ΕΡΠΗΣ ΓΕΝΝΗΤΙΚΩΝ ΟΡΓΑΝΩΝ: ΟΛΑ ΟΣΑ ΠΡΕΠΕΙ ΝΑ ΓΝΩΡΙΖΕΙΣ

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Ο έρπης γεννητικών οργάνων είναι μια πολύ συνηθισμένη λοίμωξη, η οποία συνήθως δεν προκαλεί κανένα σοβαρό πρόβλημα υγείας. Ωστόσο, πολλοί άνθρωποι νιώθουν απελπισία, θλίψη ή θυμό κάθε φορά που ο ιός κάνει την εμφάνισή του… Και, όπως συμβαίνει με τον ιό των κονδυλωμάτων (HPV), η παραπληροφόρηση χειροτερεύει την κατάσταση…

Σε αυτό το άρθρο θα βρεις τις πιο σημαντικές πληροφορίες σχετικά με των έρπητα των γεννητικών οργάνων:

Τι είναι ακριβώς ο έρπης των γεννητικών οργάνων;

Ο γεννητικός έρπης είναι ένα σεξουαλικά μεταδιδόμενο νόσημα (ΣΜΝ), και προκαλείται από έναν ιό που ονομάζεται Απλός Έρπης (Herpes simplex virus, HSV).

Ο ιός του έρπητα προκαλεί επώδυνες πληγές και φουσκάλες που μπορεί να εμφανίζονται στην περιοχή των γεννητικών οργάνων, στον πρωκτό, στους μηρούς ή στους γλουτούς. Μερικές φορές όμως, η λοίμωξη δεν προκαλεί καθόλου συμπτώματα. Μάλιστα, πολλοί άνθρωποι έχουν μολυνθεί με τον HSV και δεν το γνωρίζουν.

Υπάρχουν δύο τύποι απλού έρπητα: ο HSV-1 και ο HSV-2. Συνήθως, ο τύπος 2 προσβάλλει την περιοχή των γεννητικών οργάνων ενώ ο HSV-1 ευθύνεται  για τον έρπη στο στόμα ή το πρόσωπο. Ωστόσο, και οι δύο τύποι μπορούν να προσβάλλουν και τα γεννητικά όργανα και το στόμα.

Πόσο συχνός είναι ο γεννητικός έρπης;

Εκτιμάται ότι 1 ή 2 στα 10 άτομα (δηλαδή 10-20%) έχουν μολυνθεί με τον HSV. Αλλά από αυτά, το 80% δεν έχουν καθόλου συμπτώματα. Ο έρπης των γεννητικών οργάνων είναι πιο συχνός στις γυναίκες από ότι στους άνδρες.

Πώς τον κόλλησα; 

  • Ο έρπης των γεννητικών οργάνων μεταδίδεται σεξουαλικά, μέσω της άμεσης επαφής με τις πληγές που προκαλεί ο ιός, κατά τη διάρκεια κολπικού, στοματικού ή πρωκτικού σεξ. Ο ιός μπορεί να μεταδοθεί σε άλλους κατά τη διάρκεια της πρώτης λοίμωξης, σε κάθε υποτροπή ή ακόμη και αν δεν υπάρχουν ορατές πληγές (βλέπε παρακάτω).
  • Ο HSV πεθαίνει γρήγορα έξω από το σώμα. Ως εκ τούτου, είναι εξαιρετικά απίθανο -αν όχι αδύνατο- να κολλήσεις έρπητα με οποιοδήποτε άλλο τρόπο από ότι με τη σεξουαλική επαφή, όπως με πετσέτες, τουαλέτα, υδρομασάζ κ.α.
  • Ο ιός ενδέχεται να μεταδοθεί με την ανταλλαγή ερωτικών βοηθημάτων (δονητές κ.α.) με σύντροφο που έχει τον ιό.
  • Τα μολυσμένα άτομα μπορεί να μεταδώσουν τον ιό σε άλλα μέρη του σώματός τους (πχ, αν αγγίξεις τον έρπη που έχεις στο στόμα και στη συνέχεια αγγίζεις τα γεννητικά σου όργανα). Το ενδεχόμενο αυτό, γνωστό ως αυτοενοφθαλμισμός (autoinoculation) αν και εφικτό, είναι εξαιρετικά δύσκολο να συμβεί, καθώς το σώμα μας αναπτύσσει -στις περισσότερες περιπτώσεις- αντισώματα που μας προστατεύουν από τον αυτοενοφθαλμισμό.

Μπορώ να γνωρίζω πόσο καιρό έχω τον ιό στον οργανισμό μου;

Όταν ένα άτομο μολύνεται με τον HSV, τα συμπτώματα εμφανίζονται περίπου 2-20 ημέρες αφού ο ιός εισέρχεται στο σώμα.

Ωστόσο, πολλοί άνθρωποι έχουν τον ιό του έρπητα για πολλά χρόνια χωρίς να το γνωρίζουν, μέχρι που κάποια στιγμή ενδεχομένως να εκδηλωθεί. Το γεγονός αυτό μπορεί να δημιουργήσει παρεξήγηση σε ένα ζευγάρι, επειδή η/ο σύντροφος του νομίζει πως ο άλλος ήταν άπιστος, το οποίο δεν ισχύει σε αυτή την περίπτωση.

Ποια είναι τα συμπτώματα του έρπητα των γεννητικών οργάνων;

Η κλινική εικόνα της αρχικής λοίμωξης διαφέρει με εκείνη των επαναλαμβανόμενων επεισοδίων.

-Κατά τη διάρκεια της πρώτης λοίμωξης μπορεί να παρουσιάζονται:

  • συμπτώματα γρίπης: όπως πυρετός, ρίγη, μυαλγίες, κόπωση και ναυτία,
  • πρήξιμο των λεμφαδένων στη βουβωνική χώρα,
  • τσούξιμο ή αίσθημα καύσου κατά την ούρηση,
  • έλκη (πληγές): αρχικά είναι πολλαπλές μικρές φουσκάλες, γεμάτες με καθαρό ή κιτρινωπό υγρό. Η περιοχή όπου εμφανίζονται οι φουσκάλες μπορεί να είναι πρησμένη ή ευαίσθητη. Μετά από λίγες μέρες, οι φουσκάλες σπάνε, αφήνουν ρηχά έλκη που είναι συνήθως πολύ επίπονα. Αυτά τα έλκη σχηματίζουν μια κρούστα και στη συνέχεια επουλώνονται χωρίς να αφήνουν ουλές.

