Genital herpes is a common sexually transmitted infection (STI) for which you can find effective treatment in Warsaw, Poland. It can affect ANY sexually active person.
The herpes simplex virus has two types: herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2).
📈 About 3.7 billion people worldwide (67%) under 50 are infected with HSV-1.
As for HSV-2, 491 million people (13%) aged 15 to 49 are infected.
If you have any questions, feel free to consult a gynecologist in Warsaw.
How is Genital Herpes Transmitted?
Genital herpes is very easily transmitted. You can get it:
- sexually (including vaginal, anal, and oral sex);
- through contact with the genital surfaces, skin, sores (or fluids) of a partner;
- by using sex toys.
The risk of transmission is highest during an outbreak, but it can also be transmitted by a partner who has no visible signs of a herpes infection. Many carriers show no genital herpes symptoms, but the risk of transmission remains high.
You cannot get genital herpes from a toilet seat, bedding, swimming pool, cutlery, bathroom accessories, or towels. The virus dies very quickly in the environment. Don't believe the myths!
What is Genital Herpes?
Genital herpes is a viral disease that affects the mucous membranes of the genitals. It is one of the most common sexually transmitted infections. Genital herpes is caused by herpes simplex viruses type 1 and type 2 (HSV-1 and HSV-2). The virus is transmitted through direct contact with infected mucous membranes or skin with micro-tears. It is important to understand that even in the absence of visible symptoms, the virus can be transmitted and cause disease in a partner.
Causes and Risk Factors for Genital Herpes
Anyone can get genital herpes, regardless of age or gender. However, some groups of people are at higher risk. Risk factors include:
- Direct contact with infected mucous membranes or skin with micro-tears
- Having other sexually transmitted infections
- A weakened immune system
- Early onset of sexual activity
- Multiple sexual partners
- Frequent change of sexual partners
- Negligent use of barrier contraception methods
These factors can significantly increase the likelihood of contracting the herpes virus and developing the disease.
Is There a Link Between Genital and Oral Herpes?
Oral herpes (cold sores) is almost always caused by HSV-1, while genital herpes is usually caused by HSV-2.
BUT! During oral sex, HSV-1 can "migrate" from the oral cavity to a partner's genitals, resulting in genital herpes caused by HSV-1.
If you already have an oral herpes infection, subsequent infection of the genital area with HSV-1 is unlikely. You may have no symptoms at all.
Genital herpes in women is a common condition, with women being affected more often than men. It is important to be aware of the specific symptoms and manifestations in women, especially for those who are planning a pregnancy or are already pregnant.
Symptoms of a Primary Genital Herpes Outbreak
If symptoms do occur, they usually appear 2-12 days after the initial infection and include:
- pain or itching in the genital area;
- the presence of small blisters or sores (which can cause pain during urination).
- The first outbreak of genital herpes can last 2-4 weeks. During this time, the sores open and release fluid. After a few days, they scab over and then heal without leaving scars.
Symptoms of a primary infection can also include fever, body aches, headache, and swollen lymph nodes.
Diagnosing Genital Herpes in Warsaw
A diagnosis can be made clinically (by visual inspection) based on typical vesicular lesions and with the help of certain laboratory tests:
✔️ Culture method — examining the contents of blisters and sores; ✔️ PCR — detecting the virus's DNA in blood, blister fluid, or cerebrospinal fluid. This is considered the gold standard for diagnosis. ✔️ Blood test for antibodies to HSV to detect a past herpes infection.
The immune system produces specific antibodies upon contact with the virus, and the level of immune response plays an important role in diagnosis.
In a primary infection, IgG HSV antibodies are absent; seroconversion (the period during which specific antibodies appear in sufficient quantity to be detected) is observed after 90 days.
There is NO need to search for herpes using direct methods (culture and PCR) if you have no visible signs of herpes — blisters or sores. It's highly likely that we won't find it and won't be able to confirm carrier status.
When is Serological Testing for Genital Herpes Useful?
Serological diagnosis of genital herpes in the absence of symptoms may be useful in the following cases:
- You have symptoms or suspicion of an atypical genital condition, but direct virus detection methods are negative. However, a negative test for IgG HSV-2 and a positive test for IgG HSV-1 does NOT confirm the role of HSV-1 as the etiological factor of recurrent atypical genital disease;
- During the first episode of genital herpes, when differentiating between a primary infection and a previously asymptomatic course. In a primary infection, IgG HSV antibodies are absent, and seroconversion is observed after 90 days;
- Your sexual partner has been diagnosed with genital herpes and you are very concerned about being infected. Read below for what to do in such cases to reduce the risk of transmission;
- You are an asymptomatic pregnant woman, but your sexual partner has had symptoms of genital herpes in the past.
