In the United States, the incidence of genital herpes has reached nearly epidemic proportions. Only 20% of all infected people know they have herpes. While some people experience extremely painful, noticeable herpes outbreaks, many assume their symptoms are a result of a common cold or other viral infection. Knowing the symptoms of a potential herpes outbreak is the best defense against recurring, painful outbreaks, and passing the disease on to future partners.
Incidence Among Women
According to the most recent statistics, women have a much higher chance of contracting herpes than men. 1 in five men over the age of 12 have herpes, in contrast to 1 in 4 women nationwide. Contrary to popularly held belief, women who contract herpes don’t necessarily have more sexual partners than the average man. Herpes is primarily spread through breaks cuts on the surface of the genitals. Women are more likely to have small cuts, allowing more opportunities for the herpes virus to gain a foothold.
Types of Herpes
Herpes comes in two, distinct forms: HSV-1 and HSV-2. 80% of the population carries the HSV-1 virus, and it primarily makes its appearance in the form of cold sores. An HSV-1 infection isn’t contracted through sexual activity. It’s been shown, however, that HSV-1 can cause a genital infection if oral sex is performed by someone with an HSV-1 cold sore in their mouth or on their lips.
HSV-2 virus is the version of the herpes virus most commonly associated with genital herpes. As previously mentioned, the HSV-2 virus primarily infects its host through tears or small cuts in the skin of the genitals. For this reason, HSV-2 infection is generally assumed to be an STD, or a product of unprotected sexual intercourse.
The First Outbreak
Sufferers of herpes exhibit a range of symptoms, usually within two to twenty days of initial contact with the virus. While some of these symptoms occur across infected groups; others are primarily experienced by female sufferers.
Initial outbreaks of herpes are especially difficult for individuals who have never been exposed to any form of the herpes virus (i.e. HSV-1, or cold sores). The initial outbreak can last anywhere from 10 to 21 days.
It’s important to note that up to 60% of infected individuals don’t experience any symptoms of being infected with herpes. In fact, many herpes sufferers have herpes outbreaks, or viral shedding events, and don’t realize they’re contagious. This is more likely to happen after the initial herpes outbreak has already occurred, and can generally be controlled with prescription anti viral medications.
Herpes Symptoms
Before any actual external sores or blisters appear, initial symptoms —also called prodromal symptoms— may occur. These are more likely to appear after the initial outbreak has occurred and subsided. For patients who have chosen to forego sexual activity during an outbreak, prodromal symptoms provide an early warning system, allowing them to predict the outbreak before it happens. Here’s a list of the most common prodromal symptoms and how they manifest in women:
Prodromal Symptoms
1. Patients experience a tingling, numb, itching sensation in the buttocks, thighs, and vulva.
2. Lymph nodes under the armpits and in the groin become swollen.
3. Flue-like symptoms are reported, including fatigue, headache, and a low-grade fever.
4. Urination can become painful. Approximately 70% of women suffering from an initial herpes outbreak report problems urinating, whereas only 40% of men report a similar experience.
After the prodromal symptoms make their appearance, the primary herpes symptoms follow in their wake.
Primary Herpes Symptoms
1. Inflammation flares up around the affected area. Burning and sensitivity is common.
2. Red bumps appear in the affected area. These soon turn into clusters of blisters. When the blisters rupture, they form open sores. During the first, or primary, herpes outbreak, there’s a much greater likelihood that large numbers of blisters will appear. Later outbreaks will often include fewer actual blisters.
3. Women will often experience a watery vaginal discharge during the second phase of the herpes infection. In women who are otherwise asymptomatic, irregular vaginal discharge might be the only symptom of an ongoing herpes outbreak.
During their first year with herpes, most patients experience at least four outbreaks. These outbreaks are generally much shorter than the initial outbreak, and generally only last 3 to 5 days. Responding to the effects of menstrual hormones, some women experience herpes symptoms on a monthly basis. The best treatment for recurring outbreaks is prescription suppression therapy.
Triggering Future Outbreaks
Continued herpes outbreaks can be triggered by a variety of factors. A few examples of these include:
- Stress
- Physical Exertion
- Sunlight
- Illness With Fever
- Surgery
- Poor Diet
- Asthma Medication/Steroids
While avoiding all of these factors isn’t always a viable option, understanding the factors that influence outbreak occurrence can make future outbreaks easier to predict.
Pregnancy and Herpes
Pregnancy and its immunosuppressive effects can trigger a herpes outbreak during the second or third trimesters. Many first-time herpes outbreaks are triggered by pregnancy. A first-time outbreak during pregnancy is particularly dangerous if the woman hasn’t had any reason to produce antibodies to fight the virus in the past. American doctors don’t routinely test for herpes infections when a woman goes in for her annual gynecological exam, and very few test for herpes at the onset of pregnancy.
Birth Control Concerns
A herpes diagnosis has an impact on many aspects of a woman’s life, including her choice in birth control. Some doctors suggest avoiding IUD use, and some types of birth control pills can trigger future outbreaks. Discussing birth control options should be a primary concern immediately after herpes diagnosis.
Every year, herpes becomes more prevalent in The United States. A woman under the age of 30 is 20 times more likely to have herpes than a woman of the same age thirty years ago. Medical professionals and private health organizations are now suggesting that sexually active women ask for a herpes test with their yearly exam or when they find out they’re pregnant.