Genital Herpes

Genital herpes is a sexually transmitted disease caused by type 1 or 2 of the herpes simplex virus. The disorder is characterised by red spots on the skin, blisters and itching around the genitals. 

What is genital herpes? 

Genital herpes is a sexually transmitted disease caused by type 1 or 2 of the herpes simplex virus. While herpes simplex virus type 1 is mostly responsible for a cold sore, herpes simplex virus type 2 is the one that often leads to genital herpes. If you are infected, you will notice this in the form of blisters and scabs on and around the genitalia and/or anus. The virus remains dormant in the body, namely withdrawn into a nerve of the pelvis. If resistance is lowered, the virus can be reactivated. The virus is transmitted through the skin and mucous membrane of the genitalia and the anus. It can also be spread via the fingers. The risk of infection is greatest when someone has blisters or sores. If the virus returns, the symptoms are often less severe and do not last as long. It is important to start medication immediately after the first bout.  

Recently, there has been a lot of talk about the HPV virus (Human Papillomavirus). This is a virus that can later lead to cervical cancer. The two viruses are often mixed up. However, genital herpes cannot cause cervical cancer and does not damage the uterus.  

What are the causes of genital herpes? 

The cause of genital herpes lies in the transmission of the virus, which occurs through contact between the mouth and the genitals or only between the genitals. Herpes type 1 (herpes labialis) can sometimes lead to genital herpes (herpes type 2).  It is a sexually transmitted disease because it is caused by sexual contact. The person who has herpes infects the other person if they come into contact with the infected person's skin or mucous membrane. The herpes infection can also be spread across your own body. It is important to know that the condition can also be transmitted even if no symptoms, such as blisters, are visible. 50 to 70% of people are carriers of the herpes virus. After the complaints have disappeared, it remains in a dormant state in the body. The virus can then be 'reactivated' during a period when you are living less healthily or if your resistance is low for other reasons such as taking medication.  

What forms of genital herpes are there? 

Herpes, in full Herpesviridae, is a virus that leads to diseases in humans and animals. The diseases that the virus can cause in humans include chicken pox, shingles, herpes stomatitis, herpetic whitlow (on the fingers), herpes labialis (cold sores) and genital herpes. Genital herpes is an STI generally caused by herpes simplex virus type 2. A characteristic of the herpes virus is that it remains latently present in the body and occasionally manifests itself again. When the virus is active it manifests itself through symptoms such as itching, redness on the skin as well as mucous membranes and blisters around the genitalia. This can be accompanied by fever, fatigue, swollen glands. 

After a first outbreak of the virus, another episode of complaints may occur. In 90% of the cases, this occurs within the first year. The outbreak is often provoked by stress and fatigue. In addition, sunlight, flu and menstruation are possible 'triggers' for the virus. Re-infection is prevented thanks to the production of antibodies after the first infection. The severity is greatest during the first infection because the antibodies offer partial cross protection.  

The psychological aspects 

A large number of people have to deal with an STI during their lives. Unfortunately, however, the subject is still taboo. It is often thought that someone who has an STI has had a profligate sex life. It is hard to deal with, and it takes a lot of courage to talk about it. Even when the symptoms of genital herpes have disappeared, the virus remains present in the body. Knowing that you cannot get rid of it can also be very hard to deal with. It is important that it is discussed so that people no longer have to feel stigmatised. The tricky thing about genital herpes is that you can transmit it at any time, even when the virus is 'at rest'. Even if the chance is very small because you have not had any complaints in a while, you should always tell your sexual partner about it. This can cause a lot of tension. 

How can you recognise genital herpes? 

Most people do not notice when they have contracted the herpes virus. If complaints do occur, they are usually expressed one week after the infection. The first infection, or primary destination, causes the most complaints. Genital herpes can cause a large number of complaints, such as fever, headaches, muscle pain and painful swollen lymph nodes. In addition, it causes complaints to the genitals, such as a red rash with blisters filled with clear fluid. The symptoms of a primary infection in women include: pain, itching, difficulty urinating, vaginal discharge and lymph node swelling. In men, the infection is sometimes accompanied by an inflammation of the urethra. The blisters are often very painful. 

Is there anything I can do myself about genital herpes? 

