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
|
|
|
|
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.
