Genital herpes is a genital infection caused by the herpes simplex virus (HSV). Most individuals carrying herpes are unaware they have been infected and many will never suffer an outbreak, which involves blisters similar to cold sores. While there is no cure for herpes, over time symptoms are increasingly mild and outbreaks are decreasingly frequent. When symptomatic, the typical manifestation of a primary infection is clusters of genital sores consisting of inflamed papules and vesicles on the outer surface of the genitals, resembling cold sores.[5] These usually appear 4–7 days after sexual exposure to HSV for the first time.] Genital HSV-1 infection recurs at rate of about one sixth of that of genital HSV-2.
Genital herpes causes considerable psychological and psychosexual morbidity. The most common emotional responses are depression, anguish, anger, diminution in self-esteem and hostility towards the person believed to be the source of the infection. These emotional problems appear to be worse in women than in men. The psychological morbidity in patients with first episode genital herpes is statistically significantly greater than that occurring in non-herpes patients attending sexually transmitted disease clinics. It was previously believed that stressful life events could precipitate recurrences. However, recent studies suggest that ongoing recurrences cause the emotional stress rather than vice versa. There is some evidence that premorbid personality may effect recurrence rates, but an equally plausible explanation is that frequent recurrences adversely affect personality. Long-term aciclovir suppression significantly reduces the psychological morbidity associated with recurrent genital herpes, over at least the period of treatment. Cognitive coping strategies and social support from a partner appear to assist with adjustment. Improving a patient's problem-solving skills, and long-term aciclovir therapy should form an integral part of the long-term management of recurrent genital herpes.
