Living With Herpes
If you are one of the many people diagnosed with genital herpes- either Herpes Simplex Virus 2 (HSV2) or Cold Sore Herpes (HSV1) you were probably a bit surprised, probably even shocked. Many diagnosed will have already had some concerns or suspicion about their own health or those who they are intimate with. Figuring out how the disease was contracted will generally lead to some sort of a blame scenario and then likely a look inward to exposure possibilities. Having to live with herpes often takes a fair amount of mental adjusting. It doesn’t have to put your sex life on hold or prevent you from being active sexually, but there are some important things to consider.
The common viruses, HSV2 and HSV1, are but two of the seven related groups of viruses that infect human beings. The Varicella-Zoster virus- the cause of chicken pox or shingles is another. There is a blood test called the Western Blot Test which can easily determine the form of herpes someone might be infected with. It is helpful in diagnosing even without any sores, but accuracy is only in the 90% range. This isn’t something you would want a false positive or false negative reading. The most accurate method of verifying herpes infections is by a physician swabbing a freshly cut lesion and sending the culture to a lab to be grown. This can be painful, but will leave little doubt to the results.
Infections affecting genital areas is traditionally HSV2. When symptoms are not present, this virus lies dormant at the spinal base in the sacral nerve. Infections around the mouth occur from the HSV1 as mentioned earlier, and this virus camps out in the neck in the trigeminal nerve when the disease is inactive. About 12% of the population in western nations are infected with HSV2- this is one in eight people, a fairly high incidence for such an annoying affliction. It is possible that only 20% of those are even diagnosed.
In a scenario taking place in a roomful of people- say 40-50 at a gathering, at least 6 or 7 would actually have HSV2, but only 1 or 2 would even know it. As many as 25-30 would have had a symptom once or twice. As far as determining it to be herpes, most would just consider it a mild acne blemish, a clogged follicle or similar occurrence. For this patient group, being accused by a partner, who has more serious symptoms or outbreak, of being unfaithful or not disclosing the condition would be received in disbelief. The world population may have as high as a 90% level of ability to infect another with HSV1 herpes. Around half (50%) of these would be symptomatic. The likelihood of contracting herpes from someone who has no idea that they are even infected is a very real possibility, even the norm.
The supposed safe sex educational doctrine may have produced some more conservative behavior, but many are still under the impression that only penetration requires safe sex practices. Specialists in sexual health disclose that at least half of the HSV cases in their clinics have been confirmed as HSV1 on the genitals by microbiological testing, this would mean that there is oral contact transmitting the HSV1 virus. It is believed that about 20% of the herpes infections reported on genitals are in fact HSV1. Fortunately, for most of these people, the HSV virus may not be living in its ideal conditions and infections tend to be less severe and infrequent. Obviously when HSV2 is on the genitals or HSV1 is in the oral cavity symptoms of the infection are much more difficult to deal with and more pronounced.
Is important for patients to be aware that even during dormant phases of the disease- when there are not any symptoms present, there is still a risk of transmitting the virus to someone else. There are several studies that show even when one partner is positive and the other negative the rate of transmission is still 10%. This require diligent management of using condoms at all times and abstinence when a partner is experiencing symptoms. For the record, according to experts in the field, if one of the partners remains negative for 10 years or more, the likelihood of them contracting the virus is extremely low. The level of immune protection they have is a mystery to science, but a very welcome mystery indeed.
Once infected with HSV2 an outbreak can last for up to ten days. A systemic response including swollen glands, the general feeling of having the flu, and the more apparent genital itching and burning, toss in painful urination or inability to urinate and you have a very uncomfortable situation. Many times a patient seeks treatment with what they think is a primary infection, but based on the severity of symptoms indicates a recurrence of an existing condition. Sometimes when run down or under stress the body responds as if it were an original outbreak. From there symptoms return every five days or so unless there is an underlying immune disorder or breach. Under these conditions a good physician will conduct further testing.
Skin to skin contact or what is called viral shedding is required in the transmission of HSV, this will often confine the infection to the genitals with HSV2. Areas affected in women are the labia and vulva, men experience it on the penis and scrotum, as penetration during sex is quite localized. When HSV1 becomes an infection on the genitals, the area affected is larger due to the extra skin to skin contact and possible oral activity in these broader surface areas. Anti-viral drugs are used effectively for both of these types of herpes infections.
There is an ideal host environment for each of the viral conditions discussed here. One who is infected with HSV1 on the genitals the ongoing infections are less virulent and sometimes only recur a few times in a lifetime. If HSV2 is contracted on the genitals the recurring incidence of infection will vary greatly depended upon the diet, lifestyle and general well being of the patient. Obvious triggers can be stress, lack of sleep, sun exposure, and some women will experience symptoms during menstruation. There are distinct phases. During the first year one might have recurrences every month or only once. The years after, once the immune system builds itself to help protect against infection, the individual right recognize when an infection will occur and avoid the negative stimulus that creates the symptoms. As one begins to recognize these influences they are able to administer remedies and minimize the duration of attacks. In some cases avoid any further symptoms whatsoever. No matter they are still at risk of infecting a sexual partners and must take steps to protect those exposures.
Anti-viral medications are taken in maintenance doses daily in some cases to help reduce the number of recurrences. There are reports that determine 50% of those utilizing these type of therapies have an absence of symptoms and infections within a 12 month period of time. When the therapies are stopped the virus once again infects and creates uncomfortable and embarrassing sores and symptoms within only a few weeks. The therapy is halted when the yearly recurrences cease. When recurrences of the outbreaks are reduced in frequency and severity people become accepting of the disease and come to terms with treating it regularly. Unfortunately for some folks this is never the case. When there is difficulty in dealing with the infection, a doctor might refer up to 20% for counseling to deal with the psychological effects.