On some level, you already know that genital herpes is super-common and not at all a death sentence (for you or your sex life)—but all of that knowledge tends to go out the window when you see bumps in a place where bumps should not be.
But, just to reiterate: Genital herpes really isn’t a life ruiner—an estimated 776,000 people in the U.S. get new infections each year, according to the Centers for Disease Control and Prevention. And 15.7 percent of people in the U.S. ages 14 to 49 years old currently have genital herpes—though, this number is probably much higher as a quarter of people who have herpes don’t know it.
Still, it’s not something you’ll necessarily welcome into your life. Do your best to protect yourself by knowing as much as you can about this (again, super-common, totally NBD) STD.
What is genital herpes?
Genital herpes is caused by two viruses: The herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). Typically, HSV-2 is linked to genital herpes, and HSV-1 is linked to oral herpes, but either one can cause an outbreak of painful blisters in your crotch, according to the CDC.
HSV-2 is more common in women, per the CDC, likely because the infection is more easily transmitted from men to women during penetrative sex.
How do you get genital herpes?
Here’s where it gets kind of tricky: Both herpes viruses (HSV-1 and HSV-2) can cause genital herpes. For example, if a person with HSV-1 performs oral sex on someone—that person then gets genital HSV-1, per the CDC.
“I was sick of making myself small because I had herpes”
And while it is possible for the opposite to happen—getting oral HSV-2—genital herpes is generally only spread through genital-to-genital contact, according to the CDC.
You can also get genital herpes from a partner who doesn’t have any visible sores or symptoms—that’s because, even when it’s asymptomatic, the virus is still there and can be contagious, the CDC notes.
The good news in all of this? Contrary to popular belief, you can’t get herpes from things like public toilet seats, hotel sheets, swimming pools, or towels.
What are the symptoms of genital herpes?
Pimples down there:
“Although there are tons of conditions that can cause bumps in the genital area, usually when patients ask me about these ‘pimples,’ the cause is genital herpes,” says Nicole Van Groningen, M.D., a primary-care physician and women’s health expert at NYU Langone Medical Center.
Small herpes sores are often dismissed as ingrown hairs, clogged sweat glands, or razor burn, which is why it’s important to get any bump checked out if it lasts for more than a few days, becomes painful, or spreads.
Open genital sores:
The most common tip-off, and the symptom most likely to cause someone to go to the doctor, is painful sores around the genital area or rectum. These blisters, also referred to as a “breakout” or “flare,” may break open and leak fluid, and can last for a week or more, says Van Groningen.
Feeling hot…then cold…then hot again:
A low-grade fever often accompanies the first breakout, per the CDC. Many people assume they have the flu, but if you don’t have any other flu-like symptoms (like a sore throat or cough) or you do have any other symptoms of herpes (like bumps or sores), it’s wise to get checked out.
Lumps in your neck or armpits.
The first genital herpes outbreak is also associated with swollen lymph nodes, particularly in your neck, as your body tries to fight off the virus, according to the CDC.
No symptoms at all.
Perhaps the scariest symptom of genital herpes is that most sufferers show no symptoms of a herpes infection, or very mild symptoms, according to the CDC. This is known as asymptomatic genital herpes, and yep, it’s still contagious.
How is genital herpes generally diagnosed?
Now’s not the time to be shy—your doctor is the only one who can officially diagnose you with genital herpes, says Van Groningen. This can be easily done through a visual exam of the area—many doctors can recognize the blisters on sight—or a swab of a sore that gets sent to a lab for testing.
There is a blood test available, but it’s not necessarily the most accurate way to test for genital herpes—it doesn’t differentiate between HSV-1 and HSV-2. The blood test also won’t be able to tell you how long you’ve had the virus.
How is genital herpes treated?
There is no cure for herpes—genital or oral—but there are ways to manage it. It’s important to get treatment as soon as possible so you can prevent future outbreaks and reduce your risk of spreading the disease to others, says Van Groningen. Left untreated, genital herpes can damage your fertility, and in rare cases, spread to other parts of your body, like your eyes.