Η πρώτη λοίμωξη από τον έρπητα διαρκεί 2-4 εβδομάδες.

Μετά από αυτή την αρχική εκδήλωση, ο HSV παραμένει στο σώμα μας για πάντα, εντός συγκεκριμένων νευρικών κυττάρων. Υπό ορισμένες συνθήκες (δείτε παρακάτω), ο ιός επανενεργοποιείται: “ταξιδεύει” κατά μήκος των νεύρων πίσω στην περιοχή των γεννητικών οργάνων, και προκαλεί ένα νέο ξέσπασμα, το οποίο ονομάζεται υποτροπή ή υποτροπιάζουσα ερπητική λοίμωξη.

-Κατά τη διάρκεια μιας υποτροπής τα συμπτώματα είναι:

  • Πρόδρομο στάδιο: δηλαδή, ένα αίσθημα φαγούρας ή καύσου στο κάτω μέρος της πλάτης, τους γλουτούς, τους μηρούς, ή τα γόνατα.
  • Λίγες ώρες αργότερα, εμφανίζονται οι φουσκάλες, συνήθως χωρίς πυρετό ή πρήξιμο στην περιοχή των γεννητικών οργάνων.

Οι πληγές επουλώνονται πιο γρήγορα, συνήθως μέσα σε 3-7 ημέρες,  και είναι λιγότερο επώδυνες.

Τι προκαλεί υποτροπές του γεννητικού έρπητα;

Αν και δεν είναι πάντα ξεκάθαρο πότε ή για ποιο λόγο ο ιός του έρπητα επανενεργοποιείται, ορισμένοι παράγοντες μπορεί να “ξυπνήσουν” τον ιό και να προκαλέσουν μια υποτροπή. Οι πιο συνηθισμένοι είναι:

  • Στρες: είτε σωματικό (κόπωση) ή ψυχικό (κατάθλιψη, άγχος).
  • Αδύναμο ανοσοποιητικό σύστημα: από ασθένειες, μολύνσεις, ορισμένα φάρμακα, κ.λπ.
  • Τραύμα ή ερεθισμό της γεννητικής περιοχής: λόγω εντόνου σεξ, υπερβολικής εφίδρωσης, στενών ρούχων, κ.α.
  • Εκτεταμένη έκθεση στον ήλιο ή σε υπεριώδεις ακτίνες.
  • Ορμονικές διακυμάνσεις: μερικές γυναίκες παρατηρούν ότι οι υποτροπές είναι πιο συχνές τις μέρες πριν την περίοδο, ή κατά τη διάρκεια της εγκυμοσύνης.
  • Υπερβολική κατανάλωση αλκοόλ.
  • Ορισμένες τροφές: κάποιες μελέτες (εδώ και εδώ) έχουν βρει ότι ή L-αργινίνη, ένα αμινοξύ που υπάρχει σε κάποιες τροφές μπορεί να επιδεινώσει ή να προκαλέσει πιο συχνές εξάρσεις του έρπητα. Οι τροφές με υψηλή περιεκτικότητα σε αργινίνη περιλαμβάνουν: ξηροί καρποί (αμύγδαλα, καρύδια, κάσιους, φιστίκια), δημητριακά (σιτάρι ολικής αλέσεως, βρώμη, καστανό ρύζι, προϊόντα από αλεύρι), σοκολάτα και ροφήματα με καφεΐνη.

Πόσο συχνά θα εκδηλωθεί ο γεννητικός έρπητας;

  • Η συχνότητα και η ένταση των εξάρσεων διαφέρει από άτομο σε άτομο. Ενώ μερικοί άνθρωποι έχουν συχνές και επώδυνες υποτροπές με πολλά έλκη, άλλοι έχουν μόνο σπάνια και ήπια συμπτώματα.
  • Τα “ξεσπάσματα” συνήθως είναι πιο συχνά το πρώτο έτος μετά τη μόλυνση. Στους περισσότερους ανθρώπους, ο αριθμός των υποτροπών μειώνεται με την πάροδο του χρόνου.

Πόσο σοβαρός είναι ο έρπης των γεννητικών οργάνων;

  • Ο γεννητικός έρπης δεν θεωρείται απειλητικός για τη ζωή.
  • Ωστόσο, οι πληγές που προκαλεί ο έρπητας καθιστούν ευκολότερο για τον ιό HIV (ο ιός που προκαλεί το AIDS) να εισέλθει στο σώμα. Επιπλέον, η ταυτόχρονη μόλυνση με τους δύο ιούς μπορεί να κάνει και τις δύο λοιμώξεις πιο σοβαρές.
  • Αλλά ένα από τα συχνότερα προβλήματα που προκαλεί ο έρπης των γεννητικών οργάνων είναι η συναισθηματική επιβάρυνση. Το γεγονός πως ο HSV προκαλεί επώδυνα συμπτώματα, επιβάλλει ορισμένους περιορισμούς στην σεξουαλική δραστηριότητα, και είναι μια δια βίου κατάσταση μπορεί να οδηγήσει σε έντονη στενοχώρια, άγχος, θυμό, ακόμα και σε κατάθλιψη (διάβασε περισσότερα εδώ). Μην διστάζεις να συζητήσεις για τα συναισθήματά σου με το γιατρό σου, ο οποίος θα σε συμβουλεύσει πώς να αντιμετωπίσεις την κατάσταση.
  • Μια έγκυος γυναίκα μπορεί να περάσει τον έρπητα στο μωρό της (βλέπε παρακάτω). Συνεπώς, είναι πολύ σημαντικό να ενημερώσεις το γιατρό σου αν είσαι έγκυος και έχεις τον έρπητα.

