Genital Herpes: Symptoms, Diagnosis, and Treatment Options

Q: Genital Herpes: Symptoms, Diagnosis, and Treatment Options

Hello： Your skin condition is likely balanitis. <br>Genital herpes does not manifest unless there are symptoms (it may flare up if your immune system weakens). <br>The tests at major hospitals are quite accurate. <br>It is advised to avoid unsafe sexual practices, as both genital

Genital herpes

On February 13 of this year, I visited the clinic due to frequent urination and discomfort in my bladder.
After taking medication for five days, I only experienced slight improvement, but then I developed sharp pain in my left testicle.
I was prescribed another five days of medication, but this time I felt unwell and stopped taking it.
Since my symptoms persisted, I went to the National Taiwan University Hospital branch to consult a urologist about my balanitis.
The first time I had balanitis, I noticed red spots and itching, which was caused by masturbation, as I had not engaged in sexual intercourse at that time.
I visited a general urology clinic and was diagnosed with balanitis, which eventually resolved.
Later, I had sexual relations with a friend at a sexual venue, using protection, but I engaged in unprotected oral sex.
Afterward, the symptoms recurred, and I was again diagnosed with balanitis.
Each time I returned, I was treated for recurrent balanitis, receiving both oral medication and topical ointments for the persistent red spots, which were mildly itchy but not painful.
Applying the ointment usually resolved the issue within a few days.

After my last sexual encounter on December 8 of last year, I did not engage in sexual activity again until I returned to the National Taiwan University Hospital branch on February 13 of this year for my bladder discomfort.
The doctor also examined my balanitis and provided topical treatment.
During my second visit to the same doctor for bladder discomfort, frequent urination, and testicular pain, I was prescribed Doxycycline EC 100mg/cap and had my balanitis evaluated.
The doctor ordered blood tests for syphilis, which came back negative, but herpes was positive.
However, the doctor diagnosed the red spots on my penis as balanitis.
Although my blood test showed a positive result for herpes, the red spots on my penis did not resemble blisters and were not painful, only mildly itchy.
After taking the prescribed Doxycycline EC 100mg/cap, the red spots on my penis disappeared, but I still experience occasional itching.

I am still dealing with bladder issues, right groin pain, and localized pain in my left thigh.
I would like to ask the doctor whether my condition is balanitis or genital herpes.
Is it possible for the blood test to yield a false positive result? Would a retest change the results, or is it 100% certain that I am infected? Additionally, could this have any impact on my future fertility and reproductive health? Is this type of sexually transmitted infection related to HIV or syphilis? How does this condition occur, and can sharing underwear, towels, or clothing lead to transmission? This situation has significantly affected my mood and energy levels.

Joe, 10~19 year old female. Ask Date: 2017/03/09

Dr. Du Shixi reply Urology

Hello: Your skin condition is likely balanitis.
Genital herpes does not manifest unless there are symptoms (it may flare up if your immune system weakens).
The tests at major hospitals are quite accurate.
It is advised to avoid unsafe sexual practices, as both genital herpes and balanitis are difficult to treat.
If you do not take care, they can recur, so you need to maintain cleanliness and keep the skin dry.
Additionally, sexually transmitted infections (STIs) such as herpes, HIV, syphilis, and warts are mostly transmitted through sexual contact, so you should consider whether your sexual partner has any STIs, as this could lead to transmission through sexual activity.
Furthermore, I am unclear about your living situation and why there is a need to share underwear, towels, or clothing.
Is it really necessary to share these items? Although the risk of transmitting STIs this way is low, skin conditions can be troublesome enough, so please refrain from sharing underwear, towels, or clothing.
Focus on treatment, and seek medical attention if you have any issues.
Thank you for your inquiry.

Reply Date: 2017/03/09

More Info

Genital herpes is a common sexually transmitted infection (STI) caused primarily by the herpes simplex virus (HSV), which has two types: HSV-1 and HSV-2. While HSV-1 is often associated with oral herpes, it can also cause genital infections, and HSV-2 is primarily associated with genital herpes. Understanding the symptoms, diagnosis, and treatment options for genital herpes is crucial for managing the condition and reducing the risk of transmission.

Symptoms of Genital Herpes
The symptoms of genital herpes can vary widely among individuals. Some may experience severe symptoms, while others may have mild or even asymptomatic infections. Common symptoms include:
1. Painful Blisters or Sores: The most characteristic symptom is the appearance of painful blisters or sores in the genital area, which can rupture and form ulcers.

2. Itching and Discomfort: Many individuals report itching or discomfort in the genital region before the blisters appear.

3. Flu-like Symptoms: During the initial outbreak, some may experience flu-like symptoms, including fever, body aches, and swollen lymph nodes.

4. Recurrent Episodes: After the initial outbreak, the virus remains dormant in the body and can reactivate, leading to recurrent episodes. These recurrences are usually less severe than the initial outbreak.

Diagnosis
Diagnosis of genital herpes typically involves a combination of clinical evaluation and laboratory tests. A healthcare provider may:
1. Perform a Physical Examination: The doctor will examine the affected area for sores or blisters.

2. Take a Sample: If sores are present, a swab may be taken from the blister for laboratory testing to confirm the presence of HSV.

3. Blood Tests: Blood tests can detect antibodies to HSV, indicating a past or current infection. A positive result for HSV-2 antibodies typically confirms genital herpes.

Treatment Options
While there is no cure for genital herpes, several treatment options can help manage symptoms and reduce the frequency of outbreaks:
1. Antiviral Medications: Medications such as acyclovir, valacyclovir, and famciclovir can help reduce the severity and duration of outbreaks. They can also be used as suppressive therapy to decrease the frequency of recurrences and lower the risk of transmission to partners.

2. Topical Treatments: Over-the-counter creams may help alleviate itching and discomfort during outbreaks.

3. Pain Relief: Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help manage pain associated with outbreaks.

Impact on Fertility and Sexual Health
Genital herpes does not directly affect fertility. However, it is essential to manage the infection, especially during pregnancy, as it can pose risks to the newborn if the mother has an active outbreak during delivery. It is crucial to inform healthcare providers about the infection to ensure appropriate precautions are taken.

Transmission and Prevention
Genital herpes is primarily transmitted through direct skin-to-skin contact during sexual activity, including vaginal, anal, and oral sex. It is important to note that the virus can be transmitted even when no visible sores are present. Sharing personal items like towels or underwear is not a common mode of transmission.

To reduce the risk of transmission:
1. Use Condoms: While condoms do not provide complete protection, they can significantly reduce the risk of transmission.

2. Avoid Sexual Activity During Outbreaks: It is advisable to abstain from sexual activity when symptoms are present.

3. Inform Partners: Open communication with sexual partners about STIs is crucial for mutual health and safety.

Conclusion
In summary, genital herpes is a manageable condition with appropriate medical care. If you have tested positive for HSV, it is essential to follow up with your healthcare provider for personalized treatment and management strategies. Understanding the nature of the infection, its symptoms, and treatment options can help alleviate anxiety and improve your quality of life. If you have concerns about your symptoms or the implications of genital herpes on your health, do not hesitate to seek medical advice.

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