Definition

Genital herpes in women is a sexually transmitted infection (STI) that affects the female genital area. Genital herpes can spread through vaginal, oral, or anal sex. Many sufferers are unaware they have herpes because no signs of infection appear.

Causes

Genital herpes infection is caused by two types of herpes simplex viruses (HSV):

• HSV Type 1: This virus most often causes infections in the mouth and lips, known as oral herpes. If HSV-1 spreads to the genital area and causes symptoms, it is still referred to as an HSV-1 infection.
• HSV Type 2: This virus most frequently causes genital herpes. HSV-2 can spread to the mouth during oral sex. If HSV-2 spreads to the mouth and lips during oral sex, it is still referred to as an HSV-2 infection.

Both viruses are contagious and can cause similar symptoms. The infection spreads through contact with someone already infected with HSV. Some people are unaware they have herpes because they show no symptoms. These individuals can still transmit herpes to others.

Genital herpes generally spreads through:

• Sexual activities or contact through the vagina, mouth, or anus.
• Contact with open sores.
• Contact with the skin of someone infected with the herpes virus.
• Childbirth, from mother to baby.
• A baby coming into contact with sores on the mother's breast during breastfeeding.

Risk factor

Genital herpes is more commonly found in women than in men. Among those aged 14-49, 1 in 5 women is estimated to have genital herpes, compared to 1 in 10 men in the same age range. The anatomy of the female body makes women more susceptible to genital herpes. Small tears in vaginal tissue can facilitate herpes infection.

Genital herpes is also much more common among African-American women. One in two African-American women aged 14 to 49 is infected with HSV-2, which causes genital herpes.

Symptoms

Most women with genital herpes are unaware they are infected. Once infected, the virus can remain in your nerve cells for life. Symptoms can appear when the virus becomes active in the body. Some women may never experience symptoms or may have occasional outbreaks when the virus becomes active, causing recurrences. Factors like stress or weakened immunity from illness can also trigger the virus to become active and cause symptoms.

Symptoms can be severe and prolonged, especially in individuals with weakened or compromised immune systems, such as those with HIV or cancer.

Initial symptoms of genital herpes typically appear 2-12 days after contact with an infected person and can last for 2-4 weeks. Small red spots may appear on the vagina or mouth. Mild sores are sometimes mistaken for insect bites or other issues. After a few days, the sores will crust over and heal without leaving scars.

In addition to sores, other initial symptoms of genital herpes can include:

• Abdominal discomfort
• Flu-like symptoms such as fever, joint pain, muscle aches, or headache
• Itching or burning sensation in the genital area
• Pain in the legs, buttocks, or genital area
• Swollen lymph nodes
• Unusual vaginal discharge

Meanwhile, a fetus infected with herpes during pregnancy can be born prematurely or have brain, skin, or eye disorders. If you have genital herpes and are pregnant, make sure to inform your doctor, even if you are not experiencing symptoms.

Diagnosis

Doctors typically examine the appearance of sores and ask detailed questions about your symptoms. If your doctor suspects an STI, they will also ask about your sexual history. Comprehensive STI screening is generally performed on high-risk individuals, such as those with multiple sexual partners.

Sores can also be sampled for further examination in the laboratory. However, if there are no symptoms, genital herpes can be difficult to diagnose. Blood tests to detect antibodies against the herpes virus can help diagnose the disease in asymptomatic women.

Management

There is no cure for genital herpes. However, doctors can prescribe antiviral medications to prevent recurrences and shorten the duration of symptoms. Daily antiviral therapy for herpes can reduce the risk of transmitting the virus to partners. Antivirals are usually prescribed once symptoms appear. Consult your doctor for further treatment.

When symptoms occur, you can take the following steps to speed healing and prevent herpes from spreading to other body parts or healthy individuals:

• Keep the sores clean and dry.
• Avoid touching the sores.
• Wash your hands after touching the sores.
• Avoid sexual activity while experiencing symptoms until the sores heal.
• Inform your sexual partner so they can get tested and treated if necessary.

Remember that the herpes virus does not leave your body; it simply becomes inactive. Consult your doctor about steps you can take to prevent the spread of herpes to others.

Complications

In most women, genital herpes does not usually cause serious health problems. However, in women with weakened immune systems, herpes symptoms can be severe and prolonged. Additionally, though rare, HSV-1 and HSV-2 can cause serious complications like inflammation of the membranes covering the brain and spinal cord (aseptic meningitis). Herpes in newborns is also a serious complication of genital herpes.

Prevention

Most women contract genital herpes through sexual contact with someone with herpes sores. You can contract the virus without having sexual intercourse. To prevent herpes infection:

• Avoid skin and sexual contact with someone with herpes, especially during an outbreak.
• Practice safe sex by:
• Reducing the number of sexual partners.
• Using condoms during sexual intercourse.
• Engaging in sexual activity with one partner who does not have herpes and does not have other sexual partners.
• Avoid touching herpes sores as much as possible. If you do touch them, wash your hands immediately to prevent spreading the infection to other body parts or others.
• Regularly get STI screenings for you and your partner.

When to see a doctor?

If you have suspicious sores or lesions on your genital area, consult a doctor for more information.

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