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GENITAL HERPES CAUSES |
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While anyone can be infected by herpes
virus, not everyone will show symptoms. Risk factors for genital
herpes include: early age at first sexual activity, multiple sexual
partners, and a medical history of other sexually-transmitted
diseases. Most patients with genital herpes experience a prodrome (symptoms of oncoming disease) of pain, burning, itching, or tingling at the site where blisters will form. This prodrome stage may last anywhere from a few hours, to one to two days. The herpes infection prodrome can occur for both the primary infection and recurrent infections. The prodrome for recurrent infections may be severe and cause a severe burning or stabbing pain in the genital area, legs, or buttocks. Primary genital herpes The first symptoms of herpes usually occur within two to seven days after contact with an infected person but may take up to two weeks. Symptoms of the primary infection are usually more severe than those of recurrent infections. For up to 70% of the patients, the primary infection causes symptoms which affect the whole body (called "constitutional symptoms") including tiredness, headache, fever, chills, muscle aches, loss of appetite, as well as painful, swollen lymph nodes in the groin. These symptoms are greatest during the first three to four days of the infection and disappear within one week. The primary infection is more severe in women than in men. Following the prodrome come the herpes blisters, which are similar on men and women. First, small red bumps appear. These bumps quickly become fluid-filled blisters. In dry areas, the blisters become filled with pus and take on a white to gray appearance, become covered with a scab, and heal within two to three weeks. In moist areas, the fluid-filled blisters burst and form painful ulcers which drain before healing. New blisters may appear over a period of one week or longer and may join together to form very large ulcers. The pain is relieved within two weeks and the blisters and ulcers heal without scarring by three to four weeks. Women can experience a very severe and painful primary infection. Herpes blisters first appear on the labia majora (outer lips), labia minora (inner lips), and entrance to the vagina. Blisters often appear on the clitoris, at the urinary opening, around the anal opening, and on the buttocks and thighs. In addition, women may get herpes blisters on the lips, breasts, fingers, and eyes. The vagina and cervix are almost always involved which causes a watery discharge. Other symptoms that occur in women are: painful or difficult urination (83%), swelling of the urinary tube (85%), meningitis (36%), and throat infection (13%). Most women develop painful, swollen lymph nodes (lymphadenopathy) in the groin and pelvis. About one in ten women get a vaginal yeast infection as a complication of the primary herpes infection. In men, the herpes blisters usually form on the penis but can also appear on the scrotum, thighs, and buttocks. Fewer than half of the men with primary herpes experience the constitutional symptoms. Thirty percent to 40% of men have a discharge from the urinary tube. Some men develop painful swollen lymph nodes (lymphadenopathy) in the groin and pelvis. Although less frequently than women, men too may experience painful or difficult urination (44%), swelling of the urinary tube (27%), meningitis (13%), and throat infection (7%). Recurrent genital herpes One or more outbreaks of genital herpes per year occur in 60–90% of those infected with herpes virus. About 40% of the persons infected with herpes simplex virus type 2 will experience six or more outbreaks each year. Genital herpes recurrences are less severe than the primary infection; however, women still experience more severe symptoms and pain than men. Constitutional symptoms are not usually present. Blisters will appear at the same sites during each outbreak. Usually there are fewer blisters, less pain, and the time period from the beginning of symptoms to healing is shorter than the primary infection. One out of every four women experience painful or difficult urination during recurrent infection. Both men and women may develop lymphadenopathy. |
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