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Whenever I diagnose someone with genital herpes, their natural instinct is to panic. It is a sexually transmitted disease that is incurable, and most people have a difficult time wrapping their minds around their new reality. I'm sure all of you have heard of herpes before, but as far as the specifics and what that means if you are infected, there is a general lack of knowledge. I want to provide this resource so that anyone who is newly infected or dating someone who has herpes can better understand how this disease affects their life and relationships.
Oral vs. Genital Herpes
I'm going to discuss genital herpes, but there is also a form of oral herpes, commonly called cold sores. Most people who have oral herpes contracted this as a child or young adult through saliva; it is caused by herpes simplex virus type 1 (HSV-1). Sometimes, when there is an active outbreak of oral herpes and that person performs oral sex on another individual, then that individual can develop genital herpes caused by HSV-1. Genital herpes can also be caused by herpes simplex virus 2 (HSV-2). There's often a misconception that genital herpes is only HSV-2, but it can be both.
Symptoms of Genital Herpes
Unfortunately, many people who have herpes have no idea that they have it. They may have no symptoms or mistake genital sores for a pimple or ingrown hair. Usually, the outbreak begins as one or more blisters that then transform into painful sores that could take a week or more to heal. The first outbreak could also be associated with a fever, body aches, or swollen glands. In general, the outbreaks tend to be more severe and more frequent when someone is newly infected. If you go into your provider's office with a genital sore, they can culture it and see if it is HSV.
How It's Spread
Genital herpes is spread through vaginal, anal, and oral sex, but it's important to note that it's spread through skin to skin contact. So if your partner has an active herpes sore or you come in contact with their skin around the infection, then you can be infected. This is why it's so important to refrain from sexual activity altogether if an active outbreak is present or beginning. When you use condoms (which you should actively use), you are protecting yourself from being exposed to secretions, but not your partner's actual skin. So, condoms don't fully protect against herpes unfortunately. Once someone has herpes for some time, they MAY start to learn the symptoms of a beginning infection. Even if a sore isn't present, if they feel a tingling in that area, they should refrain from sex as the disease can be spread during that time. Of course, someone may not experience symptoms at all and can still spread the infection.
Sex Life After Herpes Diagnosis
Most people assume their sex life is over once they receive the diagnosis, but this is not true. Here are my recommendations for a healthy sex life with herpes:
Always inform your partner of your diagnosis before being sexually active. This doesn't mean that you have to tell them on the first date; you can certainly wait until you are comfortable. However, it is not responsible to tell them after intercourse has already occurred. Imagine how you would feel if someone told you after the fact. Be courteous and allow that person to decide if they are willing to assume that risk.
Use condoms always to help lower the risk, but remember it doesn't fully protect against transmission.
Consider taking antiviral medication daily. There is no cure for herpes, but antivirals can reduce the occurrence of outbreaks and therefore, reduce your risk of spreading it.
If you have an active outbreak, refrain from any type of sexual activity until it has completely cleared.
Herpes During Pregnancy
Just because you have genital herpes doesn't mean that you can't deliver vaginally. During the last 4 weeks of pregnancy, we start you on antiviral medication daily to prevent an outbreak during the time of delivery. If a delivery is present during the day of labor, then we proceed with a C-section. We don't want you to deliver vaginally with an active infection because you could pass herpes to your newborn and put them at risk for a deadly infection called neonatal herpes. If you have an outbreak during pregnancy, alert your provider right away so that you can receive treatment.
I hope this resource provides valuable information. Feel free to ask additional questions below or contact me directly.
xoxo, Global Midwife
Disclaimer: This is not medical advice, only education. Always check with your healthcare provider.
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