What is genital herpes?

Genital herpes is a sexually transmitted disease that can cause sores on the skin and mucous membranes (soft tissue lining the inside of certain organs) of male and female genital organs. Once contracted, the virus is usually not easily eliminated from the body.

Symptoms

Symptoms of genital herpes can vary, and some people may be asymptomatic, meaning they show no signs of the disease. However, the most common symptoms include:

ulcers or sores: painful lesions that may appear anywhere on the body and can rupture and form scabs before healing
itching and burning: before ulcers appear, many people experience itching, burning, or tingling in the genital area
pain when urinating
swelling and sensitivity: the genital area may become swollen and sensitive during intense outbreaks
fever and general discomfort: some people may experience fever, body aches, and general malaise during stronger outbreaks

Causes

Genital herpes is caused by the herpes simplex virus (HSV), most often HSV-2, although HSV-1 can also be responsible. The virus is highly contagious and transmitted through direct contact with infected areas or bodily fluids such as saliva or genital discharge.

Transmission can occur through:

sexual contact: the most common form of transmission, including vaginal, anal, or oral sex
contact with active lesions: the virus is most contagious when there are active sores in the genital area
contact with mucous membranes: the virus can infect moist surfaces like the mouth and genitals

Importantly, the virus can be transmitted even when the infected person has no visible symptoms or only mild ones. Practicing safe sex, using condoms, and getting tested for HSV are essential.

Diagnosis

Diagnosis is made by a dermatologist, gynecologist, or urologist, and may involve:

medical history: questions about symptoms and previous episodes of similar genital sores
physical examination: inspection of the genital area for typical lesions. Sometimes, sores may not be present during the exam
laboratory tests: to confirm diagnosis, one or more of the following may be requested:
- viral culture: a sample from the genital area is collected and sent to a lab to identify the herpes virus
- PCR test: detects herpes virus DNA in fluid from blisters or genital lesions. Highly sensitive and specific
- blood test: detects antibodies against the herpes virus but cannot determine the infection site or whether it is recent or old
recurrence evaluation: if the patient has recurrent genital sores, the case's characteristics and patterns are assessed

Early diagnosis and proper treatment help manage the infection, relieve symptoms, and reduce transmission.

Treatment

Treatment involves antiviral medications to relieve symptoms, reduce the frequency and severity of outbreaks, and help prevent transmission. While there is no definitive cure, treatment helps control symptoms. Options include:

oral antivirals: usually the first line of treatment
topical antivirals: creams or ointments applied directly to lesions to relieve symptoms
suppressive therapy: daily low-dose oral antivirals for people with frequent intense outbreaks. Helps reduce frequency and severity
self-care: keeping the genital area clean and dry, avoiding tight underwear, and using pain relievers to ease discomfort

Prevention

Prevention involves several strategies to reduce the risk of contracting or spreading HSV:

safe sex practices: correct condom use during vaginal, anal, or oral sex reduces risk, though not completely, as the virus can spread through uncovered unprotected areas
communication with sexual partners: informing partners allows them to take precautions
suppressive therapy: daily antiviral medication to reduce outbreaks. Consult a healthcare provider
proper hygiene: keeping the genital area clean and dry and avoiding excessive irritation
avoid sharing personal items: do not share towels, underwear, or sex toys during outbreaks

References

HERPES GENITAL - DIVE (Santa Catarina Epidemiological Surveillance Directorate)
Genital Herpes - Veja Saúde

You may also be interested in reading about:

Herpes

Cold sores (oral herpes)

Herpes Zoster (shingles)

By Einstein Editorial Board