Are those lesions down there. . . herpes? Gulp!

I saw a patient this week.  Bright, engaging, and single. . . . she admits how dirty she feels since genital herpes was diagnosed.  “Good people get this!”  I tell her.  And, indeed it is true.  In a population-based cross-sectional survey of New York City adults, nearly 28 % were infected with herpes simplex virus (HSV-2) of which 88 % of them didn’t know it.

There is the question of:  How did I get it?  From sex (oral or genital).   Door knobs, toilet seats, utensils, or bed sheets are NOT the offending vector.

When (Read this:  from whom) did I get it?  This is difficult to say, especially if a person has had more than one sexual partner.  A current sexual partner may NOT be the source of the infection. The first outbreak usually occurs within a few weeks after infection with the virus and can be severe with symptoms like

  •  painful genital ulcers,
  •  fever,
  •  tender lymph nodes in the groin,
  •  painful urination,
  •  viral symptoms (like fever and muscle aches) and
  •  headache.

In other patients, however, the infection is mild or entirely asymptomatic. The symptoms resolve within two to three weeks

Will I get rid of the virus?  No.  After the initial outbreak, the virus travels to a nerve bundle at the base of the spine where it hibernates.  There are no symptoms during this stage.

How often will I get a recurrence?  Good question.  Within the first year after contracting HSV2, most have at least one recurrence, 1 in 3 had 6 outbreaks,  and 1 in 5 had 10 outbreaks.

How do I not get it?  (Or spread it?) HSV can shed (read this: spread to you/your sexual partners or newborn) when there are no lesions.  Use of condoms and suppressive antiviral medication can decrease the risk of spreading the infection to partners who are not infected, especially during the first year after a person becomes infected. 

Diagnosis:  See your physician for a blood test  if you have no genital lesions, or a culture if there are lesions.  This will rule out other non-herpes genital ulcers.

Stay tuned for treatment options. . . .

About Leslie Greenberg

I have been practicing as a family physician for 15 years--as both an educator of physicians and clinician. From infancy to the elderly, I perform obstetrics and general medicine. I love my career and am passionate about my field of knowledge and my patients. Follow me on Facebook at Leslie Md Greenberg Medical Disclaimer The content of this website is provided for general informational purposes only and is not intended as, nor should it be considered a substitute for, professional medical advice. Do not use the information on this website for diagnosing or treating any medical or health condition. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.
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