Πώς μπορώ να μάθω αν έχω τον ιό του έρπητα; 

Αν νομίζεις ότι έχεις έρπητα των γεννητικών οργάνων θα πρέπει να συμβουλευτείς έναν γιατρό, ο οποίος θα επιβεβαιώσει τη διάγνωση με την κλινική εξέταση και, εφόσον χρειαστεί, με ορισμένες εργαστηριακές εξετάσεις:

  • Ένα δείγμα υγρού από τα έλκη. Το δείγμα μπορεί να επεξεργαστεί με διάφορες τεχνικές, από τις οποίες οι πιο αξιόπιστες είναι η καλλιέργεια του ιού και η αλυσιδωτή αντίδραση πολυμεράσης (PCR).
  • Μια εξέταση αίματος, οι οποία θα ανιχνεύσει τα αντισώματα που παράγει το σώμα μας να καταπολεμήσει τον ιό.

Όλες οι προαναφερόμενες τεχνικές θα δείξουν αν έχεις τον ιό, και εάν είναι ο τύπος HSV-1 ή HSV-2.

Πώς αντιμετωπίζεται ο έρπης των γεννητικών οργάνων;

  • Δεν υπάρχει θεραπεία για τον γεννητικό έρπητα.
  • Ωστόσο, ορισμένα αντι-ιικά φάρμακα – όπως ακυκλοβίρη, φαμσικλοβίρη και βαλακικλοβίρη – μπορεί να μειώσουν τη διάρκεια του επεισοδίου και να κάνουν τα συμπτώματα λιγότερο σοβαρά. Επιπλέον, κάποιες μελέτες δείχνουν ότι τα φάρμακα αυτά μειώνουν τον κίνδυνο να μεταδοθεί ο έρπης σε άλλο άτομο.
  • Όταν λαμβάνονται σε καθημερινή βάση, τα αντι-ιικά φάρμακα μπορεί να μειώσουν ή να αποτρέψουν εντελώς τις επιτροπές. Αυτή η κατασταλτική θεραπεία ενδείκνυται, μεταξύ άλλων, σε άτομα που παθαίνουν πολύ συχνά ξεσπάσματα (συνήθως περισσότερα από έξι επεισόδια ανά έτος).

Είναι δυνατή η πρόληψη του γεννητικού έρπητα;

  • Τα προφυλακτικά μειώνουν τον κίνδυνο μετάδοσης του HSV, αλλά δεν παρέχουν πλήρη προστασία, επειδή οι περιοχές του δέρματος που έχουν τον ιό, αλλά δεν καλύπτονται από το προφυλακτικό μπορεί να εξαπλώσουν τη μόλυνση.
  • Είναι πολύ σημαντικό να αποφύγετε τη σεξουαλική επαφή εάν εσύ ή ο σύντροφός σου έχετε ορατές πληγές στα γεννητικά όργανα. Το ίδιο ισχύει και για στοματικό σεξ από κάποιον που έχει επιχείλιο έρπη. Να δώσετε ιδιαίτερη προσοχή στις προδρομικά συμπτώματα που “ανακοινώνουν” ένα ξέσπασμα: η ερωτική επαφή θα πρέπει να αποφεύγεται από τη στιγμή που θα νιώσετε το πρόδρομο μέχρι λίγες μέρες αφού οι πληγές έχουν φύγει. Αν και λιγότερο μεταδοτικός, ο έρπης μπορεί να εξαπλωθεί ακόμη και αν δεν υπάρχουν ορατές αλλοιώσεις, μια διαδικασία γνωστή ως απόπτωση (ή shedding, που σημαίνει ότι ο HSV είναι ενεργός στο δέρμα). Δυστυχώς, δεν υπάρχει τρόπος να γνωρίζουμε πότε ένα άτομο είναι σε φάση απόπτωσης.
  • Να πλύνεις καλά τα χέρια σου μετά από κάθε πιθανή επαφή με πληγές, προκειμένου να αποφύγεις τη μόλυνση του εαυτό σου σε άλο σημείο του σώματος ή την μετάδοση σε κάποιον άλλο.
  • Σε ορισμένες περιπτώσεις, η κατασταλτική θεραπεία ενδεικνύεται για να μειωθεί ο κίνδυνος μετάδοσης της λοίμωξης στο σύντροφό σου.
  • Όταν έχεις τον ιό, η αποφυγή των γνωστών παραγόντων που επανενεργοποιούν τον ιό μπορεί να μειώσει τη συχνότητα και την ένταση των επεισοδίων: η καλή διατροφή, η ξεκούραση, η διαχείριση του άγχους μπορεί να βοηθήσουν σημαντικά.

Ο έρπης θα επηρεάσει την εγκυμοσύνη ή το μωρό μου;

  • Μια έγκυος γυναίκα μπορεί να μεταδώσει τον γεννητικό έρπητα στο μωρό της, το οποίο μπορεί να αναπτύξει μια σοβαρή λοίμωξη που ονομάζεται νεογνικός έρπης.
  • Αν και ο ιός μπορεί να μεταδοθεί σπανίως μέσω του πλακούντα, τα περισσότερα μωρά θα μολυνθούν κατά τη διάρκεια ενός φυσιολογικού τοκετού, με το πέρασμα τους από τον κόλπο.
  • Αυτό είναι πιο πιθανό να συμβεί αν η πρώτη λοίμωξη με τον HSV συμβεί κατά τη διάρκεια της εγκυμοσύνης, και κυρίως αν είναι προς το τέλος της κύησης. Παρότι είναι δυνατόν να μεταδοθεί ο ιός ακόμη και αν η πρώτη λοίμωξη έγινε πριν από την εγκυμοσύνη και υπάρχει μια υποτροπή κοντά στον τοκετό, ο κίνδυνος αυτός είναι πολύ μικρότερος.
  • Σε ορισμένες περιπτώσεις, μπορεί να χορηγηθεί αντι-ιική θεραπεία προς το τέλος της εγκυμοσύνης για να μειωθεί ο κίνδυνος τυχόν υποτροπών και μετάδοσης στο μωρό.
  • Αν υπάρχουν πληγές ή προειδοποιητικά σημάδια εμφάνισης της νόσου τη στιγμή του τοκετού, μπορεί να χρειαστεί να γίνει μια καισαρική τομή για να μειωθούν η πιθανότητες να μολυνθεί το μωρό.

