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Genital Herpes: What You Need to Know

Find out what genital herpes is, how it’s diagnosed, what its complications are, and how you can treat it.

By
Sanaz Majd, MD,
June 15, 2011

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A  Girlfriend MD podcast listener recently contacted me regarding her recent diagnosis of genital herpes. She told me how the diagnosis made her feel as though she could no longer go on dates or be sexually active since she feared she’d be rejected if she disclosed her health status.

Reading about how she was feeling truly made me so very sad.  Because although a genital herpes diagnosis may not be the most welcoming news, there are truly much worse health conditions to have.  So that’s why I have decided to devote this article to genital herpes.

How Common Is Genital Herpes?

Over fifty million people in the United States are affected by genital herpes.  That’s how common it is.  In my clinic I often see men and women of all ages who have a history of genital herpes.  And I even have 70- and 80-year-olds coming in asking for antiviral medications…frequently.  I tell you all this just to give you perspective on how widespread of an infection it truly is.  Additionally, it’s not just an infection for those with multiple partners--all it takes is one time without a condom with a partner who is affected with it in order to contract it.  That’s it.

What Is Genital Herpes?

Genital Herpes is transmitted from person to person via sexual intercourse.  There are two types: Herpes Simplex Virus (HSV) type 1 and type 2.  HSV type 2 is usually the culprit in those with genital herpes, not oral herpes.  However, these days type 1 is being increasingly found to cause genital herpes as well, and vice versa.

What Are the Symptoms of Genital Herpes?

Patients with outbreaks of genital herpes report small (often less than one centimeter) inflamed spots in the genital area.  These small ulcers are often tender or even painful to the touch.

The very first outbreak is often the worst.  Patients may experience fever, overall malaise, headaches, and lymph node enlargement in the groin.  However, there are some patients who have a very mild first outbreak with very minimal symptoms. 

Once you’ve had that very first outbreak, your immune system produces special proteins called antibodies that help to fight off any future outbreaks.  And therefore, recurrent outbreaks tend to be less severe and shorter in duration. 

Some patients very rarely get a recurrent outbreak, whereas others may get them as frequently as once a month.  Most patients do experience a recurrence at some point.

How Is Genital Herpes Diagnosed?

Genital herpes is really best diagnosed by a physical exam.  Your doctor will be able to tell if you have it simply by looking at the affected area.  No further testing is typically necessary. 

Your doctor may also use a special swab to culture an active herpetic lesion.  However, that test is only 50% accurate, so most doctors don’t run it.  And even though a blood test is another possible diagnostic tool, these results can often be inaccurate. Many people may have had exposure to a herpes virus but never actually gotten genital herpes—so if the blood test came back positive in those cases, it would be misleading and often meaningless.

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