- None of the diagnostic methods can give a precise answer as to how long ago you were infected with herpes. Symptoms may not appear for the first few weeks or even years after contracting the herpes virus.
- If you are diagnosed with genital herpes, be sure to inform your current and previous sexual partners.
What to Do if Your Partner Has Genital Herpes
You can reduce your risk of infection if your partner takes antiviral medication every day and/or if you avoid sexual intercourse during your partner's herpes outbreaks.
To completely avoid genital herpes, you must abstain from ALL types of sex.
A less effective alternative:
- Choose long-term, mutually monogamous relationships;
- Use a condom correctly during every sexual act.
The effectiveness of using condoms to prevent the sexual transmission of herpes has not been officially confirmed. You can get infected through contact with an infected area of your partner's skin that a condom does not cover. But it's better than nothing.
By the way, women have a higher chance of contracting herpes than men. The virus is more easily transmitted from a man to a woman than the other way around.
Genital Herpes Treatment Options
An infection caused by either HSV-1 or HSV-2 stays with you for life. It is IMPOSSIBLE to cure herpes once and for all.
Treatment for genital herpes can be highly effective and should begin as early as possible, based solely on clinical findings. There is no time to wait for laboratory results. I repeat, in this case, we have the right to prescribe treatment based on visual inspection. Treatment involves taking antiviral medications such as Acyclovir, Valacyclovir, and Famciclovir. Consultation with a medical professional is crucial for selecting an individual therapy and preventing complications.
Taking antiviral medication is indicated TO:
- promote faster healing of sores during a primary episode of genital herpes;
- reduce the severity and duration of symptoms in recurrent cases;
- decrease the frequency of recurrences;
- minimize the likelihood of transmitting the virus to a partner.
To be effective, antiviral treatment should be started within the first 5 days after symptoms appear.
The antiviral drugs that can be prescribed for treating any type of herpes are Acyclovir, Valacyclovir, and Famciclovir. Period. No herbal remedies like Proteflazid or immunostimulants that supposedly "help the immune system get rid of the virus" should be prescribed.
Treatment usually lasts 5-10 days. You will be prescribed ONE of the above medications orally (in pill form).
Topical treatment (antiviral ointment, cream) is NOT recommended due to lower efficacy and the frequent development of resistance.
Intravenous therapy may be indicated in very rare cases (e.g., persistent vomiting, inability to swallow a pill).
To reduce pain, local anesthetics in the form of a gel or ointment (lidocaine) can be used.
Home Care Tips to Relieve Symptoms
- Regularly wash the areas with blisters and sores with plain running water to prevent them from becoming infected;
- Apply an ice pack wrapped in a cloth to the affected skin area to reduce pain. DO NOT apply ice directly to the skin;
- Apply petroleum jelly or a 5% lidocaine cream to the skin to reduce pain during urination;
- Wash your hands before and after applying any pain relief products;
- Avoid tight clothing that can irritate the blisters or sores;
- Do not touch the blisters and sores, except when applying creams or ointments;
- Pouring water over the area while urinating can significantly reduce pain (urinate in the shower or using a bidet sprayer).
Why Do Herpes Recurrences Happen?
Once in your body, the herpes simplex virus stays there forever. It "settles" in a nearby nerve and causes blisters and sores to form in the same area, usually without spreading elsewhere.
Recurrences are milder than the first episode of genital herpes. Over time, recurrences tend to happen less frequently and become less severe. Some people do not experience recurrences at all.
What Can Trigger a Recurrence?
- Ultraviolet light (tanning beds, sunbathing);
- Friction in the genital area (due to dryness during sex, from tight clothing);
- Smoking;
- Alcohol consumption;
- Any illness;
- Stress;
- Menstruation;
- Surgical interventions on the genitals;
- Chemotherapy.
Treatment Plans for Recurrent Genital Herpes
- Episodic antiviral therapy for one to several days — effective in reducing the duration of clinical manifestations by 1-2 days (the sooner you start treatment, the better).
- Suppressive therapy, i.e., continuous intake of low-dose antiviral drugs — in some cases, this can prevent flare-ups for a long period, but spontaneous recurrences may still occur from time to time.
