Genital herpes in men and women: treatment,symptoms of recurrent herpes

Update: October 2018

Herpes infection is widespread on Earth, it is known
that about 90% of the world’s population is infected with a virus
herpes Identified and described 8 types (varieties) of the virus
herpes virus: cytomegalovirus, varicella-zoster virus, Epstein-Barr virus, and
also herpes simplex virus type 1 and type 2 (HSV-1 and HSV-2). Exactly
ВПГ-1 и ВПГ-2 являются возбудителями генитального herpes
Infection of the population with genital herpes reaches 40 – 50% to 35
– 40 years old.

The reasons

Genital herpes is a highly contagious disease, then
there is very contagious, and the likelihood of sexual transmission
partner is 100% in the period of its exacerbation. No so long ago
genital herpes was believed to be caused by the herpes simplex virus 2
type, but it has been proven that herpetic manifestations on the genitals
HSV-1 may also be caused by symptoms.
the so-called “cold” (the formation of bubbles around the mouth or on
lips).

However, infection with herpes does not mean that after
the person becomes sick immediately. The occurrence of herpetic
rashes caused by reduced immunity for various reasons and even
upon contact with the patient, the sexual partner has characteristic symptoms
will appear immediately, the manifestation of the disease can occur much
later in the presence of conditions favorable to the virus (reduction
body defenses).

Genital herpes: transmission routes

Sexual – as it becomes clear from the name of this infection,
the main route of transmission is sexual. Moreover, it does not have
meanings of how sexual intercourse was:

  • genital
  • anogenital
  • or oral genital.

Airborne – virus transmission is also possible
by airborne droplets, in particular HSV-1.

Household – it is not excluded and household way of infection, especially
through wet objects and if there are wounds and cracks in
the area of ​​the anus and genitals. Self-infection is also possible: transference
infections from the lips to the genitals with non-compliance
hygiene.

From mother to fetus, there is a vertical transmission path, then
there is with the clinical manifestations of genital herpes with
pregnancy, infection of the fetus occurs either transplacentally or
during childbirth during the passage of the fetus through infected generic
mother’s ways.

Risk factors

The relationship between the number of cases of genital herpes
and the following factors:

  • socio-economic status and material situation (than
    they are lower, the higher the chances of “catching up” the infection);
  • пол (женщины чаще заражаются genital герпесом, но не по
    due to a weaker immunity, and due to the large area
    mucous genital organs);
  • возраст (резкий подъем заболеваемости genital герпесом к 30
    – 40 years old, which coincides with the age of sexual activity).

Based on the above, you can select groups of high
risk of incidence of genital herpes:

  • representatives of the weaker sex;
  • antisocial groups of society (prostitutes, bums, drug addicts,
    alcoholics);
  • homosexuals;
  • representatives of the Negroid race (blacks have sex
    herpes in 45% of cases, and Europeans only 17%).

Risk factors for infection with genital herpes and development
diseases include all immunosuppressive causes and
promiscuity in sexual contact:

  • promiscuous sex;
  • neglect of mechanical means of protection (condoms
    provide protection only by 50%);
  • stress;
  • overwork, chronic fatigue;
  • lack of vitamins;
  • insufficient and inadequate nutrition;
  • unfavorable housing conditions;
  • significant physical exertion;
  • hypothermia;
  • recent ARVI and high propensity to
    respiratory diseases;
  • use of intrauterine device;
  • abortions;
  • climate change;
  • taking drugs that suppress the immune system (cytostatics,
    glucocorticoids);
  • HIV infection;
  • the presence of cancer;
  • chronic foci of infection (caries, genital infections,
    chronic tonsillitis and others);
  • excessive drinking;
  • insolation (both sunbathing and visiting
    tanning bed).

All factors that suppress immunity, with genital
herpes are also causes of exacerbation.