Μπορώ να θηλάσω το μωρό μου αν έχω τον ιό του έρπητα;

  • Στις περισσότερες περιπτώσεις θα μπορέσεις να θηλάσεις. Μάλιστα, ο ιός του έρπητα δεν μεταδίδεται μέσω του μητρικού γάλακτος.
  • Είτε θηλάζετε είτε όχι, το μωρό μπορεί να μολυνθεί αν έρχεται σε άμεση επαφή με μια πληγή στο σώμα σου. Για να αποφευχθεί η εξάπλωση του ιού, είναι πολύ σημαντικό να καλύπτεις τα σημεία όπου υπάρχουν πληγές και να πλύνεις πολύ καλά τα χέρια σου πριν αγγίξεις το μωρό σου. Αν έχεις έρπη στο στήθος δεν θα πρέπει να θηλάσεις από εκείνη την πλευρά έως ότου η περιοχή έχει επουλωθεί πλήρως.

 

Βιβλιογραφία

Centers for Disease Control and Infections: Genital Herpes: CDC Fact Sheet (ΗΠΑ)

The American College of Obstetricians and Gynecologists: Genital Herpes (ΗΠΑ)

GENITAL HERPES: ALL YOU NEED TO KNOW

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Just got diagnosed with genital herpes? You are not alone! You should know that this is a very common condition, and that usually does not cause any serious health problem; however, anxiety, anger or even depression are common feelings every time the virus makes its appearance… And, as with HPV infection, misinformation makes things worse…

In this article you will find the most important facts regarding genital herpes:

Getting to know genital herpes

Genital herpes is a sexually transmitted infection (STI). It is caused by a virus called herpes simplex virus (HSV).

The herpes virus causes painful sores and blisters in the genital area, the anus, the thighs and the buttocks. Sometimes though, the HSV infection causes no symptoms at all; in fact many people are infected with HSV and don’t know it.

There are two types of HSV: HSV-1 and HSV-2. In general, type 2 affects the genital area and HSV-1 is the main cause of cold sores on the mouth or face. However, both types can cause either genital or oral infections.

How common is it?

It is estimated that 1 or 2 in 10 people (10-20%) are infected with the HSV; of those, 80% don’t have any symptoms. Genital herpes is more common in women than in men.

How did I get genital herpes? 

  • As stated before, genital herpes is sexually transmitted: the HSV is spread through direct contact with herpes sores during vaginal, oral or anal sex. The virus can be passed to others during a first infection, with subsequent outbreaks or even if there are no evident sores (see below).
  • The HSV dies quickly away from the body; thus, it’s extremely unlikely -if not impossible- to get genital herpes any other way than by sexual contact, such as from towels, toilet sits or hot tubs.
  • It is possible to get infected by sharing sex toys with a partner who has the virus.
  • Infected people can transmit the virus to other parts of their own bodies (for example if you touch your cold sore on the mouth and then you touch your genitals). This process, known as autoinoculation, although theoretically possible is extremely rare, as our body develops -in most cases- antibodies that protect us against autoinoculation.

Is there any way of knowing how long I’ve had the herpes virus?

When a person is first infected with HSV, symptoms appear about 2–20 days after the virus enters the body.

However, many people have genital herpes for years or even decades without knowing it; that is, the virus remains silent for years, and at some point it becomes symptomatic. This situation can create misunderstanding in a monogamous couple, as a person assumes his/her partner was unfaithful, which may not be true.

What are the symptoms of genital herpes?

The symptoms are different the first time and the recurrent episodes.

During the first herpes infection you may have:

  • flu-like symptoms: such as fever, chills, muscle aches, fatigue and nausea;
  • swelling of the lymph nodes in the groin;
  • stinging or burning feeling while urinating.
  • sores: initially small, fluid-filled blisters, often grouped in clusters; the area where the sores appear may be swollen and tender. Over a period of days, the sores open and release fluid, become crusted and then heal without leaving scars.

The first outbreak of genital herpes may last 2-4 weeks.

After this first infection, HSV remains in the body for life, within some specific nerve cells. Under certain circumstances (see below), the virus becomes active again: it travels along the nerves back to the genital area, and causes a new outbreak of sores. This is called a recurrence.

-During the recurrent outbreaks the symptoms are:

  • a prodrome: a burning, itching, or tingling sensation in the lower back, buttocks, thighs, or knees;
  • few hours later, sores may appear, usually without fever or swelling in the genital area.

The sores heal more quickly, within 3-7 days in most cases. Also, recurrent outbreaks usually are less painful.

What can trigger herpes outbreaks?

Although it is not always clear why or when the herpes virus will reactivate, certain factors are known to trigger herpes outbreaks. The most common are:

  • Stress: either physical (fatigue) or emotional (depression, anxiety).
  • Weak immune system: caused by sickness, infections, certain medications, etc.
  • Trauma or irritation of the genital area: due to vigorous sex, intense sweating, tight clothes, etc.
  • Exposure to sunlight or ultraviolet light.
  • Hormone fluctuations: some women may notice that outbreaks are more common right before their period, or during pregnancy.
  • Excessive alcohol consumption.
  • Certain foods: some studies (here and here) have found L-arginine, an amino acid present in food can aggravate or cause more frequent herpes outbreaks. Foods high in arginine include: nuts (almonds, walnuts, cashews, peanuts), grains (whole wheat, oats, brown rice, flour products), chocolate and caffeinated beverages.

How often will I have symptoms of genital herpes?

  • The frequency and intensity of the outbreaks vary with each person. While some people have frequent, painful outbreaks with many sores, others have only rare and mild symptoms.
  • Outbreaks usually are most frequent in the first year after infection. For many people, the number of outbreaks decreases over time.

Is genital herpes a serious condition?

