threatening.

Genital herpes, despite not being an STD with great risks in people with a stable immune system, is very common and worrying, because even asymptomatic is capable of being transmitted. In addition, infection with this virus increases the chances of acquiring and transmitting other viruses, especially HIV.

Complications

Genital herpes is a common condition, which can be controlled with medication and health care. However, in some patients with weakened immune systems and in people who do not receive adequate treatment, the chances of complications increase.

See in which conditions genital herpes can evolve to more severe conditions:

Other STDs

Patients with genital herpes are at an increased risk of contracting other sexually transmitted diseases, so complications such as the HIV virus may have complications.

Thus, in addition to the treatment done to control herpes, the patient will have to take additional care to prevent the transmission of other viruses, including the fact that he may suffer more severe symptoms.

Give us no fetus

This is a very worrying complication that can happen when the pregnant woman transmits the genital herpes virus to her baby. This transmission is rare, known as vertical transmission. It does not happen when the baby is in the mother’s womb, but during delivery.

Infection of herpes by newborn babies can result in brain damage, blindness and can even lead to death in the most severe cases. For this reason, prenatal care is extremely important.

Bladder problems

Genital herpes can cause sores in the urethra, which ends up blocking the urine outflow. In such cases, the patient may need to use a catheter to drain the bladder.

Meningitis

The meningitis is an inflammation that occurs in the meninges, membranes responsible for protecting and coating the brain and spinal cord. It can be caused by a variety of infectious agents, including the herpes virus. It is a serious illness that can lead the patient to death.

Retite

It is an inflammation that occurs in the rectum, usually caused by sexually transmitted diseases. It is caused, most of the time, by the sexual act without using condoms.

The main symptoms of this condition are painless bleeding and mucus secretion. In the case of retitis caused by herpes, the patient may experience severe pain in the region.

More serious infections

Some people can develop very serious herpes infections that affect the brain, eyes, esophagus, liver, spinal cord or lungs.

These complications usually develop in people with a weakened immune system, such as those who are undergoing chemotherapy, radiation therapy or who are taking high doses of cortisone.

How to prevent?

The only 100% guaranteed way of not getting any type of STD is to not have sex. However, when people have an active sex life, this “method” is no longer useful.

Therefore, the best way to prevent this and other sexually transmitted diseases (STDs) is to use condoms during sexual acts .

If your partner is infected with herpes, it is best to avoid any kind of sexual contact until the disease is under control, especially during the onset of symptoms.

Therefore, it is important to have an open communication with your partner to avoid any form of contagion.

The use of condoms reduces the chance of transmission, but does not eliminate it completely, since herpes lesions can appear in areas of the genital region that are not covered by condoms.

For example, a herpes lesion in the scrotum remains exposed even with the proper use of condoms.

The virus does not survive for a long time outside the human body, so transmission occurs only through contact between people, and it is not possible to be contaminated in bathrooms, with towels and other objects.

In the case of pregnant women infected by the virus, to prevent transmission to the baby, medical monitoring and guidance for antiviral treatment is necessary, especially in the first and last 3 months of pregnancy .

Common questions

Genital herpes is a very common sexually transmitted disease and raises many doubts for people who are infected or not. See the most frequent ones:

Is there a relationship between genital herpes and HIV?

-Yeah . Infection caused by the herpes virus can cause cuts in the skin of the mouth and genital area, which can facilitate the entry of the HIV virus into the body.

According to studies carried out by the Carlos Chagas Institute with the Department of Pediatrics at the Federal University of São Paulo, the presence of HSV-2 increases the risk of HIV acquisition, excretion and transmission.

The presence of the HSV-2 virus can also accelerate the progression of the disease in patients with HIV.

Can I still have sex normally if I have herpes?

Patients with genital herpes are not destined for a life of chastity just because they have been diagnosed with the disease, however they need to know that care must be redoubled.

The first step in achieving a sex life without risk of infection for the partner is talking and making the condition clear to the other person.

With the treatment done with suppressive antiviral medication and with the use of condoms, the risk of transmission is reduced, but it is not zero. Therefore, it is important to have a medical follow-up so that the disease does not interfere with the patient’s sexual life.

In addition, it is important to emphasize that sexual intercourse should be avoided when the patient is during an outbreak of the disease, as it is during this period that the risk of transmission is greatest.

What happens if I don’t get the treatment?

Failure to receive treatment can be detrimental to the health of patients with genital herpes. That’s because the disease can cause painful genital wounds and other complications.

These complications are even an even greater risk for people with weakened immune systems.

If the pregnant woman has herpes, is vaginal delivery safe?

It depends . The risk of transmission is greater when the pregnant woman was infected by the virus during pregnancy, between the first 3 or 3 last months of pregnancy. In such cases, normal birth can be a greater risk for the baby.

This is because the mother’s body did not have enough time to produce the antibodies needed to protect the baby. However, treatment with antivirals can help to lower the risk, being the first treatment option to make childbirth safe. When this is not possible, cesarean delivery becomes an option.

In any case, the doctor should always be consulted.


Genital herpes is a very common STD with no cure. Treatment can help control the disease and reduce the chances of transmission, but it is still not enough to eliminate 100% of the risks.

It is becoming increasingly important to emphasize the relevance of good sex education, so that people know the importance of using condoms to reduce the risks of diseases like this.

We seek in this article to clarify all the risks of genital herpes and to show ways to make this disease under control.

If you have or know someone with this disease, you should know how important it is for people to have access to forms of prevention. So don’t forget to share this information with more people. Thanks for reading!

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