“I’m upfront with potential partners about my status. It hasn’t been much of a deal-breaker.”
If you have the virus, know the first outbreak is usually the worst, says Van Groningen. “Since herpes is caused by a virus, your doctor can prescribe antiviral medication to take at the first sign of the outbreak,” she says. The most commonly prescribed medications for herpes are Valtrex, Zovirax, and Famvir.
However, if you’re having several outbreaks each year—usually six or more—you can try chronic antiviral suppressive therapy, which can be a game changer, she says. This requires you to take a daily pill. “I’ve had patients who never have outbreaks anymore after starting chronic suppressive therapy,” she says. These pills can also lessen the chance of spreading the virus to others (though they won’t get rid of it entirely).
Can you ever prevent herpes?
Using a condom during all types of sex is the best way to reduce your risk of getting genital herpes. However, it’s not a guarantee, as it is possible to get infected when other parts of your body come into contact with infected bodily fluids, the CDC says.
“Honestly, the hardest part is that now I have to take a daily medication for the rest of my life.”
And also, because it bears repeating, while it’s still possible to transmit herpes without any symptoms, having sex with someone in an active outbreak makes transmission more likely.
While you may not be able to 100 percent prevent getting genital herpes, you can do your best to prevent spreading it to others—and that starts with being honest about your status. Not only will that help strengthen your relationships, it can protect you legally as well.
What women living with genital herpes want you to know.
“I was sick of making myself small because I had herpes. Six months after my first outbreak, I started dropping the ‘herpes bomb’ into conversations casually. My logic was that every time I told someone, ‘I have herpes,’ the words would get easier to say. ..So when I told Andy I had herpes, he immediately replied that it didn’t bother him because it was just a skin condition and he’d seen way worse during his days as a high school wrestler. Suddenly, ringworm was the most romantic thing in the world. ..Fighting the cultural stigma surrounding STDs is a battle I actually enjoy fighting. I’m not afraid of letting herpes define me if it helps someone newly diagnosed feel less alone. But to my partners—and more importantly, to myself—I’m always going to be me, not just someone with herpes.” –Ella Dawson (Read the rest of her story here)
“I actually got herpes from my ex’s ex. A couple of months into our relationship, my boyfriend casually mentioned that he felt some tingling and thought he was having a herpes flare up. I freaked out and he said it was a ‘parting gift’ from his last girlfriend but that as long as we didn’t have sex during an outbreak I should be fine. Well, that wasn’t true. I ended up testing positive for genital herpes. There is no cure for it and at first I was devastated, but in the year since I’ve come to accept it. I take medication to prevent flare-ups and, unlike my now ex-boyfriend, I’m upfront with potential partners about my status. It actually hasn’t been as much of a deal-breaker as I thought it would be. Some guys nope out but a lot of them already have it or are fine as long as we use condoms.” —Anonymous
“I think I got herpes from a Tinder hook-up. I was always careful to ask about the person’s STD status before we had sex, and we used condoms, but I love oral and, let’s be honest, lots of dudes lie. Now I have it. Honestly the hardest part to deal with is that now I have to take a daily medication for the rest of my life. It’s crazy-expensive because I have crappy insurance, but I don’t dare stop taking it because the outbreaks are really painful, plus I want to protect my new boyfriend. I’m glad I have the meds but it still pisses me off every morning when I have to take it.” —Anonymous
“Two years ago, I got a call from a previous hook-up saying he’d tested positive for herpes and I needed to get checked too. I thought I was safe—I’d had an STD screen right after I slept with him and it was negative for everything—but I scheduled one just to be safe. To my surprise, I tested positive for herpes. I didn’t have any signs at all and my doctor said it’s possible I tested too soon the last time and there weren’t enough antibodies in my system to show up on the test. I was shocked but to this day I haven’t had an ‘outbreak’ so it’s hard to believe that I really have it. I don’t take any medications for it and I really haven’t changed my sex habits at all but those are things I should probably think about soon.” —Anonymous
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