Position: Girls / Women with herpes » What Causes Herpes?
The source of herpes is not known. Many researchers believe that the virus is transmitted through sexual contact, and consider it a sexually transmitted disease. Herpes may be spread through contact with the blisters at any time that they are visible. Men may have blisters in their urethras, where they cannot be seen. They may be unaware of a mild attack and transmit the disease unwittingly.
The herpes viruses enter the skin or mucous membrane through tiny, even microscopic, breaks in the tissue. Because an infected person may transmit the disease even when he or she does not have signs or symptoms of herpes, avoiding sexual contact with someone with active blisters does not guarantee protection against the infection.
Individual outbreaks of herpes vary among affected people in terms of their frequency and severity. Outbreaks can be related to the function of the immune system and are typically worse in cases in which the immune system is suppressed. For example, at times of physical or emotional stress, during illness, or when you are taking certain medications.
HSV infection is transmitted by direct person-to-person contact. Genital herpes is acquired through sexual contact of any type that involves contact with the genital areas. Genital herpes can also be caused by mouth to genital contact with a person who has cold sores or herpes infection of the mouth. Transmission from an infected male to a female partner is more likely than transmission from an infected woman to a male partner.
In most cases where the characteristic signs and symptoms are present, they are sufficient to establish a diagnosis of genital herpes infection, although some evidence exists that because of atypical presentations, missed clinical diagnoses can be high. Laboratory tests, such as viral culture and nucleic acid amplification tests to detect the genetic material of the virus, are also available. Immunologic tests to identify antibodies to genital herpes are other possible tests to establish whether infection has occurred.
There is no cure for genital herpes, and once a person is infected with genital herpes, the infection persists throughout the individual's life, with the potential for recurrent outbreaks. However, there are medications that can reduce the severity and frequency of outbreaks and treatments to manage the symptoms.
Antiviral medications are available that can help manage the severity and duration of outbreaks, if taken immediately prior to (when there are tingling or unusual skin sensations but no blisters) or within 24 hours of an outbreak. The medications typically used are acyclovir (Zovirax), famciclovir (Famvir), or valacyclovir (Valtrex). These are all typically taken orally. In severe cases of viral infection, antiviral medications may be given intravenously, but this is not typically done for genital herpes. Topical medications that are applied directly to the sores are also available, but these are less effective than oral medications and are not generally used.
All of these medications may also be given as suppressive therapy to decrease the number of outbreaks in people who have frequent outbreaks (more than six outbreaks per year).
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