Herpes in Women
Q: What is herpes?
A: Herpes is a group of viruses that affects the skin or nervous system.
Q: What are the symptoms of herpes?
A: There are a number of symptoms that can occur with a herpes outbreak. The classic presentation follows a course of progression that often begins with a tingling feeling, also known as a prodrome,
1- followed by an irritation or redness on the skin
2- Within a short period of time, tiny fluid-filled blisters appear at the site
3- They are often painful and itchy. These blisters then begin to ooze, and the site becomes crusted over
4 – When the blisters burst, an ulcer or depression occurs
5 – A scab begins to form
6- Generally, it takes two days to two weeks for the wound to heal.
Q: How is herpes transmitted?
A: Herpes has three modes of transmission
- Intimate Contact (horizontal transmission): usually kissing or sexual contact (oral or genital)
- Autoinoculation: transmission from one area of the body to another
- Congenital (vertical transmission): present at birth, passed from mother to newborn
Herpes is an infection that most commonly is spread by skin-to-skin contact, at a site where there is friction, a mucous membrane, or a break in the integrity of the skin. Herpes likes moist, warm, dark places and is killed pretty rapidly outside of the body. It is a parasite and as such needs a host to survive. During an outbreak, it is important to refrain from intimate contact. Proper hand washing with soap and water will kill the virus, so there is no need to obsess with hand washing every five minutes. As a precaution, it is also advised to properly clean any sex toys after use.
Q: What is the prevalence of women with genital herpes in the US?
A: The statistics differ depending on what study you read, but in general it is safe to say that at least 1 in 4 or 25% of American women have HSV2 genital herpes. (That doesn’t even account for HSV1 genital herpes! I have yet to find THAT statistic.)
Q: Is there a cure for herpes?
A: At the present time, there is no cure for herpes. The virus can be managed effectively with all natural and/or pharmaceutical treatments.
Q: How do I protect my partner if I have herpes?
A: According to a University of Washington study, “simply avoiding sexual contact during the active phases of the infection provides enough protection for more than 95 percent of susceptible men and more than 81 percent of susceptible women per year.” The best way to protect your partner is to abstain from sexual contact during any active symptoms and to use a protective barrier like a condom or oral dam.
Q: I am overwhelmed by the testing options. What is your advice?
A: The most important thing regarding testing is to make sure you are getting a type-specific test. A type-specific test is one that identifies whether or not you have type 1 (HSV-1) or type 2 (HSV-2) herpes.
Q: If I don’t have symptoms, can I still transmit the virus to my partner?
A: Yes. There is always a risk of asymptomatic shedding. This is when you don’t have symptoms, but you still could transmit the virus.
 Fujie Xu, MD, PhD; Maya R. Sternberg, PhD; Benny J. Kottiri, PhD; Geraldine M. McQuillan, PhD; Francis K. Lee, PhD; Andre J. Nahmias, MD; Stuart M. Berman, MD, ScM; Lauri E. Markowitz, MD, “Trends in Herpes Simplex Virus Type 1 and Type 2 Seroprevalence in the United States,” JAMA 296(8): 964–973, doi: 10.1001/jama.296.8.9642006.
 Sacks, Stephen L., MD. The Truth About Herpes. Gordon Soules Book Publishers Ltd., 1997