Forms of the disease

There are two forms of genital herpes primary and recurrent.
Primary genital herpes is referred to when clinical signs
appeared for the first time after infection, which can happen in a couple
weeks, and in some cases months. Recurrent Herpes –
this periodic exacerbation of the disease at the slightest weakening
immunity. Depending on the number of relapse exacerbations
genital herpes throughout the year allocate 3 degrees
severity:

  • mild – the number of relapses is 3 or less in
    year;
  • среднетяжелая – обострения случаются 4 – 6 раз за year;
  • severe – relapses occur monthly.

In turn, recurrent genital herpes is inherent
several forms of flow:

  • atypical microsymptomatic or subclinical (symptoms
    eat but do not deliver excessive concerns for the patient:
    slight itching, instead of vesicles – cracks);
  • atypical macrosymptomatic form (symptoms are expressed, but
    not fully manifested: itching and pain, but absent
    vesicles or vesicles are present, but there is no discomfort);
  • abortive form (observed in patients who previously
    antiviral therapy and vaccination was carried out);
  • the asymptomatic form is the most dangerous since the clinical
    there are no signs, and the patient continues to have sex,
    spreading the infection through partners.

Symptoms of primary genital herpes

Phenomena of primary genital herpes occur in 3 – 14 days
after infection and persist for 21 – 35 days, and
the clinic is growing during the first week.

  • First, in the area of ​​the affected skin and mucous membrane appears
    redness, swelling, unbearable itching and burning.
  • After some time, bubbles form in this place.
    (vesicles), filled with turbid contents. Bubble formation
    combined with the general symptoms of intoxication: a rise in temperature,
    muscle and stomach pain, joint pain, weakness, sleep disturbances and
    nausea.
  • Besides того, увеличиваются паховые лимфоузлы, отекают половые
    lips or penis, painful urination appears.
  • After 5-7 days, the vesicles open and in their place
    small ulcers are formed, not prone to merge. Sores
    crusty, not deep and not bleeding, and heal without
    scar formation.
  • The primary episode of the disease is characterized by bilateral
    (symmetrical, on both sides) rashes.
  • As the process subsides and the ulcers heal (from them
    epithelium peels off) discomfort in the affected focus
    disappears.

In the case of the accession of a secondary infection, the discharge of sores
becomes purulent, and the formations themselves are very painful.

Recurrent genital herpes

The diagnosis of recurrent genital herpes is established in
case of detection of clinical signs and antibodies in the blood to
reactivated (activity return) type of herpes virus. Almost in
50% exacerbation of the disease occurs in the first six months from the primary
episode. It is characteristic that the intensity and duration of symptoms
recurrent herpes is less pronounced in contrast to the primary
проявления полового herpes Relapse lasts 4 – 10 days, and
more often exacerbations occur during infection with HSV-2 type.

Prodromal period characterized by itching, pain or burning
in the affected place, lasts 12 to 36 hours. May occur
neuralgic pains radiating to the lower back and legs. Then
rashes appear on the reddened area of ​​the skin / mucous membranes,
which are presented both separately and grouped
vesicles. In the future, the bubbles are opened and form erosion with
jagged edges. Common symptoms in recurrent herpes
either absent or represented by a minor headache and
weakness. Inguinal lymph nodes increase only with massive
herpetic eruptions.

Recurrent genital herpes can occur in a different way.
scenario, that is, in the form of atypical forms (arrhythmic, monotonous or
diminishing flow). With an arrhythmic course, relapses alternate.
remissions without a clear periodicity (from 2 weeks to 6 months).
Moreover, the longer the remission lasts, the longer and
more pronounced exacerbation and vice versa.

Monotonic flow is characterized by frequent episodes of the disease.
and periods of remission, during which the symptoms of herpes almost
do not undergo changes. Monotonic course of the disease
different persistence and poorly amenable to therapy. Most
favorable is genital herpes of subsiding type. With every
new exacerbation of the manifestation of manifestations is reduced, and
the duration of remission increases.