  • Genital herpes is not life threatening in itself.
  • One of the biggest problems of genital herpes is the emotional burden. The fact that genital herpes causes painful symptoms, imposes certain limitations on sexual activity, and it’s a lifelong condition may lead to frustration, anxiety, anger and depression (read more here). Don’t hesitate to discuss your feelings with your doctor, who can advise you how to cope with them.
  • Having herpes sores makes it easier for HIV (the virus that causes AIDS) to enter the body. Moreover, having both viruses together may make each one worse.
  • A pregnant woman can pass herpes on to her baby (see below). Therefore, it is very important that you inform your doctor if you are pregnant and have herpes.

How can I find out if I have the herpes virus?  

If you think you have genital herpes you should consult a healthcare provider, who can diagnose herpes by performing a physical exam and certain laboratory tests:

  • If sores are present, a sample of fluid taken from a sore can show if you have the virus and what type of HSV it is. The sample may be tested with several techniques, of which cultures and polymerase chain reaction (PCR) are the most utilized.
  • Blood tests can detect the antibodies our body produces to fight the virus; these tests can show the type of HSV as well.

How is genital herpes treated?

  • There is no cure for genital herpes.
  •  However, antiviral medicationsaciclovir, famciclovir and valaciclovir – can reduce the duration of the outbreak and make symptoms less severe. There is some evidence that these drugs also reduce the risk of giving herpes to someone else.
  • When taken on a daily basis, medications can decrease or completely prevent the outbreaks. This is called suppressive therapy and is indicated, among other situations, in persons suffering very frequent outbreaks (usually more than six episodes per year).

How can genital herpes be prevented?

  • Condoms may reduce your risk of passing or getting HSV, but do not provide complete protection: areas of skin that have the virus but are not covered by the condom can spread the infection.
  • Avoid sexual intercourse if you or your partner has visible sores on the genitals; likewise, you shouldn’t receive oral sex from someone who has a sore on the mouth. Also, pay close attention to the prodromic symptoms announcing an outbreak: sexual contact should be avoided from the time you feel the prodrome until a few days after the sores have gone away.  Although less contagious, herpes can be spread even if there are no visible lesions, through a process known as shedding (means that the herpes virus is active on the skin). Unfortunately, there is no way to know when a person is shedding.
  • Wash your hands thoroughly after any possible contact with sores, in order to avoid reinfecting yourself or passing the virus to someone else.
  • In certain cases, suppressive therapy may be proposed to reduce the risk of passing the infection to your partner.
  • Once you got the virus, avoiding known triggers may reduce the frequency and intensity of outbreaks: a good diet, enough rest, stress management may all help.

Will herpes affect my pregnancy or my baby?

  • If you are pregnant and infected with HSV you may pass it to your baby, who may eventually develop a severe infection called neonatal herpes.
  • Although the virus may rarely spread through the placenta, most babies get infected during a vaginal birth, with the passage through the infected birth canal (vagina).
  • This is most likely to occur if you first become infected with HSV during pregnancy and if you have your first outbreak late in pregnancy. It is possible to transmit the virus even if you were infected before pregnancy and you have a recurrent outbreak near delivery, but the risk is much lower.
  •  In certain cases, you may be offered herpes medicine towards the end of your pregnancy to reduce the risk of having any symptoms and passing the virus to your baby.
  • If you have sores or warning signs of an outbreak at the time of delivery, you may need to have a cesarean section to reduce the odds of infecting your baby.

Can I breastfeed my baby if I have the herpes virus?

  • In most cases you will be able to breastfeed; in fact, herpes virus is not transmitted through breast milk.
  • Whether you breastfeed or not, the baby may get infected by touching a sore on your body. To avoid spreading the virus, cover your sores and thoroughly wash your hands before holding your baby. If you have a herpes blister on your breast don’t nurse from that side until the area has completely cleared up.

 

References

Centers for Disease Control and Infections: Genital Herpes: CDC Fact Sheet (USA)

The American College of Obstetricians and Gynecologists: Genital Herpes (USA)

WHEN SEX IS PAINFUL: 8 COMMON PROBLEMS – AND HOW TO FIX THEM

Sexual intercourse is supposed to provide pleasure, satisfaction and fulfilment. We -particularly women- tend to expect flawless, movie-like sex, romantic, luscious or passionate, with music playing in the background! Well, in real life sex is not always that perfect: according to an American survey, about 1 out of 3 women reported pain the last time that they have had sex. What’s more, many women feel ashamed to talk about it, giving up the idea of pleasurable sex. It is not unusual for these women to avoid having intercourse, leading to couple conflicts and eventually to psychological problems…

But why so many women feel pain while making love?

Whether it happens each time or occasionally, you feel just some discomfort or unbearable pain, dyspareunia (painful intercourse) can be related to a gynecological or medical problem, to your emotions or your state of mind; occasionally your partner is to blame, or maybe both of you, let’s not forget that it takes two to tango!

Below you will find 8 common painful situations you may encounter during intercourse. Understanding the type and location of the pain will help us pinpoint its cause, so that you can take some measures to get over it!

Problem # 1: “I feel a burning sensation outside the vagina”

painful-intercourse-burning-loveYou may feel a painful, burning sensation in your vulva (the external genitals), the area may be red and eventually swollen.

Possible causes:

  • Yeasts or other infections: a yeast infection will cause “cottage cheese-like” discharge; other bacteria can produce yellow or green discharge which may also be foul-smelling.
  • Contact dermatitis: you may realize that the problem starts after using certain lubricant, soap or cream, laundry soaps or softener; certain clothes can also be responsible.
  • Allergic reaction to condoms: the burning feeling starts after having sex, usually within 48 hours.
  • Menopause: although menopause generally causes vaginal dryness, some women also feel intense burning, which gets worse with intercourse.

What to do about it:  

  • Check with your doctor, who can give you a treatment for your yeast infection, if you are prone to get them, over-the-counter medications are available.
  • In the doubt, your doctor may order a culture, to see which bacteria is responsible for your symptoms.
  • In case of dermatitis or allergic reaction, stay away from possible irritants, your doctor can prescribe you a cream to soothe discomfort.
  • If you are allergic to latex (the material condoms are made of), stick to non-latex condoms.

