The following are questions about genital herpes that many people ask - whether they suspect they have genital herpes, are newly-diagnosed, or have been living with the condition for some time. It is hoped that the answers to their questions, reviewed by infectious disease specialist Dr. Barbara Romanowski, will also help answer questions you may have.
Barbara Romanowski, MD, FRCPC, FACP Clinical Professor, Division of Infectious Diseases Department of Medicine, Faculty of Medicine and Dentistry University of Alberta Edmonton, Alberta
Dr. Barbara Romanowski is a Clinical Professor in the Division of Infectious Diseases, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, with a cross appointment in the Department of Medical Microbiology and Immunology. She is also an Associate Clinical Professor in the Department of Community Health Sciences, University of Calgary.
Dr. Romanowski earned her BSc in Medicine (1971) and Doctor of Medicine (1973) from the University of Alberta, where she also completed her postgraduate training in Internal Medicine and Infectious Disease in 1978.
Dr. Romanowski held the post of Director of the Sexually Transmitted Disease Program for the Province of Alberta from 1979 to 1998. She is interested in not only the epidemiology and clinical aspects of genital infections, STIs, hepatitis and HIV, but also in clinical research, emphasizing improved diagnosis and treatment of these conditions.
Dr. Romanowski has published extensively on STIs, including major monographs. She is a member of a large number of medical societies, on the editorial board of national and international scientific journals, a member of reviewing bodies for national granting agencies, and has held national and international posts in the area of STIs. She is an accomplished teacher at the undergraduate and graduate levels and devotes significant time to continuing medical education.
Presently, Dr. Romanowski is continuing her research and patient care in private practice.
Genital herpes is a common medical condition1 caused by a virus called the herpes simplex virus (HSV).2 HSV-1 is the most common form of the virus3, causing cold sores around the mouth.4 HSV-1 is also responsible for an increasing number of genital herpes infections3 because it can be transmitted to the genitals from a person with a cold sore during oral sex.1 HSV-2 is the most common cause of genital herpes, causing sores and blisters on or near the genitals or rectum.1 It is usually transmitted through genital-to-genital contact.5
HSV is passed from one person to another through skin-to-skin contact.6 In general, HSV cannot pass through the thicker skin on most parts of the body. HSV needs an easy place to enter and infect the skin cells. Mucous membranes and thinner skin, like the skin of the genital and anal areas and the mouth, can provide an easy entry point.7
There are two types of HSV: HSV-1 and HSV-2.4 HSV-2 is the most common cause of genital herpes.1 However, HSV-1 (which generally causes cold sores) can also cause genital herpes through oral-to-genital contact1 and is becoming a more frequent cause of genital herpes.3
It's important to learn more about how genital herpes is passed on, because there may be more ways to reduce the risk than you realize. For more information, your doctor is your best source.
While there is currently no cure for genital herpes, there are antiviral medications available by prescription that can help shorten the duration of sores or prevent recurrent outbreaks.3
NOTE: Like all medications, antiviral medications may cause side effects. Talk to your doctor about the possible side effects associated with these treatments.
Talking to your doctor about how you feel is an important first step. He or she can tell you about the ongoing support available for people living with genital herpes. In addition, your doctor can recommend a counsellor or clinic specializing in sexually transmitted infection (STI) counselling.
While genital herpes can be transmitted from a pregnant mother to her baby, it does not happen very often in mothers who are aware that they are infected.7 (Click here for more information). In general, the risk of transmitting herpes to the baby is highest for those mothers who become infected with genital herpes for the first time while pregnant, especially during the third trimester.7 If you are pregnant and have genital herpes or your partner has genital herpes, you should speak with your doctor.
Visit your doctor as frequently as he or she recommends. You should also talk to your doctor if you experience any complications or are having emotional or physical difficulties dealing with your diagnosis. You may want to schedule an appointment any time there is a change in your health or life situation that may impact your management of genital herpes, such as pregnancy or a new sexual relationship.
Oral herpes (cold sores) are caused by infection of the area around the mouth with herpes simplex virus type 1(HSV-1).4 When you have a cold sore, avoid touching the affected area7 (if you do, wash your hands immediately8 to decrease the chance of infecting another area of your face).8
The oral herpes you have can only be spread to other parts of your body by directly transferring it (for example, by scratching the cold sore around your mouth and then touching another area of your body where the skin is broken).7 However, oral herpes can be transmitted to your partner's genitals through direct oral-genital contact.1 Conversely, if your partner has oral herpes, the virus can be transmitted to your genital area through oral sex.
Public Health Agency of Canada. Genital Herpes: The Epidemiology and Control of a Common Sexually Transmitted Disease. Can J Human Sexuality 1997;6. Available at: http://www.phac-aspc.gc.ca/publicat/cjhs/cjhs5-eng.php. Accessed Aug. 16, 2010.
Whitley RJ, Kimberlin DW and Roizman B. Herpes Simplex Viruses. Clinical Infectious Diseases 1998;26:541-55.
Sacks SL. The Truth About Herpes. 4th ed. West Vancouver, BC: Gordon Soules Book Publishers Ltd.;1997.
Barbara Romanowski, MD, FRCPC, FACP