Herpetic eruptions are extremely painful, making it difficult
the patient’s movement, toilet visits and disturbed sleep, this is not
may not affect the mental state (the patient becomes
irritable, he has phobias: fear of new lesions,
fear for the health of relatives, thoughts of suicide).

Atypical and abortive forms

Различают следующие виды атипичной формы diseases:

  • edema – when there is marked swelling of the affected surface
    skin / mucous membranes;
  • hemorrhagic – vesicles filled with blood;
  • erosive and ulcerative – ulcers form very quickly on the spot
    herpetic eruptions;
  • necrotic – the formation of ulcers and necrotic areas on
    the location of the vesicles;
  • rupioid – formed long-term exfoliated
    brown crusts that project over the skin;
  • subclinical – in the affected area of ​​the mucous or skin
    small shallow cracks that exist
    not for long and accompanied by discomfort (itching, soreness),
    there are no characteristic vesicular eruptions. Possible and complete
    lack of clinic.

Symptoms of an atypical form of genital herpes are recorded in
60 – 65% of patients.

The difference between the abortive form of genital herpes from others is in
fast resolution process (no more than 1 – 3 days), that is, for
relapse is very short – abortive. There are the following types
abortive flow diseases:

  • erythematous – there is only a reddened itchy focus
    skin / mucous membranes;
  • papular – reddened and itchy area with slight
    elevation of the skin / mucosa, but no vesicles;
  • prurigo-neurotic – no vesicle, but there is pain along the way
    nerve endings.

Common manifestations of genital herpes

In both men and women, the disease can manifest itself in
as:

  • herpes cystitis – frequent urge to urinate, blood in
    urine;
  • herpetic urethritis – at the beginning of urination
    сильная боль, имеется кровь в urine;
  • herpes anus and rectum – the formation of cracks in the posterior
    aisles that recur when immunity is weakened,
    bleeding during stool, pain and intense itching in
    sphincter area (irritation of hemorrhoids), increased
    gas formation.

Manifestations of genital herpes in men

Genital herpes in men begins acutely, primary
symptoms resemble a cold: “breaks down”
head, aching loins, marked rise in temperature, weakness and
malaise. After a while, itching, tingling
or burning in the groin, numbness of the pelvic region after sleep or long
the seat.

An enlarged and painful inguinal can alert a man
lymph nodes, but this symptom is not marked. Only
detecting erythema and swelling on the penis mucosa, scrotum or
crotch, strong sex in a hurry to the doctor. Literally a few
hours, less days of the prodromal period in the area of ​​redness and
puffiness swell transparent bubbles localized at the extreme
flesh and glans head, on the scrotum or internal surfaces
hips, cover the pubis, and in the case of anal intercourse on
buttocks and around the anus. A week later, the vesicles are opened,
turning into sores, covered with yellow bloom. Then ulcers
�“Acquire” crusts and peel.

Recurrent herpes in men occurs with less frequency than
have the weaker sex, as the body of men is less likely to undergo
hormonal changes (pregnancy, menstruation). But any
serious illness as well as stress (men are harder
psychological stress due to the stereotype “do not show
weakness) causes recurrence of the disease. And although they have aggravations
happen less often, but flow heavier.

The consequences of genital herpes in men
include: herpetic prostatitis, urethritis and less commonly herpes
proctitis

Manifestations of genital herpes in women

Symptoms of the primary episode of genital herpes in women
Generally does not differ from manifestations in men. The disease is just like
and the stronger sex begins with a prodrome (fatigue, increase
fever, decreased appetite and nausea, arthralgia and myalgia, pain
in the lumbar region and lower abdomen, numbness of the skin in the region
pelvis).

The period of rash comes on 2 – 3 days after the prodromal and
characterized by the appearance of bubbles with a turbid liquid on the vulva
(clitoral region, small and large labia, on the commissures), in
urethra, vagina and cervix. Perhaps the formation of vesicles in
anal area, on the inner thighs and
crotch In case of lesions of the urethra, itching and tingling
during urination, and in severe cases, herpes infection
moves to the uterus and appendages.