Problem # 2: “I have a painful bump in my vulva”

painful-sex-bumpYou may feel a sharp, localized pain; while trying to precise its location you may touch a “bump” in the vulva. If you look with a mirror you may be able to identify the spot. Sex, due to rubbing, will make it even more painful.

Possible causes:

  • Pimple or ingrown hair: these are the commonest “bumps” appearing in the genitals. They can be quite sore if they become infected. A clogged sweat gland can also cause a painful pimple.
  • Bartholin gland cyst: they are soft cysts arising at the opening of the vagina. They can be very large (like a walnut) and become extremely painful if they get infected.
  • Herpes: genital herpes is a sexually transmitted infection. It causes itchy, burning and painful lesions that often start as a sore spot, becoming over a few days one or several blisters. Read more here.
  • Other dermatological or medical problems: rarely, diseases causing genital ulcers may be the cause of pain.

What to do about it:

  • Check with your doctor if you are not sure what is causing you pain.
  • Pimples may require a local cream to relief pain. If they are infected antibiotics may be necessary; more rarely incision and drainage are needed.
  • Bartholin cysts are treated with warm sitz baths. If infected antibiotics, incision and drainage may be necessary.
  • Herpes is managed with antiviral medications (locally or by mouth), painkillers may also be required.

Problem # 3: “I’ve tried everything, but penetration is impossible and triggers excruciating pain”

painful-intercourse-obstacleYou were never able to have penetration; even introducing tampons is impossible because you feel there is an “obstacle”.

Possible causes:

  • Hymen problems: you hymen may be abnormally thick, or imperforate.
  • Vaginal problems: your vagina can be too narrow or have a septum.
  • Vaginismus: see below.

What to do about it:

If penetration was never possible, check with your doctor who can rule out any anatomical problem; most of them can be solved with a simple surgical intervention.

Problem # 4: “I have intense pain in the opening of the vagina during penetration”

painful-intercourse-pins-and-needlesEven if you are aroused and willing to have sex, penetration triggers an intense pain in the entrance of the vagina; this is called entry dyspareunia.

Possible causes:

  • First time: we tend to have high expectations about our first intercourse; however many times it is less extraordinary than expected, and this includes pain; sometimes (but not always) bleeding may occur.
  • Trauma: this can be the result of childbirth (a tear or an episiotomy) or surgery; occasionally injury can be sex-related.
  • Vaginitis: due to yeast or other infection (see above).
  • Vulvodynia: it is a distressing, long-lasting condition in which the vulva is so sensitive that just touching the area makes the woman jump with pain. When pain is confined to the vestibule (the area around the opening of the vagina), it is known as vulvar vestibulitis syndrome (VVS). Its cause is unknown.
  • Emotional reasons: see below.

What to do about it:

  • If it is your first time, don’t worry too much about it. Many women have pain or discomfort during their first intercourse, an even a larger percentage will not have an orgasm. Be patient, try to be as relaxed as possible, discuss with your partner the means to reduce pain. If the problem persists, discuss it with a doctor.
  • If your just delivered, wait to have intercourse for at least six weeks after childbirth; some discomfort may persist for a few months, especially if you breastfeed, since your vagina also feels dry (see below). If pain continues for a long time or is very intense, talk to your doctor.
  • Vulvodynia may require medications, or eventually surgery. Read more here.

Problem # 5: “My vagina feels too dry”

Vaginal dryness is extremely common, and does not always mean problem. While some women produce  a lot of vaginal secretions, others are drier. However, there are factors that influence natural lubrication levels: sexual stimulation increases the amount of secretions; therefore, adequate and prolonged foreplay will help you being aroused. Sometimes though, your vagina keeps being dry and sex becomes painful.

Possible causes:

  • Menopause: due to the low level of estrogen (the hormone in charge of lubricating your genitals), your vagina will feel extremely dry and sex can be very painful, sometimes impossible.
  • Breastfeeding: also related to low estrogen.
  • Medications: some medications such as birth control pills, decongestants and antihistaminics may reduce vaginal moisture; contraceptive pills can also decrease sexual desire.
  • Medical problems: certain medical conditions can indirectly affect sexual response: diabetes, cancer, and thyroid problems, among others.
  • Your emotions: see below.

What to do about it:

  • Use a lubricant. Water-soluble lubricants are the best choice if you experience vaginal irritation. Silicone- based lubricants last longer and are more slippery. Do not use petroleum jelly, baby oil, or body lotion with condoms, as they can cause the condom to break (read more here).
  • For chronic cases, you may try long-acting vaginal moisturizers which, unlike lubricants, are absorbed into the vaginal lining for 3 to 4 days, mimicking natural secretions.
  • For menopausal women, when lubricants or moisturizers won’t work, a vaginal estrogen product may be necessary. More info here.
  • In any case, talk to your doctor if lubricants or moisturizers don’t help.

Problem # 6: “My vagina is just not opening”

Each time you try to have sexual intercourse, your vagina “closes”; any attempt of penetration is painful, and usually impossible.

Possible causes:

  • Vaginismus: it is a tightening (or reflex contraction) of the muscles of your vagina which occurs during penetration, but eventually also while attempting to insert a tampon, or during a gynecological exam. Its cause is unknown, although it is frequently related to anxiety, or fear of having pain during sex. Learn more here.
  • Your emotions: see below.

What to do about it:

  • Progressive desensitization consists of special exercises aimed at learning to relax your vaginal muscles.
  • Medical treatment may be useful in certain situations.
  • For women whose vaginismus is related to fear or anxiety, psychotherapy usually helps.

Problem # 7: I feel pain in my bladder during intercourse together with constant urge to urinate

painful-intercourse-tap-waterWhile having intercourse, you feel low abdominal pain and a persistent need to pee.

Possible causes:

  • Cystitis: read more here.
  • Interstitial cystitis (IC): also called bladder pain syndrome (BPS) is a chronic problem, which causes a feeling of pain and pressure in the bladder area, together with burning during urination. IC may feel like a bladder infection, but it’s not an infection; in fact, its cause is unknown.

