Genital herpes is a sexually transmitted infection (STI). Genital herpes causes blisters and ulcers. It is caused by the herpes simplex virus (HSV), which is passed on through skin-to-skin contact. Sexual contact is the primary way that the virus spreads. After the initial infection, the virus lies dormant in your body and can reactivate several times a year.
Herpes genital is caused by the herpes simplex virus type 1 or type 2 and can manifest as primary or recurrent infection. It causes herpetic sores, which are painful blisters (fluid-filled bumps) that can break open and ooze fluid. Genital herpes can cause pain, itching and sores in your genital area. But you may have no signs or symptoms of genital herpes. If infected, you can be contagious even if you have no visible sores.
Types of herpes genital
Two types of the herpes simplex virus (HSV) cause genital herpes:
HSV-1 This type usually causes cold sores, but it can also cause genital herpes.
HSV-2 This type usually causes genital herpes, but it can also cause cold sores.
Herpes Virus Transmission
It is a sexually transmitted infection. The viruses enter the body through skin abrasions or mucous membranes. Mucous membranes are the thin layers of tissue that line the openings of your body. They can be found in your nose, mouth, and genitals. Once the viruses are inside the body, they incorporate themselves into the cells. Viruses tend to multiply or adapt to their environments very easily, which makes treating them difficult.
HSV-1 or HSV-2 can be found in bodily fluids, including–
- Vaginal secretions
The virus can be passed on by:
- Having any skin-to-skin contact with the infected area
- Vaginal, anal or oral sex without a condom or dental dam
- Transferring the infection on fingers from someone else to your genitals
- Sharing sex toys that aren’t washed or covered with a new condom each time they are used.
- The virus is most infectious when you have blisters, but it can be passed on when someone has no symptoms. This is normally immediately before or after an outbreak.
- If you have genital herpes while pregnant you can pass the virus on to your unborn baby. It’s important to speak to your healthcare provider as soon as possible.
Classification of Herpes genitalis
Primary herpes genitalis
Primary genital infections with HSV-1 and HSV-2 are usually asymptomatic 11. The classical clinical features consist of macular or papular skin and mucous membrane lesions occurring approx. 4–7 days after sexual contact; these progress to vesicles, pustules and ulcers and can last for up to 3 weeks.
Recurrent herpes genitalis
Following the primary eruption the virus establishes lifelong latency in sensory neural ganglions; in the case of primary genital infection the sacral ganglions are mainly involved. From here the virus can reactivate, causing recurrent infection. Viral reactivation is common in the presence of immune-genetic predisposition, though reactivations decrease with increasing age.
Asymptomatic genital viral shedding
In the majority of cases endogenous viral reactivation is characterized by asymptomatic genital viral shedding. Most commonly HSV-2 is shed by HSV-2 seropositive patients, and this is the case for almost anyone who is anti-HSV-2 IgG positive. In contrast, HSV-1 shedding is uncommon.
Symptoms of Herpes genitalis
Many people with genital herpes won’t get any symptoms, or may get symptoms for the first time months or even years after they were infected. You can get herpes blisters on your penis, vagina, anus, throat, on the top of your thighs and buttocks. You can also get them around your mouth (where they’re called cold sores).
The appearance of blisters is known as an outbreak. On average, a first outbreak will appear 4 days after contracting the virus, according to the Centers for Disease Control and Prevention (CDC). However, it can take as little as 2 days, or as much as 12 days or more, to appear.
General symptoms for anyone include the following:
- Blisters may appear in the mouth and on the lips, face, and anywhere else that came into contact with areas of infection.
- The area that has contracted the condition often starts to itch, or tingle, before blisters actually appear.
- The blisters may become ulcerated (open sores) and ooze fluid.
- A crust may appear over the sores within a week of the outbreak.
- The lymph glands may become swollen. Lymph glands fight infection and inflammation in the body.
- The viral infection may cause headaches, body aches, and fever.
- General symptoms for a baby born with herpes (contracted HSV through a vaginal delivery) may include ulcers on the face, body, and genitals.
Babies when are born with genital herpes can develop very severe complications and experience:
- brain damage
It’s very important to tell a doctor if there’s a current genital herpes diagnosis or HSV is contracted while pregnant.
Complications associated with genital herpes may include
Other sexually transmitted infection- Having genital sores increases your risk of transmitting or contracting other sexually transmitted infections, including AIDS.
Newborn infection- Babies born to infected mothers can be exposed to the virus during the birthing process. This may result in brain damage, blindness or death for the newborn.
Bladder problems- In some cases, the sores associated with genital herpes can cause inflammation around the tube that delivers urine from your bladder to the outside world (urethra). The swelling can close the urethra for several days, requiring the insertion of a catheter to drain your bladder.
Meningitis- In rare instances, HSV infection leads to inflammation of the membranes and cerebrospinal fluid surrounding your brain and spinal cord.
Rectal inflammation (proctitis)- Genital herpes can lead to inflammation of the lining of the rectum, particularly in men who have sex with men.
Diagnosis of Herpes genitalis
A doctor can typically diagnose a herpes transmission by a visual examination of the herpes sores. Although testing is not always necessary, a doctor may confirm their diagnosis through laboratory tests.
Methods to detect HSV and HSV-specific antibody- Viral DNA detection, Virus isolation, Enzyme-linked immunosorbent assay (ELISA), HSV 1 & 2 related antibody detection etc.