Not always, but there are painful and enlarged lymph nodes in
groin In most cases, genital herpes in women
beautiful sex proceeds in an atypical form (about 65%). Besides
Moreover, women in the recurrence of the disease have noted an increase in
vaginal secretions that become particularly intense to
the end of the second phase of the menstrual cycle.

Tellingly, women are psychologically much harder
recurrence of the disease, leading to the development of depression, phobias (fear
sexual contact, fear of communication), suicidal thoughts,
neurosis.

Complications of the disease include:

  • vulvitis;
  • vulvodinia (itching and burning, weeping of external genital organs
    there are, and laboratory signs of inflammation are absent);
  • urethritis;
  • adnexitis and salpingitis;
  • chronic inflammation of the uterus;
  • pelvic pain syndrome;
  • emotional and mental disorders;
  • problems in sexual life;
  • decreased performance, psychasthenia (irritability and
    resentment, “close tears”).

Genital herpes during pregnancy

If a woman before pregnancy had cases of genital herpes,
then the risk of transmission to the fetus and the newborn is minimal, but
only in the absence of relapse during gestation (see herpes with
pregnancy). The great danger of genital herpes is
the period of gestation in the initial episode of the disease or
reactivation of the virus in the first 12 weeks and during the month before
expected delivery date. Exacerbation or primary infection
herpes infection leads to severe consequences in
pregnant women:

  • spontaneous abortion;
  • missed abortion (missed abortion);
  • preterm delivery;
  • the formation of malformations in the fetus;
  • infection of the newborn when passing through the “contagious”
    birth canal.

Besides того, генитальный герпес can cause habitual
miscarriage in the future, and even sterility.

Treatment

The first phase of treatment

With genital herpes, the main focus of treatment is
antiviral therapy. Prescription Antiviral Drugs
suppresses virus replication (reproduction), which quickly stops
clinical manifestations of the disease. Antiviral drugs
are applied both systemically (inside and parenterally) and locally (in
as ointments, creams and candles). It is advisable not to influence
herpes infection complex, simultaneous appointment
systemic and local drugs.

To date, such medicinal
agents like acyclovir, panavir, famciclovir and others. Etiotropic
therapy (antiviral) involves phase 1 treatment
recurrent herpes. Antiviral medications are prescribed by
2–5 times a day for a period of 7–10 days or until
complete disappearance of clinical phenomena.

Simultaneously with the listed drugs is prescribed and
symptomatic therapy aimed at relieving pain and itching, and
also sedatives. Besides того, в первую фазу лечения
ascorbic acid intake is shown and intramuscularly injected
specific antiherpetic immunoglobulin that activates
immunity of the patient.

Second phase of treatment

Conducted in the stage of remitting of recurrence (reduction of itching,
formation of scabs on ulcers and their peeling). Shown
introduction of vitamins B1 and B6, autohemotherapy, taking antihistamines
means (tazepam, suprastin) and non-specific (tincture
eleutherococcus, dibazol) and specific (lavomax)
immunomodulators.

Third phase of treatment

Held during remission and sent for warning
рецидивов diseases: больной вакцинируется герпетической вакциной
(duration of remission is at least 2 months), but vaccination
It is carried out necessarily after passage of the fortifying and
antiviral therapy.

After therapy

When treating genital herpes, should be avoided.
stress, hypothermia and prolonged sun exposure,
carry out the correction of psycho-emotional state, nutrition should
be full and rich in vitamins, if necessary
assigned bed rest.

Exacerbation prevention

And, of course, all patients with recurrent genital herpes in
stage of exacerbation of the disease should exclude sex,
follow the rules of personal hygiene (wash the affected skin
warm water with soap) to avoid attachment of secondary
infections. It is also forbidden to visit the baths, saunas and swimming pools, and
it is recommended to wear loose cotton underwear (prevents
friction of the affected areas, allows you to “breathe” the skin and reduces
pain sensations).

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