Clitoris and Clitoral Disorders
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Genital herpes is a prevalent infectious disease caused by the Herpes simplex virus (HSV). The disease is characterized by skin lesions predominantly located in the anogenital region.
Transmission of genital herpes primarily occurs through unprotected sexual intercourse. However, a less common mode of transmission is vertical contagion, from an infected mother to her child during childbirth.
The infection can manifest itself at the virus's point of entry within a week of infection, causing significant discomfort. In some cases, however, the infection may be asymptomatic. A significant factor in the spread of this infection is its unconscious transmission. Individuals may unknowingly carry and transmit the virus without showing any symptoms.
Despite the availability of treatment, the infection cannot be permanently cured. However, antiviral drug-based therapy is crucial to mitigate the disease's consequences.
Genital herpes results from an infection with the Herpes simplex virus. The primary pathogen is usually HSV-2, but HSV-1, the viral strain responsible for cold sores, also causes 10-30% of cases.
Once the infection is resolved, the viruses remain latent within the body, evading the immune system and not being definitively eliminated. Their permanence in the nervous ganglia corresponding to the affected areas allows for short and generally less severe reactivation episodes compared to the first infection. Recurrences of genital herpes are favored by stress, excessive alcohol consumption, exposure to the sun, or a decline in immune defenses.
Genital herpes is primarily transmitted through unprotected sexual intercourse (vaginal, anal, or oral) and intimate practices involving contact with infected mucous membranes. Vertical transmission, i.e., from mother to child during childbirth, is also possible.
To prevent neonatal infection, cesarean section is recommended for pregnant women with an active infection and the presence of genital lesions.
Genital herpes lesions are mainly located on the foreskin, glans, and body of the penis in men, and on the labia majora and minora, clitoris, perineum, vagina, and uterine cervix in women.
The infection presents with small, often painful papules or rounded vesicles 4-7 days after infection. These skin lesions are usually preceded by an annoying burning and tingling sensation at the virus's entry point. The blisters cause itching and discomfort and can erode within a few days, forming painful ulcers. This stage coincides with the phase of maximum contagiousness.
In some cases, genital herpes may not cause any noticeable discomfort, leading to the unknowing transmission of the disease. As the disease progresses, the ulcers left by the ruptured blisters dry out, forming scabs that progressively heal until they disappear.
The disease follows a similar course to that of cold sores: small, very annoying bubbles burst, transforming into shallow ulcerations, which heal without leaving obvious signs within two or three weeks. However, local pain and itching can persist for up to a month after the vesicles disappear.
Compared to cold sores, this type of infection is more prone to complications, especially after the first episode. In addition to genital manifestations, primary Herpes simplex infection can cause systemic symptoms, such as fever, headache, joint pain, general malaise, difficulty urinating, and constipation. Rarely, complications may occur, such as severe sacral radiculopathy or aseptic meningitis.
Diagnosis of genital herpes begins with the observation of the vesicles that appear during the acute phase. However, symptoms are not always present, especially in the relapse phase.
In suspected cases, confirmation of the diagnosis is necessary through laboratory tests. These tests can verify the presence of specific antibodies directed towards HSV. The assessment may also include the search for the virus in the material of the genital lesions using PCR (Polymerase Chain Reaction) analysis.
While current treatments cannot permanently cure the infection, antiviral drug-based therapy is effective in reducing symptoms and shortening recovery times.
These active ingredients hinder the multiplication of the virus, therefore shortening the duration and making episodes of the disease less severe. However, antiviral drugs do not completely eradicate the latent virus presence, nor do they modify the intensity and frequency of relapses after the therapeutic cycle.
Currently, there is no vaccine to prevent genital herpes. Therefore, the only effective prevention is taking precautions during sexual intercourse and abstaining from intimate contact for the entire duration of a genital herpes episode.
Therapy also does not reduce the risk of transmitting the infection to sexual partners. To prevent neonatal infection, cesarean section is recommended for pregnant women with active infection and genital herpes simplex lesions.