What is the Herpes virus?
A virus is a minute organism which requires a living cell in order to grow and replicate. Most viruses are with you for life but lay dormant most of the time. The Herpes family of viruses includes:
- Herpes Simplex Virus 1 (HSV1) – usually presents as blisters in the facial area and is commonly known as ‘Cold Sores’ although they have nothing to do with having a cold but can recur often just as a cold does. HSV1 is not limited to outbreaks in the facial area but can in fact occur anywhere on the body.
- Herpes Simplex Virus 2 (HSV2) - usually presents as blisters in the genital area and is not usually referred to as ‘Cold Sores’. HSV2, just as HSV1, can occur on other locations on the body.
- Human Herpes Virus 3 (HHV3 or VZV) - the Herpes Varicella Virus causes chickenpox (a rash which often occurs in childhood and normally only once in a persons lifetime) and shingles (a rash which can occur in later years and which also usually only occurs once).
- Human Herpes Virus 4 (HHV4) - the Epstein-Barr virus which causes Mononucleosis, commonly known as ‘Mono’ or the ‘kissing virus.’
- Human Herpes Virus 5 (HHV5 or CMV) - Cytomegalovirus causes no symptoms or illness in healthy people.
How do you catch it?
Herpes is passed on via ‘skin to skin’ contact, this can include normal forms of affection such as kissing and also all forms of sexual activity. Previously it was believed only to be contagious during an active outbreak, but it is now known that the virus can shed asymptomatically – during periods when there are no symptoms present.
What are the symptoms?
Symptoms vary between individuals and outbreaks. You can even have herpes and never show any symptoms at all. Common symptoms accompanying an initial outbreak can include flu like symptoms (aching, swollen glands), itching, redness, a rash, a ‘tingling’ sensation, pain in the lower back and legs, small fluid-filled blisters. Recurrent outbreaks are usually less severe, with the frequency of recurrences reducing with time.
Is there a cure?
At this time there is no ‘cure’ for herpes, however, medication is available which can help relieve and reduce the symptoms, and to inhibit recurrences.
What treatment is available?
Treatment includes antiviral medications, topical creams (for oral herpes), and natural therapy regimes. Antiviral medication results may differ for individuals, so it is important to monitor your condition under the supervision of your doctor or health professional to ensure you are using the most suitable treatment for your condition.
Is there a vaccination?
Research is currently underway around the world on a vaccine for the herpes virus with some initial results showing promise for the future. An Australian trial targeting teenagers is currently underway. To find out more about the study, call 1800 554 609.
How often do outbreaks occur?
This again varies amongst individuals. Some people only ever experience the first outbreak and never have a recurrence, some people never experience an identifiable outbreak at all, whilst others have regular outbreaks. Outbreak recurrences generally reduce with time, however, an increase can occur if you experience additional stress or emotional trauma or eat foods which trigger your outbreaks. It’s a good idea to learn what personally triggers your outbreaks so you can better manage your condition.
What is an ‘OB’?
Outbreak (OB) is the term used to refer to an active episode of the herpes virus, usually with blisters occurring.
What does the term ‘prodrome’ mean?
Prodrome is the term used to describe the symptoms which some people experience before an active outbreak. Common prodrome symptoms can include tingling, redness, swollen glands, and/or neural pain in the legs or lower back.
Can I spread Herpes when I am not experiencing an outbreak?
Yes, herpes can be spread whilst no symptoms are present. The virus can be active at the skins surface and viral particles can be shed and passed on to another at this time. This is called ‘asymptomatic shedding’ because there are no symptoms present. The good news is that this occurs very rarely. The bad news is that without clinical testing it is impossible to know when this is occurring.
How can I protect my partner?
Abstain from sexual contact during an outbreak or prodrome because this is when the virus is most active on the skins surface. Taking antiviral medication and practicing ‘Safer Sex’ (using a condom or dental dam) can also help reduce the likelihood of passing on the virus.
What about future pregnancies?
Obviously practicing ‘Safer Sex’ can have the sometimes unwanted consequence of preventing pregnancy. If you are in a relationship where one partner has herpes and the other does not and you wish to start a family, then at some point you must make the decision to dispense with protection and risk passing the virus on to your partner. Consult with your doctor and actively work in partnership with both your partner and doctor to reduce the risks involved.
How will having Herpes affect my unborn child?
Herpes can be passed on to your baby during birth if you are having an active outbreak. There is also a slight risk of passing on the virus during birth through asymptomatic shedding. If a baby contracts the herpes virus during birth there is a risk of brain damage and even death in rare cases. However this does not mean that you cannot have children or have a natural birth. If your doctor knows or suspects you may be having an outbreak he may suggest a caesarean, however, many people do give birth naturally without passing the virus to their baby. Consult with your doctor and actively work in partnership with both your partner and doctor to reduce the risks involved.
How do I tell someone I have Herpes?
This can be one of the most difficult aspects of having herpes… telling your current partner (or casual partner/s), or informing a potential new date that you have herpes. Choosing when and how you tell them takes some consideration and preparation. You need to consider how this person may react, what information they might be interested in (eg. having leaflets on hand or the URL for online educational and support resources). It is also very important ‘how’ you tell. If you act ashamed, you will make having herpes appear shameful. Try to speak in a normal tone and present the facts calmly. By giving them this very personal information about yourself you are showing them how much you respect and trust them.
