Sexually Transmitted Diseases

Genital Herpes

When today’s urban vixen spots her "soldier over there" she has to think about the risk of sexually transmitted diseases (STDs). Genital herpes remains a commonly acquired STD among women in the US. It is caused by the herpes simplex virus (HSV) and it is transmitted by sexual intercourse: oral, vaginal or anal. There are two reasons why genital herpes is so easy to contract:

1. Since only about one-third of people who first become infected with HSV have symptoms, many people do not know that they are infected and do not protect their partner during sexual intercourse.

2. Even with people who know that they are infected, there may be no symptoms when the virus is active (asymptomatic shedding) and again protection is not used. Therefore, condoms should always be used to decrease the risk of contracting HSV.

For women who have symptoms, they are most severe during the first episode of HSV. The symptoms may include fever, headache, vaginal pain and discharge, and blisters. The episode lasts for 5-7 days before the blisters scab over, disappear and the pain resolves. When a woman contracts HSV, it remains with her for life. After the virus infects the skin, oral, anal, vaginal or vulvar area, it travels inside her body to the nerves where it lies dormant. Under times of either physical or emotional stress, the virus reactivates, infects the involved area, and again forms blisters with tenderness, tingling, or pain. Tingling or burning in the affected area may be the first sign that an outbreak is going to occur. In that case, anti-viral medications may abort a full-blown outbreak.

Laboratory tests may be done by your doctor to make the diagnosis of HSV. A viral culture or a rapid detection test may be performed on blistered or ulcerated areas. Also, the laboratory can measure herpes antibodies in blood.

Treatment involves pain relievers, as well as the antiviral medications: Valacyclovir (Valtrex), famciclovir (Famvir) or acyclovir (Zovirax). The antiviral medications will not cure HSV but will shorten the course of the outbreak and promote healing. For women with frequent outbreaks, anti-viral medications can be taken daily to reduce the number of times the virus reactivates. Table 1 below outlines the treatment that your doctor may suggest for your HSV.

Table 1: Treatment of Genital Herpes

Drug name

First Episode

Recurrent Episode

Suppression

Acyclovir (Zovirax)

400 mg TID x
7-10 days

800 mg BID x 5 days or 400 mg TID x 5 days

400 mg BID

Famciclovir (Famvir)

250 mg TID x
7 – 10 days

125 mg BID x 5 days

250 mg BID

Valacyclovir (Valtrex)

1g BID x
7 – 10 days

500 mg twice a day for 5 days

500 mg QD for people with less than 10 episodes per year or

1 g QD for those with more than 10 episodes per year

QD=once a day BID=twice a day TID=three times a day

Bottom Line

Genital herpes is a potential risk for the sexually active urban vixen. Since it is difficult, if not impossible, to determine if your partner is infected and spreading the virus, condom use is essential. If you have contracted HSV, it is not the end of the world. With common sense, precautions and medications, you will be able to have a fulfilling sexual life.

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