If you suspect that you have genital herpes, consult a doctor immediately. The doctor can quickly determine whether this condition is involved. If necessary, the doctor will use a swab to remove some moisture from the vesicles for examination in the laboratory. 

It is important that you do not touch the blisters with your hands. You can transmit the infection through your hands. Sexual contact is not recommended if you have this infection. The wounds need time to heal. If you are sexually active while you have symptoms, make sure you use a condom. This significantly reduces the chance that you will transmit the virus.  If you have a cold sore (herpes labialis), avoid oral sex.  Discuss with your partner that you have herpes, no matter whether it is active or latent.  There is a chance that you may have contracted another STI. The blisters make the body more susceptible to getting other STIs. 

A herpes infection in someone who is pregnant can sometimes lead to miscarriage or premature birth. The risk of complications is greatest if the virus is contracted 4-6 weeks before the due date. Contamination of the child is only possible if the woman is suffering from active herpes at the time of delivery. The child may become infected during childbirth and in some cases it is necessary to carry out a caesarean section. 

What are the forms of treatment? 

The symptoms of herpes will disappear by themselves, but in the event of a severe acute bout, medication will be prescribed. The herpes virus remains dormant in your body after the symptoms have passed.  The virus cannot yet be killed by medication, but the most serious symptoms can be inhibited with tablets, such as the medication valaciclovir. The chance of the medicines being effective is greater if they are taken sooner. So you should seek immediate advice from a doctor as soon as you experience symptoms. In case of frequent bouts of herpes, medication is also recommended to slow down and reduce the symptoms. We will discuss below which medicines are recommended. 

  • Valaciclovir 500 mg p.o: 2 dd for 5 days
  • Aciclovir 200 mg p.o: 5 dd for 5 days
  • Aciclovir 400 mg p.o: 3 dd for 5 days
  • Famciclovir 250 mg p.o: 3 dd for 5 days

 

Antiviral medicines 

Antiviral medicines inhibit the growth of the virus that causes the genital herpes. This will reduce the symptoms after a few days. However, the virus is still present in the body and can therefore reappear.  

Examples of antivirals: aciclovir, famciclovir and valaciclovir. 

If the symptoms indicate a primary infection, then medication is usually started 5 days after the start of the symptoms. It is important to treat patients with antiviral therapy because patients can develop serious or long-term symptoms through a primary herpes infection. Recidivism, after the primary infection, is generally associated with fewer complaints.  

Zinc oxide has an astringent and protective effect on the skin. Some variants also reduce itching or have a cooling effect. This is often the case when zinc oxide is used in cream or paste. 

Alternative treatments 

Vaccines are currently being developed against the HSV virus. The vaccine under development is called trivalent vaccine. It forms three antibodies that bind to proteins on the virus so that the virus can be rendered harmless. This allows the immune system to eliminate the virus itself. If you are looking for alternative therapies instead of or in addition to medication, you can use certain oils with antiviral properties. Some of these are: coconut oil, oregano oil, olive oil extract. It is important that you take care of your body and ensure a healthy and balanced diet. 

Lifestyle changes 

Herpes is an STI, and that is why it is always pretty scary when it is detected. The resulting complaints, such as blisters, redness and itching, are also very annoying and often causes the infected individual to feel embarassed. If you know that you are a carrier of the virus, it is important that you discuss this with your partner or people with whom you have been sexually active. Raising awareness among you and your partners helps to prevent the virus from spreading further. Once you have the virus, it can reappear in periods when your resistance is lowered. Make sure you live a healthy life, paying particular attention to your diet and rest at night. 

 

 

References

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Rijksinstituut voor Volksgezondheid en Milieu (RIVM). (n.a.). Herpes Genitalis. Retrieved from: https://www.rivm.nl/herpes-genitalis

SoAids. (n.a.). Wat zijn de symptomen van herpes? Retrieved from: https://www.soaaids.nl/nl/soas/meest-voorkomende-soas/herpes-genitalis  

Wetenschap in Beeld (WiB). (n.a.). Herpesvaccin staat voor de deur. Retrieved from: https://wibnet.nl/geneeskunde/medicijnen/herpesvaccin-staat-voor-de-deur 

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