Long-term suppressive therapy does not lead to an accumulation of toxicity or organ damage. Dose adjustment is only necessary for severe kidney disease.
What Happens if I Don't Treat Genital Herpes?
Genital herpes can lead to very painful sores and can be severe in people with suppressed immune systems.
If you touch the blisters and sores, there is a high probability of transferring the infection to other parts of your body (e.g., your eyes). Wash your hands thoroughly to avoid spreading the infection.
During pregnancy, in some cases (discussed below), refusing treatment can have very adverse consequences for the fetus.
Complications Associated with Genital Herpes
- Increased risk of contracting other STIs, including HIV;
- Babies born to infected mothers can contract herpes during childbirth. Possible consequences include brain damage, blindness, or death of the newborn;
- Inflammation of the urethra. In some cases, due to swelling of the urethra, catheterization of the bladder may be necessary to drain urine;
- Meningitis (inflammation of the membranes surrounding the brain) — a very rare but serious complication;
- The herpes virus can affect the nervous system, causing damage to both the central and peripheral nervous systems. This complicates the clinical picture and increases the risk of various health problems;
- Proctitis (inflammation of the rectum) — more common in men who have sex with men.
Impact of Genital Herpes on the Nervous System
Genital herpes can cause neurological complications, especially in people with weakened immune systems. The virus can infect nerve cells and cause inflammation in the nervous system. This can lead to the following symptoms:
- Pain in the groin and lower back
- Numbness or tingling in the genital area
- Decreased sensation in the genital area
- Bladder and bowel dysfunction
These symptoms can significantly worsen quality of life and require timely medical intervention.
Impact of Genital Herpes on the Genitals
Genital herpes can cause inflammation and damage to the mucous membranes of the genitals. This can lead to the following symptoms:
- Pain and burning in the genital area
- Rashes and ulcers on the mucous membranes
- Swelling and redness in the genital area
- Impaired function of the genitals
These manifestations can be very painful and require timely treatment to prevent complications.
Genital Herpes Prevention
Preventing genital herpes involves several important measures:
- Using condoms during sexual intercourse
- Reducing the number of sexual partners
- Avoiding contact with infected mucous membranes or skin with micro-tears
- Timely treatment of other sexually transmitted infections
- Strengthening the immune system
- Regular medical check-ups and tests for HSV-1 and HSV-2
These measures will help reduce the risk of contracting genital herpes and maintain the health of the genitals and immune system.
Genital Herpes and Pregnancy
If you have had episodes of genital herpes BEFORE pregnancy, you have a high chance of giving birth to a healthy baby via a natural delivery.
If genital herpes is first diagnosed DURING pregnancy, the risk of transmitting the infection to the fetus increases, with the subsequent development of neonatal herpes, which can be fatal.
Treating a Primary Episode During Pregnancy
In the first and second trimesters, if you have symptoms, Acyclovir will be recommended. You will most likely be able to give birth naturally. From the 36th week of pregnancy, you will be prescribed Acyclovir again to prevent recurrences and thus reduce the risk of infecting the fetus.
A Cesarean section should be considered for all women who have symptoms of a herpesvirus infection within 6 weeks before delivery, as the risk of transmitting the virus to the fetus during a physiological birth is very high.
Treating Recurrent Episodes During Pregnancy
The risk of infecting the fetus during a recurrent genital herpes episode is very low.
Suppressive or episodic therapy is not recommended in the early stages of pregnancy.
Symptomatic recurrences of genital herpes during the third trimester are usually short-lived. A vaginal delivery is appropriate if there are no sores at the time of labor.
If a woman has clinical manifestations of genital herpes after 36 weeks or during labor, Acyclovir is indicated. If no damage to the genitals is anticipated during childbirth, there is no indication for a Cesarean section.
About the Author
Dr. Anastasiia Sergiienko is a Ukrainian gynecologist practicing in Warsaw. She adheres to the principles of evidence-based medicine and focuses on patient comfort and care. Anastasiia has international experience and has trained at Harvard Medical School. She also runs a blog about women's health for over 34,000 followers (Instagram & Facebook) and provides consultations in Ukrainian, English, Polish, and Russian.
If you have any concerns about genital herpes or are experiencing symptoms, our specialists at Aurora Medical are here to provide confidential care. Umów wizytę to schedule a consultation at our clinic in Warsaw.