If you have genital herpes you should be tested for other STIs. It’s important that you tell your recent sexual partner/s so they can also get tested and treated. Many people who have herpes do not notice anything wrong, and by telling them you can help to stop the virus being passed on.
- Using a new external (male) or internal (female) condom or dental dam every time you have vaginal, anal or oral sex will reduce the risk of herpes being passed on. If either you or your partner has a herpes outbreak (blisters) it’s best to wait until the symptoms have cleared up before having sex.
- Herpes can also be transmitted by sharing sex toys. To reduce this risk, avoid sharing your sex toys. Alternatively, make sure that they are washed and covered with a new condom between each use.
- Use a new dental dam or latex gloves for exploring your partner’s anus with your fingers, mouth or tongue. Use latex gloves for fisting.
- Wash your hands after touching blisters. This is especially important before handling contact lenses because herpes can cause an eye infection.
- Taking pre-exposure prophylaxis (PrEP), the contraceptive pill or any other type of contraception – apart from condoms – won’t protect you from herpes and other STIs.
Treatment of Herpes Genitalis
There is no cure for the herpes simplex virus. The blisters usually heal and go by themselves, so you may not always need treatment. If treatment is needed, there are antiviral medicines which can help. These can shorten outbreaks, relieve discomfort and stop symptoms from getting worse. Treatment can reduce outbreaks, but it cannot cure herpes simplex viruses.
Standard first-line drugs include acyclovir, valacyclovir and famciclovir. The specific antiviral action of these acyclic nucleoside analogues is based on their phosphorylation to monophosphate form by thymidine kinase (TK), the key enzyme of HSV-1 and HSV-2. The antiviral treatment is most effective when you take it within the first five days of symptoms appearing. Avoid touching the blisters as this can spread the infection. If treatment requires you to apply cream to a sore, gently pat the cream on, being careful not to rub around the surrounding area.
The question of possible immunization is often raised not only by doctors but also by many patients affected by herpes genitalis. To date, however, there is no licensed vaccine against herpes genitalis, though research has been ongoing for a number of decades.
You can ease your symptoms by:
- Keeping the affected area clean using plain or salt water to prevent blisters or ulcers from becoming infected
- Applying petroleum jelly, such as Vaseline, to any blisters or ulcers to reduce pain when passing urine
- Asking a healthcare provider to recommend painkilling creams
- Avoiding tight clothing because it might irritate the blisters and ulcers.
Don’t have sex until you or your partner have finished your treatment, and the blisters or ulcers have gone. Recurrent outbreaks are usually milder than the first episode of genital herpes and over time they tend to occur less often.
Ayurveda and Genital herpes
When it comes to Ayurvedic treatment for herpes, solutions are available. Herpes is known as Visarpa in Ayurveda. It is an infectious disease caused by Nita group (Herpes group) of viruses.
- Vatika Visarpa Fever, inflammation, twitching, pins and needles, tearing pain, giddiness, pricking pain, malaise, cramps, tremors, fever, bone and joint pain and their dislocation, shivering, anorexia, and indigestion
- Paittika Visarpa Fever, malaise, red pustules, which are rapidly spreading and suppurating
- Kaphaja VisarpaNumbness, stiffness, heaviness, pain in the body, pustules with exudates, deep-seated ulcers over the pustules with a surrounded capillary network and covered with many skin scabs.
- Sannipatika Visarpa
- Granthi vispara
Glandular involvement along with all the symptoms of herpes
Agni Visarpa: Fever, vomiting, diarrhea, thirst, dizziness, splitting pain in regional glands, anorexia, pain all over the body, loss of consciousness, sleeplessness, dyspnoea, hiccough, mental confusion, and finally death
Kardama Visarpa: Red, yellow and pale yellow color eruptions with dull pain, edema, deep-seated suppuration, and eruptions that are free from exudations
Management in ayurveda it includes–
- Langhana therapy for improving immunity and to fight against the virus
- Herbs are used due to their antiviral, antibacterial, anti-inflammatory, antioxidant, and antitumor activity, such as Musta, Bala, Guduchi, Yashti, Chandana, Usheera
- Tikta dravya which pacifies the vitiation of rakta and pitta, which are the main causative factor for herpes
- An induction of controlled vomiting for infection arising due to pitta dosha
- Compounds with a bitter taste (tikta rasa pradana) administration to increase the flow of gastric juice and for the virus destruction
- Administration of herbs (Sneha pana) for purgation
- Rakta mokshana should be administered if the route of transmission is blood
- Kasisadi ghruta for external application
- Ayurvedic supplements may include- Triphala, Neem, Gandhakarasayan, kanchanar guggulu, Mahamanistadi kwatha etc.
Genital herpes is a relatively common STI. It doesn’t always cause symptoms, so if there’s a chance you might have it, it’s best to get tested as soon as possible to avoid accidentally passing the virus to others. While there’s no cure for herpes, antiviral medication can help to reduce the number of outbreaks you have. Just keep in mind that it is still possible to pass it to others when you aren’t having an outbreak, so be sure to use some type of barrier protection during sexual activity.
Ayurvedic medication works on balancing the doshas by eliminating the aggravated pitta thus curing and limiting the spread of the virus. Ayurveda also helps increase the immunity which eventually helps with fighting with the virus. Ayurveda builds a good support therapy; improving the symptoms and quality of life.
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