Fifty years ago, herpes was barely a blip on the screen. Generally shrugged off and ignored by the medical community, herpes was considered a common skin condition that caused periodic outbreaks that could be annoying and unsightly, but otherwise were harmless. Herpes was seen as a facial cold sore that appeared on other areas of the body.

No big deal. Treat the symptoms. Move on.

So, what happened? How did

The short answer: The hysteria surrounding herpes was largely manufactured by a pharmaceutical company desperate to find a disease (or, rather, desperate to convince the medical community and general public about an incurable disease) that would benefit from its new antiviral drug.

After the drug company launched a purposeful campaign to scare doctors and consumers into buying into the antiviral drug, Time magazine (among many other media outlets) ran cover stories and human-interest pieces about the illness, and the rest of the story is quite literally history. It grew. It morphed. It became contagious.

Yep, the herpes stigma was essentially made-up during a marketing pitch meeting and then promulgated by a media feeding frenzy that stoked the fires of sensationalism and fear. It’s hard, if not impossible, to highlight the exact moment for the herpes hysteria. But it’s safe to say a combination of marketing prowess and media power led to a misguided misinformation campaign that, like the virus itself, is alive and well today.

At Tia, we think it’s time to set the record straight and tell a different story about herpes – a story that begins with how common it is, and in the greater scheme of things, how un-shameful it is.

Herpes is fairly straightforward. Diagnosing, recognizing, treating, and preventing it isn’t a complicated exercise. But the simple (and avoidable) truth is this:

Today, the most dangerous and debilitating thing about herpes is the unfair social stigma and stereotyping that surrounds the condition and the unnecessary psychological toll it takes on people.

Hopefully, this article can join a conversation that seems to be picking up steam (especially on social media) and become another resource that aims to re-frame the fiction of herpes and put it back in its proper place: Not as a social and sexual death sentence but as a barely noticeable blip on the screen of life. And love.

What is Genital Herpes?

Herpes is a highly-contagious, highly-common STD (sexually-transmitted disease) aka STI (sexually-transmitted infection) caused by a virus that lives in nerves and produces small clusters of itchy or painful blisters. There are two common types.

Herpes simplex type 1 (HSV-1) usually causes “cold sores” or “fever blisters” around the mouth while Herpes simplex type 2 (HSV-2) generally causes sores in the genital area.

However, it’s possible to get HSV-1 (oral herpes) in the genital area and it’s possible to get HSV-2 (genital herpes) around the mouth.

Genital herpes is transmitted through a) direct contact with a sore, b) direct contact with unbroken skin (no sore), c) genital secretions, or d) saliva (if you’re partner has oral herpes). Remember, too: Herpes can be passed from an infected person to a noninfected person even when symptoms aren’t present.

After getting infected, many people have recurrent episodes of genital ulcers for several years. Although herpes stays in the body for life, symptomatic outbreaks usually become less common over time. While technically incurable, herpes can be managed with antiviral medications, self-care measures, and safer-sex practices. These medications can reduce the number of outbreaks, shorten the duration of outbreaks, lessen the burden of outbreaks, and lower the risk of passing the infection to someone else.

Symptoms of Genital Herpes

Symptoms of genital herpes vary widely among people. Many people don’t experience any symptoms. Others experience severe symptoms at the outset of the illness and milder symptoms with each recurrence of it.

For most people, the first outbreak is the most severe. After the initial outbreak, the virus travels to a bundle of nerves at the base of the spine and remains dormant until it’s reactivated. There aren’t symptoms associated with this latent phase of herpes.

Recurrent episodes of genital herpes occur, if they occur, when the virus “wakes up” and travels back through the nerves to the skin’s surface, causing an outbreak again. In general, recurrent outbreaks are milder than the initial outbreak.

Here are some of the most-common signs and symptoms associated with genital herpes:

• Multiple itchy/painful blisters or sores around the genitals or anus that typically heal within 2-4 weeks.
• Flu-like symptoms, including swollen lymph nodes in the groin, joint pain, fever, and headache.
• Pain with urination if herpes has affected the urethra.
• Some people with recurrent outbreaks experience a prodrome – a group of symptoms that indicate an impending infection – such as tingling, itching, or pain in an area where lesions will develop.

Diagnosing Genital Herpes

Since the CDC doesn’t consider herpes to be a serious health threat, it doesn’t recommend routine testing. This even if the organization estimates that nearly 90% of people infected with HSV-2, the most common cause of genital herpes, have never been diagnosed!

The diagnosis of genital herpes depends on several factors, including medical history, visual examination, and signs and symptoms of disease. Healthcare providers can often reliably diagnose herpes by examining the sores.

If sores are present, PCR (polymerase chain reaction) testing is also available. After collecting tissue or fluid from a sore, your provider will send the sample away, where the DNA can be used to establish the presence and type of herpes virus. PCR is the most sensitive test we have and the preferred detection method when there are active ulcers.

A healthcare provider can also scrape the sore and culture it to confirm the presence of virus and which type of herpes (HSV-1 v. HSV-2) is causing symptoms.

Blood tests can be used to detect antibodies to HSV-1 and HSV-2 viruses when no visible sores are present. This method can be particularly useful if someone has a history of genital ulcers or thinks she may have been infected by a sex partner in the past.

Prevention is really the best medicine for herpes. It’s advised to avoid all sexual contact if you or your partner has an active outbreak. Another preventive strategy involves starting an antiviral medication at first signs or symptoms of an outbreak or remaining on a daily, suppressive dose of antiviral medicine. Finally, while condoms aren’t foolproof at preventing herpes transmission (or any STD), anyone with herpes should use a condom every time they have sex.

Oh, and for symptom relief, over-the-counter pain relievers or taking a “sitz bath” are safe and effective measures that often bring relief from the pain and discomfort associated with a herpes outbreak.

No Shame in the Herpes Game

The social stigma of genital herpes is a big barrier to emotional wellbeing, healthy relationships, and effective management of the condition. Despite being very common, negative perceptions that surround genital herpes often lead to unnecessary psychological distress, social isolation, and challenges in intimate relationships.

By addressing misconceptions, fostering supportive environments, and promoting education and awareness, perhaps society can finally move forward and toward a more understanding and less judgmental view of genital herpes. Removing the stigma not only benefits those living with the virus but also contributes to broader sexual health and wellness for all.

If you’re experiencing symptoms of herpes or are just curious about your reproductive and genital health, become a Tia member and schedule an appointment! If you’re ready to be seen (and heard), we’re ready to listen and help with both the physical and emotional aspects of herpes and other health conditions.