Genital herpes

General

Genital herpes is mostly caused by the virus subgroup HSV 2, which belongs to the herpes simplex viruses. In 50-70% of the cases, this virus group is the triggering virus group. The genital herpes disease is counted among the sexually transmitted diseases. Today this disease is one of the most commonly transmitted sexually transmitted diseases in Germany.

For more information, see the main Herpes article.

transmission

The transmission the virus happens in most cases through sexual contact. Especially the unprotected intercourse Having an infected partner increases the risk of infection dramatically. The entry of the viruses into the body happens through smallest injuries to the skin and mucous membrane. In the body, like all herpes viruses, the viruses Live unnoticed for a lifetime without any symptoms trigger. In some cases a genital herpes infection breaks out. Because the viruses enter the body unnoticed and can remain there for a long time, most people are unaware of their infection and for this reason cannot take the necessary protective measures to prevent it from spreading. A vicious circle develops, which is only ended once both partners have been intensively treated with medication.

Symptoms

Similar to the other herpes infections, the typical skin change is not yet at the beginning of the disease.
In many cases, the patients initially complain of malaise, tingling and itching in the genitals. However, many patients do not yet go to the doctor in this condition. Often out of false shame and because they are not yet able to assess the disease. However, the best therapy conditions would be at such an early stage. In a few cases, the patients go to a doctor here without the important treatment.

Read more on this topic at: Itching in the vagina

In the further stage, the typical skin irritations on the genitals come to light. They range from simple reddening of the skin to scaling to bumps and pustules on the genitalia. An increasing and excruciating itching is typical, which spreads in this stage of the disease. In more advanced stages, vesicles can also form on the genitalia. These vesicles can then burst and secretion can be released into the environment.
At this stage, the patients are very infectious. As a rule, sexual intercourse is avoided here because those affected notice that something is wrong. After the vesicles have opened, crusts form, which can also loosen again after manipulation. In some cases, those affected can also experience severe symptoms such as weakness, nausea and fever.

Course of the disease

Depending on the origin of the genital herpes, you can roughly determine two different courses:

1. The primary infection and the
2. Reactivation.

When those affected come into contact with the herpes virus for the very first time in their lives, what is known as a "primary infection" manifests itself. In about 50% of the cases, this even happens unnoticed and those affected show no symptoms whatsoever.

In the case of a symptomatic initial infection, on the other hand, the first abnormalities usually appear 2-12 days after contact with the virus. Patients report severe pain and the appearance of mostly grouped, small vesicles on reddened mucosa in the area of ​​the genital and anal mucosa. Sometimes the cervix or urethra can also be affected. In the course of this, problems with urinating or even bloody urine are possible.

In addition to the local skin changes, general feelings of illness can occur, especially at the beginning of an initial infection with genital herpes:
Women in particular suffer from fever, exhaustion, headache, swollen and painful lymph nodes, etc. in the first 3-4 days, the primary infection lasts about 2-3 weeks, with an average of 11 days at high risk of infection with clear, purulent vesicles.

A recurring genital herpes infection is known as reactivation or relapse. Just like the initial infection, recurrent genital herpes can occur with or without symptoms. However, the virus can also be transmitted during the symptom-free phases! Basically, genital herpes recurrences are usually shorter and milder.

Further information on this topic can be found at: Duration of genital herpes

Diagnosis of genital herpes

The diagnosis is mostly one Eye diagnosisthat either from the general practitioner, from Urologist or from Gynecologist is provided.
The typical skin changes, such as redness, lift-offs, blistering and crusting usually clearly indicate a genital herpes infection and leave little scope for another infectious disease.
The Health surveywho should find out if Burning and itching went along with it, and how often it is for Change of partner has come in the last few months and years round off the diagnosis of a genital herpes infection. In cases where a diagnosis cannot be made using a visual diagnosis, a Smear on the skin area taken and put into a microbiological laboratory sent. There it is possible to diagnose a herpes virus infection by means of complex, immunological examinations and also to make a subdivision into a herpes genitalis infection.
Furthermore, it should be checked in affected women whether a Pregnancy present is because the infectious herpes virus spreads quickly during the Birth process can be transmitted to the child's organism and cause serious infections there. In this case, a birth must be precisely planned and a corresponding one Caesarean section be planned with special protective precautions. Furthermore, in affected patients with a genital herpes infection is a prompt drug therapy initiate.

therapy

While with the other herpes infections one can usually wait and see, especially with harmless courses, should a confirmed diagnosis of a genital herpes infection Immediately started therapy be to avert serious consequences and a Curb spread as quickly as possible.
With therapy, the drug comes Acyclovir for use. Mostly be same tablets that are supposed to work systemically throughout the body. The dose is with 3x 400 mg acyclovir elected.
Treatment should at least 5 days be performed.
Can also Treatment repeated if there has either been no desired success or if there is a renewed flare-up of the disease.
You can also try with cooling and anti-inflammatory ointments symptomatic reduce the burning sensation and itching. During the time of the infection, abstinence should be exercised in order to avoid the spread of the virus.

Genital herpes medication

Most important cornerstone in the Genital herpes Therapy is the drug Acyclovir. It is one of the so-called "Nucleoside analogs“And intervenes directly in the viral replication cycle by incorporating guanine into the genome instead of the correct DNA building block. The DNA modified in this way is no longer functional and leads to the death of the virus cell. In addition to acyclovir, there are other suitable drugs with similar active ingredients, such as Famciclovir or Valaciclovir.

