If you recently experienced your first episode of genital herpes, it no doubt came as a shock. The most important things for you to realise now are that the worst is probably behind you and that if you continue to have this problem there is help available. Herpes is not dangerous and is usually mild and manageable.
|The first episode of genital herpes is almost always the most severe, and some people never have another outbreak. People with genital herpes often feel embarrassed or ashamed. It's important to realise that herpes is a virus anyone can get. In fact, about one in six Australians has genital herpes.
Your best defence against herpes is to understand it. You should know what herpes is and what causes it, what precautions to take to keep from spreading it, how to deal with emotional and social issues, what kind of help is available and where to get it.
What is Herpes?
Herpes is a common infection generally transmitted through sexual contact. You can have oral herpes (on the lips), genital herpes (on the genitals) or non-genital herpes (herpes on other parts of the body).
Strains of the virus: Type I & II
There are two types of the herpes simplex virus. Herpes I and Herpes II:
Herpes type I
Herpes type I is familiar to most of us. It is the virus that most commonly causes cold sores on the lips or face. Herpes I is often transmitted in childhood through kissing, but can be transmitted at any age. Herpes I can also be transmitted to the genitals through direct skin-to-skin contact, often oral sex.
Herpes type II
Herpes type II is the virus responsible for most genital herpes. It is most commonly transmitted through sexual contact. It is thought that about 1 in 6 Australians have Herpes II. Of these 1 in 5 have symptoms. Those without symptoms may be unaware they have the virus.
Receiving a diagnosis of genital herpes can evoke a wide range of responses. Among the many emotions associated with herpes, it is common to feel depressed, embarrassed, angry and maybe ashamed. It is a very common misconception that only people who behave in a promiscuous way get sexually transmitted infections. This is untrue. Another misconception is that people with genital herpes are dirty; herpes in the genital area acts no differently from herpes on the face, yet most people think nothing of a cold sore.
The first episode
The majority of people with genital herpes have no noticeable symptoms and do not realise they have come into contact with the virus. They may notice symptoms at a later date.
For others, the first symptoms of genital herpes may show up 2-21 days after coming into contact with the virus. The first episode of herpes is often the most severe. When you first come into contact with the virus your immune system has not had time to develop protective antibodies. This means the virus can multiply rapidly leading to significant symptoms.
If you are having a severe first episode of genital herpes, you may notice that your lymph glands are swollen (the glands under your arms, on your neck and in your groin). You may have flue like symptoms such as sore muscles, tiredness, headaches, fever and chills. You may notice swelling, pain or itching around the genitals. This may be followed by painful red spots that can form blisters. The blisters burst to form open sores or ulcers, which crust over and heal. Some people may experience a second lot of ulcers. The tenderness in the genital area can cause pain when you urinate. Women may have a discharge.
Usually, symptoms heal within 2-3 weeks. They cause no long-term damage.
Where did I get it?
It is difficult to know. You may have been recently exposed to the virus or simply be having a recurrent episode from a previous exposure, which may have been some time ago. The person who passed it to you may not have known they have the virus. Researchers do not know why some people are more affected than others.
The lifecycle of the virus
Herpes has two parts to its lifecycle: active, which is when the virus is present on the skin and sores may or may not be present, and inactive, when the virus is hidden in the body and not infectious.
What causes it to reactivate?
Researchers are uncertain about what causes the virus to reactivate. Some common triggers are menstruation, being run-down or anything that causes skin irritation, such as friction from prolonged sexual intercourse.
Triggers are different for different people and can even be different for the same person over time.
Transmission: How is herpes passed on?
When and how can herpes be transmitted?
The most common way to pass on herpes, both oral and genital, is through direct skin contact during vaginal, oral or anal sex when the virus is active on the surface of the skin. The virus cannot be spread when it is inactive (when it is in the nerve cell).
The medical terminology for the virus being released from the surface of the skin is viral shedding. Viral shedding can occur with symptoms (symptomatic herpes) and without symptoms (asymptomatic herpes). You may or may not be aware that viral shedding is occurring.
Some people get a tingling or itching feeling that may be present for a few hours or days before they develop a herpes blister. It may be accompanied by a shooting pain in the nerve that passes through the buttock of the leg. These symptoms are called a prodrome. The herpes virus may be active during a prodrome (the few days before an outbreak), while sores are present, and up to 3 days after the sores have completely healed.
Viral shedding is not always obvious. Firstly, the symptoms of herpes may be so mild they may not be noticed at all. At other times, there may be no symptoms at all. This is called asymptomatic shedding. It is currently thought that true asymptomatic shedding may occur several times a year.