What to do about it:

  • Read here to see what you can do if you have a bladder infection, particularly if you get one very often.
  • Regarding BPS, check with your doctor. No single treatment works for every woman, it should rather be individualized and based on symptoms. Learn more here.

Problem # 8: “I feel a deep pain in my abdomen during sex”

A deep pain or cramping in your abdomen during sex -or deep dyspareunia – can be the result of numerous problems.

Possible causes:

  • Gynecological problems: endometriosis, fibroids, ovarian cyst, adhesions, or infection (pelvic inflammatory disease). Many of these also cause painful periods.
  • Irritable bowel syndrome: a chronic condition that affects the large intestine; it commonly causes cramping, abdominal pain, bloating, gas, diarrhea and constipation. More info here.
  • Collision dyspareunia”: a funny name to describe the pain you may feel if the tip of your partner’s penis hits your cervix. This can happen if your partner is longer than average, if you’re not fully aroused, or if your cervix is unusually positioned. Read more here.
  • Other reasons: constipation, a retroverted uterus, a forgotten object in the vagina (usually a tampon).

What to do about it: 

Although many of the causes of deep dyspareunia are not important, some of them can be serious; therefore, you should see a doctor, especially if it is a new-onset problem. Many of these situations will be treated with medications, others require surgical intervention.

THE EMOTIONAL FACTOR

Our emotions are tightly related to our sexual life; thus, negative emotions are frequently the source of painful sex. Some examples are:

  • The way you feel about having sex: fear, embarrassment, guilt, being concerned about your physical appearance, being to too anxious about “doing it right” can all may make you unable to relax; therefore, arousal is difficult and you end up having pain.
  • Stress, fatigue, anxiety, depression: your everyday life problems can affect your desire to have sex. In addition, your vaginal muscles tend to tighten; this can also contribute to painful sex.
  • Relationship problems: problems with your partner may be related to painful sex by reducing arousal or provoking vaginismus.
  • A previous bad sexual experience: such as women with a history of sexual abuse, who tend to relate sex with something bad or negative.

WHEN YOUR PARTNER IS THE PROBLEM…

Painful sex is not always your fault!

  • Your partner may have sexual problem, which in turn can make you feel anxious about sex.
  • If your partner is taking a drug for erectile dysfunction, he may have delayed orgasm, causing long and painful intercourse.
  • Size problem: feel that your partner is “too big”? In fact, when a woman is aroused and relaxed, the vagina extends by several inches – so most women should be able to accommodate most males! Nevertheless, if size is indeed a problem, try a lubricant, and check which sex positions are less likely to make you hurt. Come close, a new device can be a good option for you.

SHARED PROBLEM: SEXUAL MISMATCH

Besides size mismatch, or differences in the way you both enjoy sex, a common issue leading to painful sex is mismatched sexual desire. Read more here.

TAKE HOME MESSAGE

painful-intercourse-dont-want-to-talk

If you have pain during sex, talk about it! It may be embarrassing to discuss your sexual problems with a doctor, but you should know that, with proper care most problems can be solved; therefore there is no reason to condemn yourself to a pleasureless, painful sexual life!

In the meantime, these are some tips that may help you relieve your pain:

  • Talk to your partner: mutual communication is essential. Discuss with your partner where and how is the pain, so you can both find ways to avoid it or minimize it.
  • Use a lubricant: a simple measure that can ease your suffering. It’s a good idea to keep always one with you.
  • Make time for sex: not always easy to include sex into our busy schedules! Nevertheless, try to find a moment of the day when you and your partner will be less tired or anxious.
  • Engage in sexual activities that don’t cause pain: if penetration is painful, you may consider other forms of pleasure, such as oral sex.
  • Try different sex positions: if you have deep dyspareunia, it can be worse in certain positions. Try to find those that are less likely to trigger pain.
  • Include relaxing activities: your partner may give a massage.
  • Take steps to relieve pain before making love: take a warm bath, empty your bladder, take a painkiller.
  • If you experience burning after intercourse: apply a frozen gel pack or some ice wrapped in a towel to your vulva.

References

  1. The American College of Obstetricians and Gynecologists: When sex is painful.
  2. Lori J, Heim LTC: Evaluation and Differential Diagnosis of Dyspareunia. Am Fam Physician. 2001 Apr 15;63(8):1535-1545.
  3. NHS UK: Why does sex hurt?

Photo credits

Intro: dailymedicalinfo.com; 1: rascoecam.wordpress.com; 2:liferunning.wordpress.com; 3: daroachbooks.blogspot.gr; 4: pixabay.com; 5: scienceclarified.com; 6: newauthors.wordpress.com; 7:diversehealthservices.wordpress.com; 8: everythingselectric.com; Take home: pinterest.com

WANT TO GET PREGNANT?

You have decided to get pregnant, that’s great! Before you start trying, here are some tips you may find useful….

  1. Schedule a visit to your gynecologist
  2. Start taking folic acid
  3. Give up drinking, smoking, drugs…
  4. Eat healthy
  5. Reduce caffeine intake
  6. Watch your weight
  7. Exercise, but not too much
  8. Don’t forget your oral health
  9. Reduce your stress levels
  10. Avoid certain infections
  11. Reduce exposure to environmental hazards
  12. Figure out your fertile days

1. Schedule a visit to your gynecologist

Embed from Getty ImagesIt is a good idea, before trying to get pregnant to consult your gynecologist. At that visit, you may want  to discuss:

-any medical problem you may have. Some diseases may get better or worse while you are pregnant, some others may affect your baby.

-any medication you are taking. Certain medications are dangerous during pregnancy, and some have to be switched before you even try to conceive.

-your family history. There are diseases that run in families, and you may be able to do some tests to understand if you are at risk. Be sure to mention whether someone in your family has any health problem (e.g. Down syndrome, thalassemia or sickle-cell disease, cystic fibrosis, mental retardation), or if someone was born with a cardiac, neurological or other defect.

-your habits: diet, weight, exercise, any unhealthy habit (such as smoking, drinking, or taking drugs).

If it’s been a year since you had a checkup, you can also expect to have a pelvic exam, eventually an ultrasound and a Pap smear. You may also get tested for sexually transmitted diseases and other bacteria that can reduce your chances of getting pregnant.

