Tag Archives: Herpes simplex

Straight, No Chaser: 10 Questions You Want Answered About Genital Herpes

Herp_leg1 herpes_2
If you’re in a room, look around. Look to your left, then to your right. Look behind and in front of you. Then look deep inside yourself. Statistically, one of the people you’ve just viewed has genital herpes. Different studies suggest between 16-25% of us between ages 14-49 are infected.

Questions You Want Answered Regarding Genital Herpes

1. How common is it? That’s actually a question with two answers. One of five or six individuals have herpes (well over 50 million Americans if you’re keeping count), but it’s estimated that just short of 800,000 new cases occur every year.
2. How do you get it? Herpes is transmitted sexually (genital, oral and/or anal contact) via someone already infected.
3. Can you really get it from a cold sore? Possibly and theoretically yes, but usually not. The Herpes Simplex Virus-1 (HSV-1) is usually found in oral blisters (i.e. ‘cold sores’ or ‘fever blisters’), and its family member HSV-2 is usually found on or near the genitalia, but both can be found in either. Although the Center for Disease Control and Prevention states that “Generally, a person can only get HSV-2 infection during sexual contact with someone who has a genital HSV-2 infection,” many (if not most) emergency physicians have diagnosed herpes based on transmission from oral as well as genital sex.
4. What are the symptoms? Most have no symptoms or symptoms that may be mistaken for the flu (fever, body aches and swollen and tender lymph nodes). The prototypical symptoms are a cluster of blisters (around your genitalia, mouth, fingers or rectum) or painful ulcers.
5. Does it really stay around forever? Yes. Fortunately, the frequency and severity of outbreaks decrease as you age (assuming your immunity is good). If you are immunocompromised, HSV infections can be devastating.
6. If I catch chickenpox or shingles, does that mean I’ll have genital herpes? No. There are many different herpesviruses. HSV-2 is the virus that causes genital herpes. Varicella zoster virus (VZV) is the virus that causes chickenpox and shingles. Varicella zoster does not cause genital herpes.
7. Is it true you can catch herpes in the eye? Yes. Wash your hands. Or else…
Herpes Simplex KeratitisHerpeticWhitlow

8. What was that last picture? That wasn’t an just eye, there was also a finger! Well, how did you get it got from the genitals to the eye (Please don’t answer in the comments section…)? That’s called herpetic whitlow. Notice the common theme of grouped clusters of small blisters (vesicles) again. Regarding that eye infection (herpes keratitis), it can cause blindness.

9. Is it true that women get it more often? Some estimates suggest that 25% of American women and 20% of men have genital herpes. Transmission from males to females is easier than from females to males, but guys, I wouldn’t take any chances.
10. What about the babies? 80-90% of general herpes infections to newborns are transmitted during childbirth as the newborn passes through the birth canal. C-section is recommended for all women in labor with active symptoms or lesions of herpes.
11. How do you treat this anyway? Antiviral medications are used at first sign of outbreaks. These medications don’t cure you of herpes, but they do shorten the frequency and severity of outbreaks. Plus, you’ve got to let your sexual partner know about this. It’s criminal not to.
Overall, my best advice to you is prevention, knowledge about your status, recognition of symptoms and prompt treatment. It is very important to emphasize that many people live quite normal lives with herpes. That still doesn’t mean you should be cavalier or irresponsible about it.
I welcome your questions or comments.
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Straight, No Chaser: The Doctor/Patient Sexually Transmitted Disease (STD) Talk

stdstud STD1in25
As an emergency physician, my first consideration is to eliminate life threats.  Along the way, I cure disease and provide a ton of information.  With all of these efforts, I provide a heavy dose of tough love and straight talk meant to empower (and hopefully never belittle).  This is heavy on my mind because this week we’ll be discussing sex – not the pleasant aspects, but those instances when something has gone wrong as a result of sex.
I’ve been on the receiving end of hundreds (more likely thousands) of couples coming in, usually one dragging the other by the ear, attempting to determine if “something’s going on”, and yes, more than a few relationships have left the emergency room dissolved after such conversations.  I would like to have the beginning of such a conversation with you much in the way that I might have with one of these couples.  This is a very appropriate prelude to a conversation about sexuality transmitted infections (aka STIs aka STDs).
Patient: I have a foul smell coming from my vagina.  I know he’s doing something!
Doctor: Can you tell me what it smells like?  Is there any vaginal discharge, rash or other lesions that you’re seeing?
Male partner (who would have been better off saying nothing): It smells like fish!
Patient (after shooting eye lasers at her partner): I am not having sex with anyone but him, so I know he did something!
Male partner: Doc, I’m not doing anything.  She’s the only one I’m with, and I don’t have any symptoms.
Doctor: So each of you only has each other as a partner?
Couple: <nods yes>
Doctor: Would you bet your lives on it?
Couple: <Stunned silence>
Doctor: Well that’s exactly what you’re doing every time you’re having unprotected sex.  Now about that discharge…
This upcoming week we are going to address 5 of the 6 most common and/or most important STIs out there for you to know about.






Not talking about them, not protecting yourself from them, and not testing yourself for them is truly believing that ignorance is bliss.  In this case, what you don’t know can kill you.  No matter what you think about how ‘good’ it is, it’s not worth risking your life over.  Also, as an additional conversation, I’ll discuss Bacterial Vaginosis.
While you’re waiting for the next post, go back and reread the other of the 6: this post on ‘The Sexually Transmitted Cancer’.  It definitely should be considered requiring reading for everyone who is sexually active or about to become active, and I would have addressed it first had I not already covered it.  Might I suggest you cover it as well?
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