Herpes in non-genital areas
Herpes prefers the soft skin on the genitals, lips and anal area. When herpes comes into contact with other parts of the body it is often difficult for it to get through thicker skin. On the rare occasion when this does occur it is often helped to get through by a cut to the skin. If you touch a sore, reduce the risk of transmission by washing your hands with soapy water to kill the herpes virus. Genital herpes is very rarely transferred on toilet seats or on towels.
How to reduce the risk of transmission
- Discuss genital herpes with your partner.
This will assist you to decide together on the precautions which suit you best.
- When you have symptoms choose sexual activities that do not include skin-to-skin contact with the affected area.
- Use condoms.
Latex condoms are good all round protection against a wide range of STDs. You are protecting yourself as well as your partner. Condoms do not cover all the potential sites of viral shedding, but they do offer useful protection against asymptomatic shedding, by covering and protecting the parts of the body that are the most likely sites of transmission. Put the condom on as soon as a complete erection occurs, not just with penetration.
- Use dental dams.
Dental dams are a thin latex sheet that can be used when giving oral sex to a woman. They will reduce her exposure to oral herpes and reduce your exposure to genital herpes. They are available from chemists.
- Keep yourself informed about available antiviral medications.
- Does your partner have herpes?
It can be useful to know whether your partner has herpes or not. If they have the same type of herpes as you, it is highly unlikely that you can pass the virus on. This knowledge may be especially useful in longer-term relationships. Read the section on diagnosis to get a better understanding of the usefulness and limitations of diagnostic testing.
Relationships: Discussing herpes with sexual partners
There are many reasons for letting potential partners know you have genital herpes before having sex with them. Being honest increases the possibility of forming an honest and trusting relationship. Once the herpes virus is discussed it is easier to work together to reduce possibilities of transmission.
Despite believing that openness is important, you may find yourself facing an inner battle when it is time to discuss genital herpes with a sexual partner/s. Think about your own experience a and how you would have preferred to learn about genital herpes. Use this knowledge to work out how you might discuss it with somebody else.
Barriers to talking about genital herpes
Often the fears of discussing genital herpes can be more stressful than the experience itself. Once you have broached the subject, some of the anxiety may disappear. You know where you stand! There are many reasons people do not tell their sexual partners:
"I so rarely get an outbreak... I don't need to let them know."
Once you have genital herpes there is a possibility that it can be transmitted when you do not have symptoms.
"It's not a long relationship, it's only casual.. and if I practice safer sex the odds of passing it on will be really small"
Many long-term relationships begin as casual relationships. Trust may be undermined if your partner believes you have not cared for them enough from the start. If you feel unable to discuss herpes avoid sex when you have symptoms and use condoms.
"I really want this relationship and if I talk about genital herpes they might reject me."
If you want the relationship and fear is holding you back from talking you may find yourself juggling to protect both your relationship and your partner's sexual health. In trying to care for your partner you may avoid sexual contact whenever you suspect a sympt5om. Your partner may not understand why you are avoiding sex and feel rejected. Often the longer you wait, the more complicated and difficult talking can be.
Take some time to work out why you are feeling the way you do. This will allow you to think clearly and to make a calm and considered decision. You can get professional support.
Approaching your sexual partner/s
What to say
Stay away from words with a negative tone such as, "prepare yourself" or "I think you might leave me". A negative tone is bound to leave both you and them feeling anxious.
Let them know that you have a history of genital herpes and that there may be times when you cannot have sex. Discuss the place of condoms in your relationship. Don't forget to ask them about their sexual health. Condoms are a good idea in any new relationship. They protect both of you from other sexually transmitted diseases. Some common sexually transmitted diseases produce no symptoms, so unless people are tested they may not know that they have them.
Through having an open discussion you are making yourself vulnerable, caring for your partner's welfare and helping create an honest and respectful relationship. It may be useful to remind yourself that this honesty reflects your values and who you are as a person.
Your partner's response
A mature partner is likely to see genital herpes as something that needs to be understood and discussed. It is reasonable to expect that they will have some initial questions. Once the topic is out in the open, concerns can be discussed, allowing you to build an honest and equal relationship This may take some time.
Sometimes a prospective partner may withdraw from you, because they have their own anxiety to deal with. However, most people will respond well and appreciate the respect you have shown them. They may ask for more information. For some, responding to genital herpes in a relationship will be a familiar experience.
Natural Ways to Reduce Outbreaks
- Buy a Dr Clark Zapper and zap at first sign of tingle.
- Do not take Arginine or Chocolate
- Take Lysine Supplements
- Oxygen cream
Stop Herpes Now, And From Coming Back.
Natural Medicine Solution For Herpes Sufferers.
Reproduced from booklet "How to get on with your life" by Novartis Pharmaceuticals Australia Pty Ltd.
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