Some couples may decide to undergo some prenatal blood exams, including genetic testing for specific conditions, such as hemoglobinopathies (e.g. thalassemia) or cystic fibrosis, based on their ethnic background or family history.

A folic acid supplement may be prescribed at that point.

2. Start taking folic acid

2800841720_ab6c229284_o

Taking a folic acid supplement is very important. By taking 400 mcg of folic acid a day for at least one month before you conceive and during your first trimester, you reduce your chances of having a baby with some births defects (such as spina bifida) by 50 to 70 percent.

You may also consider some multivitamin supplements that may help you get pregnant. Make sure though, not to exceed the recommended doses of vitamin A (unless it’s in a form called beta-carotene). Getting too much vitamin A can cause birth defects.

3. Give up drinking, smoking, drugs…

4322475363_b7d6a1c20d_qIf you smoke, drink or take drugs, now’s the time to stop!

Tobacco use can affect fertility both in women and men, and this seems to be true even for secondhand smoking. Smoking or taking drugs while you are pregnant can lead to miscarriage, premature birth, low-birthweight babies and (according to recent studies)  congenital malformations.

Alcohol can also reduce fertility, therefore it’s a good idea to cut back when you start trying to get pregnant. Drinking alcohol during pregnancy can cause birth defects and other severe problems to you baby.

4. Eat healthy

9577668909_02670b3797_qIt is now a good time to start eating healthy: plenty of fruits and vegetables every day, as well as whole grains and foods that are high in calcium – like milk and yogurt. Eat a variety of protein sources, such as beans, nuts, seeds, and meats.

While fish is an excellent source of omega-3 fatty acids (which are very important for your baby’s brain and eye development), as well as proteins, vitamin D and other nutrients, it also contains mercury, which can be harmful. It is usually recommended that pregnant women eat up to 2 servings a week of fish that are not high in mercury (such as herring, trout, salmon, and sardines), and avoid shark, swordfish, king mackerel, tilefish. The consumption of white canned tuna should be limited to 1 serving per week.

5. Reduce caffeine intake

3155462396_d7f6b94586_qThere seems to be an association between high caffeine consumption and reduced fertility. Too much caffeine has also been linked to a risk of miscarriage in some studies, but not in others. To be on the safe side, it is recommended to limit coffee consumption to 1 cup a day.

 

 

6. Watch your weight

belly-2354_1280You may have an easier time conceiving if you’re at a healthy weight. Being over or under the ideal weight makes it harder for some women to become pregnant.

 

7. Exercise, but not too much

8552318056_f938f51ff2_qA fitness program will result in a healthy body, fit for pregnancy. In addition, exercising is a great way to relieve the stress that can be both the cause and consequence of not getting pregnant…

You may consider walking or cycling or swimming, on most days of the week, for about 30 minutes. To increase flexibility, you may try stretching, Pilates or yoga.

But be careful not to overdo it. Very intense exercise seems to have the opposite effect, as it has been related to infertility in some studies.

8. Don’t forget your oral health

Woman with toothbrush

Hormonal changes during pregnancy can make women more susceptible to gum disease, causing the gums to bleed easily while flossing or brushing. But if you take care of your oral health before trying to conceive you have less chances of experiencing problems while pregnant.

 

 

9. Reduce your stress levels

7676579466_42b4fd82d1_qIt is becoming clearer that stress is responsible for infertility; indeed, several studies reveal that relaxation techniques increase the chances of getting pregnant. Furthermore, a recent study confirms something we see in everyday practice: pregnancy is much more likely to occur during months when couples report feeling happy and relaxed and is less likely to happen during the months they report feeling tense or anxious. The influence of stress on infertility, though is not straightforward, and it may vary in different women.

10. Avoid certain infections

337315801_4f8f28992f_q

You’ll want to stay away from certain foods such as raw and undercooked red meat, fish and poultry, raw eggs, unpasteurised milk and soft cheeses. These foods can cause dangerous infections, such as listeriosis, salmonella and toxoplasmosis.

In order to avoid toxoplasmosis it’s also a good idea to wear gloves when digging in the garden or the cat’s litter box, if you have one.

11.Reduce exposure to environmental hazards

2575598759_f2109d9152_qThere is some evidence to support that routine exposure to certain chemicals or radiation may be harmful for pregnant women. If you work in such an environment, you’ll need to make some changes before you conceive. In addition, some cleaning products, pesticides, solvents, etc, can be dangerous during pregnancy.

 

12. Figure out your fertile days

2827062969_951d6cf19b_qInitially, you may prefer to let fate decide when you will conceive. But if you want to be more precise in calculating your fertile days:

First, you should understand when your ovulation occurs. For that, you may use an ovulation calculator, that is, a web tool or application where you write down your period days for some months and you learn when you are fertile; you will find several online, many are designed for smart phones. With these calculators, you get a rough estimate of your fertile days.

If you want to be even more exact, you may start recording your basal body temperature (BBT) and your cervical mucus changes. If you chart them over several months, you may more easily understand when you’re ovulating each month.

Ovulation predictor kits can also help you figure out when you’re ovulating by detecting a hormone (LH) in your urine.

Once you have a clear picture of your cycle, there’s only one thing left to do — get to work! It is advised to have sex every day or every other day beginning about five days before ovulation, and continuing through the day after ovulation. This is because, though sperm can live as long as five days inside a woman’s body, an egg’s life span is only about 12 to 24 hours. By having intercourse before you ovulate, as well as on the day of and the day after ovulation, you maximize your chances of getting pregnant.

 

Good luck! And hopefully soon with good news!

More info at gofertile.eu

Photo credits
1. Getty images; 2. @Doug88888 Flickr.com; 3. Paul Heskes Flickr.com; 4. PeterFranz Flickr.com; 5. Adam Selwood Flickr.com; 6. pixabay.com; 7. Richard foster Flickr.com; 8. Wagner Cesar Munhoz Flickr.com; 9. MeditationMusic.net Flickr.com; 10. Joost Nelissen Flickr.com; 11. tk-link Flickr.com; 12..craig Flickr.com