Can I have a relationship without telling them I have Herpes?
The choice is obviously yours whether you choose to tell someone your STI status before becoming involved with them or not. However, you do need to consider the impact it may have on your relationship if you wait to disclose until after you have become intimate or involved. Many people are bitter about the circumstances under which they contracted Herpes and wish that the person had told them the truth up-front and allowed them to make their own informed decision on whether to take the risk or not. By informing someone about your STI status you are showing how much you trust, respect and care about them. If you tell them in an open and honest manner and have some educational resources on hand, eg. a leaflet or reference to online resources, such as the article for people considering embarking on a relationship with someone with the virus, you may be pleasantly surprised by their positive reaction.
What can I do to ease the physical symptoms?
Antiviral medication can help reduce the physical symptoms and promote faster healing. Topical creams are only effective for oral herpes outbreaks, but alternative therapies such as Aromatherapy have also proved beneficial for some. Applying an icepack can help relieve symptoms and if used during the prodrome stage may sometimes prevent a full outbreak from occurring. To ease the pain sometimes experienced during urination run water over the affected area (eg. In the shower, or use a sitz bath).
How can I cope with the stigma?
Oral herpes appears to be generally accepted as commonplace and of little consequence, however genital herpes is often perceived as a disease of the ‘dirty’ and ‘promiscuous’. This is obviously not the case, however the myth persists and it is most likely because genital herpes is contracted through sexual activity. Despite the modern healthy attitude towards sexuality STDs (STIs) are still viewed in such a negative manner that most people feel ashamed when they become a statistic. However, as educational programmes and media promotions become more commonplace the stigma is slowly being reduced.
What support can a doctor provide?
Doctors and medical professionals can provide an accurate diagnosis. The symptoms of Herpes outbreaks are sometimes mistaken for other problems, such as Thrush or bacterial infections so it is very important to be correctly diagnosed. A doctor can provide both information and counselling support, as well as providing a prescription for anti-viral medication which will help reduce the severity and duration of outbreaks. It’s a good idea to monitor your herpes outbreaks in concert with you doctor as some anti-viral medications are more effective for some people than others. By closely monitoring the effectiveness of your medication you and your doctor will quickly be able to identify which treatment works best for you.
What other support is available?
There are many Herpes support groups available throughout Australia and worldwide. Services provided by individual support groups may include:
- Educational resources such as flyers, leaflets, booklets, books, websites, newsletters
- Online support group forums, messageboards and chat rooms
- One-on-one peer support
- Self-help / support meetings
- Social functions
- Guest speaker talks
Can I transfer the virus to other parts of my body?
Autoinoculation is the process where a person can pass the infection from one area of the body to another. This is common with children passing facial oral Herpes on to the hands or other areas (it can be difficult to discourage scratching in children or make them aware of the need to be careful during outbreaks). For the virus to enter the body at another location an open cut in the skin is necessary. Normal hygiene procedures – washing hands after touching an outbreak area should be enough to prevent this from happening. Does this mean the end of my love / sex life?
Many people fear that contracting Herpes means their love / sex life will never be the same again and that no one will ever love them again or want to have sex with them again. This is far from the truth. Whilst it is true that having Herpes will have some impact on your love life and some changes will need to be made, the changes required can be minimal and easily managed. Abstaining from sex during an outbreak is an obvious precaution and one which shouldn’t be too hard to implement because most people would not feel like having sex during an outbreak anyway! But this does not mean that you cannot be affectionate or intimate with your partner… intimacy is not dependent on genital contact. Practicing ‘Safer Sex’ at all times is important, this means using a condom or dental dam during all sexual contact, including oral sex because either type of herpes can be transferred during oral sex.
Can I ever have unprotected sex again?
Herpes is with you for life and you can shed viral particles without showing any visible symptoms so there is always going to be a risk of passing the virus on. However, the risk can be minimised by avoiding contact with the outbreak area during the active phase; by practicing ‘Safer Sex’ and taking anti viral medication to reduce outbreaks and the incidence of viral shedding. Note: It may be a good idea to have a blood test for antibodies in case you are taking unnecessary precautions against passing it on to someone who does in fact already have Herpes but is unaware of it. If you are in a relationship where both partners have Herpes and there is limited risk of passing on any other infection then there should be no reason why you cannot have ‘unprotected’ sex during non outbreak periods so long as you are using some form of contraception if that is necessary. Obviously if you are planning a family ‘Safer Sex’ practices will not be possible all the time. To reduce the possibility of transmission you should consider limiting unprotected sex to the ovulation phase only.
Can I still have oral sex if I have Herpes?
Since both forms of Herpes can be passed to other locations it is best to use some form of protection for oral sex. Coloured and flavoured condoms can add a fun element, and dental dams may be worth a try. Some people do choose to opt for unsafe practices during oral sex and this is a personal choice which requires your own individual assessment of the level of risk and the individual’s preparedness to face the consequences.