We at Bustle love giving you tips for how to tap into your sexual potential and troubleshoot when things aren’t going your way in the bedroom. But what about finding solutions to those stressful sexual health situations that inevitably crop up when you’re getting down? Emma Kaywin, a Brooklyn-based sexual health writer and activist, is here to calm your nerves and answer your questions. This week’s topic: how common genital herpes is in women — and how to live with a diagnosis.
Q: I was just diagnosed with genital herpes . I’m freaking out because all I know about this infection is that I can’t ever get rid of it, and I feel super unclean. When my doctor told me I’d tested positive, I felt like vomiting and bursting into tears at the same time. What’s going to happen to me — is my health going to be impacted? And what about dating? Will anyone ever love me if I have herpes again?
A: Learning you have any sort of sickness is awful, and when it’s something incurable and so loaded with stigma as genital herpes, it can feel like your life is over. But the good news is that, with genital herpes, that is totally not the case! At its core, herpes is a manageable skin condition that unfortunately comes with a ton of cultural baggage. Here's what you need to know about living with it.
What Exactly Is Herpes?
What we commonly call herpes is actually the symptoms caused by a virus called the herpes simplex virus, or HSV. HSV is an incurable virus that affects your nerves. It’s in the same family as the chicken pox, shingles, and mononucleosis (mono). While humans can’t get rid of it (at least not yet, scientists are actively working on that) it’s mostly dormant, only popping out every once and a while to become a nuisance to the body it's parasite-ing.
There are two types of HSV infections that can cause herpes sores in human special parts: HSV-2 is most likely to cause genital herpes blisters. HSV-1 is most likely found around mouths, and is called cold sores. But, while HSV-1 likes to be around lips, it can also thrive in the genital region.
HSV mostly hangs out dormant in the nerve cells near the spinal cord. During this time, there are no symptoms. However, the virus periodically reactivates, which means it wakes up, grows, and moseys on along the nerve fibers to the skin of the infected area, where it causes more blisters.
How Prevalent Is It?
There’s some not-so-great news if you own a vagina: our anatomy is much more likely to get infected with HSV-2 than a penis. This has to do with the optimal living conditions for HSV-2, as well as the transmission areas. In the United States, about 1 in 4 women have HSV-2 infection compared to almost 1 in 8 men.
Unfortunately, most people don’t get tested because HSV isn’t on the usual list of STI tests offered at clinics — you have to ask for it specifically. So even folks who are being active in knowing their sexual health status may not be aware of whether they are HSV-infected or not. It's important to get tested.
What Does It Feel Like?
When a person first gets infected with HSV, it usually shows up as a bunch of tiny, fluid-filled blisters on the affected area, and can also include flu-like symptoms such as achy muscles, headache, or fever. These blisters burst, leaving behind ulcers that hurt and take one to three weeks to heal, but the painful skin situation can take up to over a month to resolve.
The initial outbreak is generally the worst, and will occur in most people anywhere from three days to two weeks after the exposure event. Outbreaks are often preceded by tingling, burning, itching, or painful feelings in the affected areas.
After the first infection, the virus is mostly hiding in the nerve cells, coming out periodically to say what's up in the form of more sores — which tend to be less frequent and painful then the first outbreak because the body becomes familiar with the virus and makes antibodies to combat it. Recurrence can be triggered by a number of things, including stress, menstruation, or a fever.
Because a herpes outbreak is just what you need when you’re feeling gross or having a bad week, am I right?
Where Can I Get It On My Body?
There are actually a lot of places on the human body where you can get herpes sores. You can get them on and around your mouth, including lips, tongue, and gums. Depending on what genitalia you're rocking, you can get sores on your labia (vaginal lips) and cervix or penis, scrotum, and urethra. All humans can also get them around the anal opening and on the thighs and butt. Finally, sores can show up on fingers, eyes, and even the brain.
The important thing to note about where HSV likes to hang out is that it’s not just the parts of the body covered by condoms. (We'll get to how to deal with that in a second.)
Is It Dangerous?
HSV is not life-threatening. If you’re healthy overall, you won’t experience health complications from carrying this virus in the body. There are two main things that can make HSV dangerous. If you are having sex with someone who has HIV while you have an outbreak, your chances of becoming HIV infected are increased.
If you’re pregnant and have an outbreak during the third trimester of your pregnancy, you can pass the virus to your baby, which can be deadly for the brand new human you just made. However, this method of transmission can be prevented through medication and by birth through cesarean section.
How Can I Give It to Someone Else?
While genital herpes is designated as a sexually transmitted infection (STI) because it’s mostly transmitted during sexual activity, it’s actually spread through skin-to-skin contact. This means that you can get or give it without actually having to have sex. HSV gets transmitted when a mucus membrane (which is a type of skin) of one person touches the infected mucous membrane of another person.
What part of the body this happens to is important, because if you get infected, the sores will show up wherever the actual touching took place. However, you can spread herpes all by yourself by touching a sore and then touching another part of your (or someone else's) body.
How Do I NOT Give It To Someone Else?
The only way to 100 percent not give HSV to someone else is to not let your parts touch their parts. Since that’s not how most adults live their lives, we’re in luck that there are some things people with HSV can do to minimize the risk of transmission (note that I didn’t say 100 percent prevent).
Since the actual genitals are only one of the places where HSV blisters can hang out, it makes sense that condoms wouldn’t prevent transmission completely. However, wrapping it up can reduce the risk by around 25 to 30 percent. Researchers have found that condoms are especially effective in protecting women, but not so good with men.
Some people take medications — which can come in the form of pills and/or topical creams — at the first sign of an outbreak to minimize the duration and physical symptoms of herpes sores and reduce the risk of infection. These medications are generally taken for a two to five day period.
For people who experience multiple outbreaks, daily suppressive medication is available, which is a pill you can take every day that minimizes the risk of getting sores. This daily course of antiviral medications can reduce outbreaks by up to 80 percent, and in many people suppresses outbreaks altogether. Additionally, these medications have been shown to diminish the risk of spreading the virus to other humans.
Abstaining During Outbreaks
While HSV can be transmitted when an outbreak isn’t occurring, the research shows that abstaining from touching and sexual activity when there are visible sores is helpful for minimizing transmission risk. Knowing when an outbreak is on its way is important, so that you can plan accordingly (such as starting to take suppressive meds and/or abstaining from canoodling for a few days).
Telling your sexual partner or partners about your status is not just honest, it can help you negotiate sexual activity around any outbreaks that may occur. If your partner knows you have HSV, it’s that much easier to tell her or him if you are feeling the first stirrings of a recurrence, so that you can act accordingly — together.
The Bottom Line
HSV is a very common disease that has become uniquely stigmatized, even among the category of STIs. In American culture, it’s most often discussed as a punchline to signal promiscuity, instead of as an annoying skin condition that happens to people of all sorts.
The stigma associated with HSV isn’t helpful, because it leads people to flip the f$%k out when they learn they are carrying the virus and think their lives are over and that they will never be loved again. Stigma also leads people to be terrified to disclose their status to lovers, which continues the spread of the virus. Luckily, many people are working to combat this cultural reality and smash the stigma associated with HSV — like the folks over at (h)Opportunity.
The most important thing to remember is that herpes is a skin condition that happens to exist in a part of our bodies that really stress us out as a culture (I mean, we call them "privates"). From a health perspective, it’s not a dangerous condition. Testing positive says nothing of who you are as a human, and you are no less deserving of love because of it.
Images: _HAAF/Flickr; Lisa Bass; Giphy