Genital herpes is one of the most common sexually transmitted infections worldwide. This disease is caused by the herpes simplex virus (HSV) and can be both physically and psychologically distressing.

Causes
Genital herpes is triggered by two types of the herpes simplex virus:

1. HSV-1: This type is primarily responsible for oral herpes (cold sores) but can infect the genital area through oral contact.
2. HSV-2: This type is the main cause of genital herpes and is predominantly transmitted through sexual contact.

Transmission occurs through direct skin or mucous membrane contact with an infected person, especially when they have active blisters or skin changes. However, even asymptomatic individuals can transmit the virus—this is called shedding.

Recurrent (Reactivating) Herpes Simplex Infections

• Herpes simplex infections often recur, even with treatment, usually in the same location.
• Triggers: Stress, sunlight, flu, menstruation, alcohol consumption, or other stressors.
• There are two herpes virus types (Type 1 and Type 2), and both can cause genital infections.
• HSV-1 (oral herpes) is more common in young women and men, as it spreads through kissing. HSV-2 (genital herpes) becomes more frequent with increasing age and the number of sexual partners.

Symptoms
The symptoms of genital herpes vary widely, ranging from asymptomatic cases to painful outbreaks.

Common Symptoms

• Key symptom: Painful genital lesions in the form of blisters, which heal like abrasions.
• Primary infection: Symptoms may include painful lesions, swollen lymph nodes, difficulty urinating, fever, discomfort, and headaches.
  • If these symptoms occur, it is crucial to seek medical attention, as complications such as viral meningitis can arise. In such cases, intravenous medication is required.
• Recurrent infections: Symptoms are usually milder, with fewer blisters and different lesion appearances. These outbreaks are often self-limiting within a few days.
• Asymptomatic infection: The virus can still be transmitted even if there are no visible symptoms (shedding).

Diagnosis
Diagnosis is typically made through:

• Clinical examination: Identifying characteristic blisters and ulcers.
• Laboratory tests: PCR tests from swabs to confirm the virus’s DNA or serological tests to detect HSV antibodies.
• Viral culture: A sample from the blisters is taken for analysis.

Treatment
Currently, genital herpes is not curable, as the virus remains dormant in the spinal ganglia and can reactivate when triggered. However, antiviral medications can relieve symptoms and shorten outbreak durations.

• Acute Treatment Medications such as Acyclovir, Valacyclovir, or Famciclovir help control symptoms during an outbreak:
  • Acyclovir: 200 mg, 5 times daily
  • Valacyclovir: 500 mg, twice daily
• Suppressive Therapy (Long-Term Treatment) For patients with frequent recurrences or those with uninfected sexual partners, daily antiviral therapy can help:
  • Acyclovir: 400 mg, twice daily
  • Famciclovir: 250 mg, twice daily
  • Valacyclovir: 500 mg, once daily
• Episodic Therapy (Treatment on Demand) Starting treatment within 24 hours of symptom onset can significantly reduce discomfort.
• No Treatment Option For patients with mild or no symptoms.

While antiviral therapy does not eliminate the virus, it alleviates symptoms and reduces the risk of transmission to sexual partners.

Prevention

• Safer sex: Using condoms can reduce, but not completely prevent, transmission.
• Avoid skin contact: Direct contact should be avoided, especially when blisters are present.
• Informed partners: Honest communication about infection status with sexual partners.
• Abstaining from sex: Sexual activity should be avoided during outbreaks.

Psychological Aspects
A genital herpes diagnosis can be emotionally challenging and lead to feelings of shame, guilt, or fear of rejection. It is important to talk to your doctor and obtain backup medication and information so you are prepared in case of an outbreak. Knowing how to handle it can provide reassurance and reduce stress.

Conclusion
Genital herpes is a widespread condition that can be effectively managed through targeted treatment and preventive measures. Educating people about transmission and prevention is crucial to limiting the spread of the virus and helping affected individuals maintain a normal sex life.