In the case of rather mild primary infections, however, attempts are often made to avoid acyclovir. Instead, mainly pain reliever drugs such as Ibuprofen or even local anesthetic ointments (local anesthetics).

More severe courses or recurring genital herpes infections require the use of acyclovir tablets or even infusions. The latter, however, is only carried out in hospitals with particularly severe genital herpes. If those affected suffer from recurring relapses (e.g. 10 times a year), long-term therapy with the drug can be considered. Doses of about 6-12 months can significantly reduce the recurrence of genital herpes.

Homeopathy for genital herpes

Many sufferers want alternative means of treating genital herpes.

In the case of an acute, severe initial infection with a typical rash and painful blisters in the genital region, homeopathic remedies are, in all probability, not able to do too much. There is also a pregnancy or an acquired / congenital immune deficiency, should under all circumstances a doctor should be consulted, otherwise dangerous complications can arise.

However, if you suffer from genital herpes infections that are milder and want to strengthen your immune system, you may be able to resort to homeopathic substances. Ideally, you should seek advice on this from a knowledgeable pharmacy or from an experienced homeopath.

In addition to homeopathic therapy options, there are also other alternative healing concepts, such as Sitz baths in question.

Genital herpes in pregnancy

Fortunately, relatively few women in Germany's district halls suffer from it Genital herpes. However, such infection can sometimes have dramatic consequences for the child during pregnancy. Unfortunately, there is often great uncertainty and perplexity among affected women:

When is there a danger to the newborn? How can the child be protected? Must be for genital herpes Caesarean section be performed?

When pregnant women first approach Genital herpes suffer from the so-called "Primary infection“There is an acute danger to the unborn child.
Depending on the time of occurrence, the disease leads to one in up to 50% of cases Termination of pregnancy or one Miscarriage.
However, if pregnant women are exposed to recurring (recurrent) Suffer from genital herpes infections, the dangers for the child are significantly lower.

The closer a first-time illness approaches the end of pregnancy or the due date, the more likely it is that a caesarean section has to be performed, as the newborn could otherwise become infected through the birth canal.
So that no unnecessary caesarean sections are performed, the gynecologist uses a vaginal smear to check whether the virus that causes the disease can be detected.

In order to protect the child and alleviate the mother's symptoms, after careful examination and information from the attending gynecologist, antiviral drugs such as e.g. Acyclovir, administered. Studies have also shown that only topical ointments do not promise any improvement.

If the virus is nevertheless transmitted to the newborn, it is called "Herpes neonatorum“, Also called neonatal herpes. A total of three types of progression can be distinguished:

1. Around 45% show rather mild symptoms, with the typical vesicular rash on the skin and lips, as well as inflammation in the area of ​​the eyes. If drug therapy is started quickly, the symptoms usually subside without significant long-term effects. If a suitable therapy remains with e.g. Aciclovir can spread the virus in central nervous system spread and e.g. life threatening Meningitis trigger.
2. About 30% of children get infected with the Genital herpes Viruses with significant central nervous system involvement. Unfortunately, despite therapy, affected newborns often suffer from permanent, severe neurological disorders and failures.
3. If the mother suffers from severe genital herpes disease at birth, her baby can develop a life-threatening "Blood poisoning“(Lat. sepsis) become ill with infestation of various organ systems.

In summary, genital herpes must be taken seriously during pregnancy and discussed with the attending gynecologist. However, by taking the right measures before and during the birth, many risks can be minimized!

Please also read: Infections in pregnancy

Transmission of genital herpes

Genital herpes is prioritized sexual Transmitted through sexual intercourse and is therefore one of the so-called "Sexual Transmitted Diseases", short HOURS. The viruses enter the human body through the smallest, often invisible injuries in the genital and anal mucosa and cause the infection there.

Both symptomatic carriers of the disease, i.e. those affected with the typical blisters and redness in the genital area, as well as virus carriers during a symptom-free phase, i.e. without visible genital herpes, can transmit the disease to their sexual partners. Although the risk of transmission is higher during an acute infection, many infections occur every year even during the described symptom-free phase.

Since the virus can only survive outside the body for a very short time, transmission is usually only possible through direct physical contact. Alternative transmission routes through e.g. sharing a toilet are therefore rather unlikely.

However, when genital herpes is not through the usual Herpes simplex virus 2 (HSV 2), but is transmitted by the herpes simplex virus 1 (HSV 1), the exchange of saliva is theoretically sufficient (kissing!). Usually, however, causes HSV 1 no genital herpes, but the much more common cold sores. Conversely, can HSV 2 in rare cases also trigger cold sores.

How can you prevent genital herpes?

Genital herpes is a sexually transmitted disease.

The use of condoms significantly reduces the risk of infection, but it cannot be regarded as one hundred percent prevention. Especially during an acute infection with many blisters, the condom is not sufficient as protection against Genital herpes. During this phase of the illness, sexual contact should be avoided as far as possible.

However, since infection is also possible during symptom-free intervals, there is ultimately no absolutely safe preventive method. In particular with frequently changing sexual contacts, the risk of infection is relatively high, even with apparently healthy partners.
If you live in a stable partnership, that is absolute openness and communication about a possible infection A and O. An automatic co-treatment of the partner does not make sense, since he is almost certainly already infected.

In summary, the use of a condom is a great protection against infection, but it cannot completely minimize the risk. In order to prevent infection, you should definitely refrain from sexual intercourse during acute genital herpes infections.