Genital Herpes Treatment in Delhi, India

Genital herpes is mainly caused by the HSV (herpes simplex virus). It is a sexually transmitted infection that doesn't have any known cure yet. It usually spreads due to skin-to-skin contact during coitus. People infected with HSV may either suffer from mild symptoms or have no symptoms at all. Medications are typically prescribed to ease the symptoms of genital herpes. It is a common sexually transmitted infection that affects at least 67% of the global population.

Types of Herpes

Herpes can be of two kinds. They are:

• HSV-1 (Oral Herpes): Oral herpes causes sores and blisters around one's mouth. These sores can last for two to three weeks before clearing up.
• HSV-2 (Genital Herpes): Sores usually occur around the genital area. It can cause a few changes in vaginal discharge. The affected patients have also complained about mild pain while urinating.

Different Stages Of Herpes

The infection puts the infected through 3 stages. They are:

• Primary Stage: The infected typically go through this stage two to eight weeks after they've been infected. Here, they may notice the formation of small with white fluid. Urination could hurt during this stage. Some patients may not notice any symptoms during this stage. They may be unaware of their condition.
• Latent Stage: Here, the virus travels from the skin into the nerves near the spine. During this stage, patients have no symptoms. All the symptoms suffered during the primary step vary.
• Shedding Stage: In this stage, the virus multiplies into nerve endings. The virus enters the fluids near the affected nerve endings. Liquids could be in the form of saliva, vaginal fluids, or saliva. This is the stage when herpes becomes contagious.
• Recurrence: Most symptoms of herpes may reoccur after a particular period. They won't be as severe as they were the first time. One can predict reoccurrences when the skin starts to itch. Women may notice recurrences during their menstruation.

Causes of Genital Herpes

Genital herpes is caused by a virus called HSV. Sometimes, if the person with herpes is pregnant, even the baby might get infected by herpes. Once infected, certain things may trigger the symptoms of herpes. They are:

• Fatigue
• Emotional stress
• Menstruation
• Genital stimulation
• Low immunity
• Chemotherapy
• Diabetes
• Exposure to cold
• Exposure to sunlight
• Injuries
• Illnesses
• Physical exertion

Genital herpes can spread due to the following:

• Having coitus without using a condom.
• Sharing sex toys.
• Failure to clean the sex toy after every use.
• Any oral or genital contact with somebody who has herpes.

Symptoms of Genital Herpes

Most of the time, the symptoms of herpes are mild and considered to be a skin-related issue. Symptoms usually include:

• Itching
• Severe pain while urinating.
• Severely painful sores around the genital area, thighs, or buttocks.
• Blisters around the genital area.
• Painful ulcers form after the blisters rupture or bleed.
• Scab formation as the ulcers heal.
• Abnormal discharges from the urethra.
• Abnormal vaginal discharge.

During the first stage of genital herpes, one may also witness the following:

• Severe headache
• Severe body aches
• Fever
• Swelling in the groins lymph nodes.

Diagnosis of Genital Herpes

Several diagnostic tests may be conducted to detect genital herpes. A few of them are:

• Culture test: This test helps to detect the presence of HSV in the ulcers. However, this test successfully detects herpes only in about 40% of the patients. It can detect the virus more accurately when the blisters are new. Thus, it is essential to consult a doctor within 48 hours of the outbreak.
• Polymerase chain reaction test: This test is more sensitive than the culture test. It is conducted to identify the virus in urinary and genital tract cells and secretions.
• Blood tests: Blood tests may be conducted if the patient is asymptomatic but has had a history of blisters and ulcers. It is usually performed on those who think that they've been infected with herpes in the past.

Usually, doctors can diagnose genital herpes just by looking at the sores. However, conducting the above-mentioned tests is essential to distinguish the virus from other ulcer-causing sexually transmitted diseases like syphilis and chancroid. The results of the above-mentioned tests are usually available within 24 hours, and treatment begins almost immediately in case the report is positive for herpes.

Treatment for Genital Herpes

There is no known cure for herpes, but one can manage it to a certain extent with the help of specific antiviral drugs and self-care measures. Treatment may involve:

• Episodic therapy: Here, antiviral medications are consumed only during an outbreak. It is usually recommended for those who witness less than six outbreaks yearly. This therapy does not reduce the frequency of the outbreak. It reduces the severity and duration of the illness by a few days. It is most effective when started within 72 hours of the outbreak.
• Consumption of antiviral medications: A few antiviral medications can be used to treat genital herpes.
• Suppressive therapy: One must take this antiviral treatment daily to prevent any outbreaks. This treatment method is very effective since it reduces the frequency of outbreaks and the duration of recurrences. It also reduces the risk of transmitting herpes to an uninfected sexual partner. This treatment is usually recommended for those with more than six outbreaks yearly.
• Self-care measures: One can temporarily relieve any panic caused by an ulcer by sitting a few inches inside warm water for some time. Patients can use a sitting tub available on prescription or a bathtub. It is suggested to avoid soap and bubble baths if they have herpes. It is also recommended not to wear tight-fitting underwear or clothing that may irritate the groin.

People with herpes must educate themselves about their condition to deal with it better. The healthcare provider may also recommend joining support groups and going for counselling.

Prevention of Genital Herpes

All sexually active people are at risk of contracting herpes. The chances of getting herpes can be reduced by:

• Having one long-term sexual partner who regularly gets tested for STIs and isn't infected.
• Using a condom while partaking in sexual activities. It is suggested to use a condom even while having oral sex.
• Don't partake in coitus with the partner if they are showing symptoms of herpes.

One can still indulge in sexual activities with the partner if they have been diagnosed with herpes. However, specific precautionary measures can be taken to ensure that it doesn't get transmitted to the uninfected partner. They are:

• Using a latex condom.
• Using a condom even when there are no blisters or other symptoms of herpes.
• Avoid indulging in sexual activities when blisters and ulcers are present.

If diagnosed with herpes and are pregnant, contact the doctor immediately. A patient may be asked to consume antiviral drugs during the last few trimesters of the pregnancy to avoid outbreaks during labour. In case of an outbreak during labour, doctors may suggest one get a C-section instead of a normal delivery. This surgery can lower the risk of transmitting the STI to the child.

Outlook of Herpes

Herpes is a ubiquitous STI. Unfortunately, it has no cure yet, but it can be easily managed with the help of specific antiviral drugs. If one has herpes, it is crucial to inform the sexual partner immediately. More importantly, please learn more about the disease to help manage it better. In case of a sexual encounter with someone infected with herpes, consult a doctor immediately.

Review

Dr. Gaurav Garg (Uro) Senior Consultant - Urology/Andrology