All About Genital Herpes: FAQ - How Can You Tell If You Have It?

Genital herpes can be a confusing disease. Symptoms can look like other conditions, or there may be no symptoms at all. How to tell if you have it? These questions and answers will help.

Could I have herpes and not know?

Unless no one has ever kissed you, and unless you've never had sex, it is possible that you've picked up a herpes virus.

Oral herpes, usually caused by the herpes simplex virus type 1 (HSV-1), shows up as cold sores or fever blisters on the mouth. Even a casual peck on the lips from someone with a cold sore can give you the virus. That's why it's so common: As many as 50% to 80% of adults in the U.S. have oral herpes.

Genital herpes, most often caused by the second type of herpes virus (HSV-2), is less common, but plenty of people still have it. Roughly one in five American adults has genital herpes. But up to 90% of those who have it don't know they are infected. You could be one of them.

What are some signs that I might have genital herpes?

Often it's hard to tell by looking. The textbook symptom of genital herpes is a cluster of small fluid-filled blisters that break, forming painful sores that crust and heal during several days. Affected areas include the penis, scrotum, vagina, vulva, urethra, anus, thighs, and buttocks.

But many people don't get these sores. Some people have no symptoms at all, while others get symptoms that can be easily mistaken for razor burn, pimples, bug bites, jock itch, hemorrhoids, an ingrown hair, or a vaginal yeast infection.

After you're infected, the symptoms go away, but can flare up from time to time. Luckily, the first outbreak usually is the worst. And some people may have just one or two outbreaks in their lifetime.
 

Is there a test for genital herpes?

Yes. A doctor can take a sample from what appears to be a herpes sore and examine it under a microscope. You can also have a blood test. The blood test looks for antibodies to the virus that your immune system would have made when you were infected. HSV-2 almost always infects the genitals, so if antibodies to HSV-2 are detected in your blood, you probably have genital herpes.

A blood test that shows antibodies to HSV-1 means you could have genital or oral herpes. That's because oral herpes, typically caused by HSV-1, can be spread to the genitals during oral sex.
 

If I don't have it now, how can I avoid it in the future?

The only sure-fire way to avoid getting genital herpes is to abstain from sex or have sex only with someone who is also herpes-free. Short of that, a latex condom offers some protection if it covers the infected area. Remember, you can get genital herpes by receiving oral sex (fellatio, cunnilingus, analingus) from someone with a cold sore on the mouth. Likewise, you can get oral herpes from someone's genitals by way of oral sex.

If you know that a sex partner has genital herpes, you can reduce your risk by having sex (vaginal, anal, or oral intercourse) only when he or she has no symptoms. Nevertheless, genital herpes can be contagious even when there are no visible symptoms, so you should always use a latex barrier, such as a condom or a dental dam.

HPV and Cervical Cancer: What Women and Girls Should Know

Nearly two decades ago, experts discovered a relationship between infection with HPV (human papillomavirus) and cervical cancer. Since then, these experts have learned much more about how HPV can lead to cervical cancer.

Here, what every woman and girl should know about HPV and cervical cancer.

About HPV Virus
There are more than 100 types of HPV. About 30 or so types can cause genital infections. Some can cause genital warts; other types can cause cervical or other genital cancers. (The other 70 or so HPV types can cause infections and warts elsewhere on the body, such as on the hands.)

Most sexually active women and men will contract HPV at some time in their lifetime. Most will never even know it. Usually, this virus does not cause any symptoms and doesn't cause disease. Often, the body can clear HPV infection on its own within two years or less.

Some types of HPV, typically HPV 6 and HPV 11, cause genital warts. The warts are rarely associated with cervical cancers. They are considered "low-risk" HPV.

HPV and Cervical Cancer
Certain HPV types are classified as "high-risk" because they lead to abnormal cell changes and can cause genital cancers: cervical cancer as well as cancer of the vulva, anus, and penis. In fact, researchers say that virtually all cervical cancers - more than 99% -- are caused by these high-risk HPV viruses. The most common of the high-risk strains of HPV are types 16 and 18, which cause about 70% of all cervical cancers.

If the body clears the infection, the cervical cells return to normal. But if the body doesn't clear the infection, the cells in the cervix can continue to change abnormally. This can lead to precancerous changes or cervical cancer.

Rates of Cervical Cancer
Actual cervical cancer is rare in the U.S. because most women get Pap tests and have abnormal cells removed before they turn into cancer. In 2006, about 10,000 women in the U.S. found out they had cervical cancer and 4,000 women died from cervical cancer.

HPV Transmission
HPV types associated with genital infections are transmitted sexually, primarily through skin-to-skin contact during sexual activity. HPV can also be transmitted through oral sex. The chance of getting HPV rises with certain risk factors:

* Number of lifetime sexual partners (risk increases with more partners)
* Young age: Women aged 20 to 24 are most likely to be infected, but they usually clear the HPV infection with no problems.
* Women who are sexually active with men who have other partners at the same time.

Symptoms of High-Risk HPV Infection and Tests
When infection with high-risk HPV types occurs, there usually are no symptoms. Often, the first clue is a Pap test result that is abnormal. In a Pap test, the doctor takes a swab of cervical cells and has them analyzed in a laboratory. If the Pap test results are unclear, the doctor may order a HPV test to check the DNA type of the virus. This analysis can identify 13 of the high-risk HPV types associated with cervical cancer. It does not identify cancer. But it tells the woman and her doctor if she has a type of HPV capable of causing cancer.