Cervical herpes is an infection of the cervix caused by the herpes simplex virus (HSV). This condition is a form of genital herpes, primarily caused by herpes simplex virus type 2 (HSV-2), though herpes simplex virus type 1 (HSV-1) can also cause it. The virus can be transmitted through skin-to-skin contact during sexual activity, even when no visible sores are present. While there is no cure for herpes, medical management is available to reduce the frequency and severity of outbreaks, making it a manageable condition.
Symptoms and Diagnosis of Cervical Herpes
Cervical herpes often presents without noticeable symptoms. Its asymptomatic nature means it’s often identified during routine gynecological examinations. When symptoms occur, they typically appear within 2 to 20 days after exposure to the virus. Symptoms include unusual vaginal discharge, pain in the genital or anal area, and bleeding, particularly after sexual intercourse.
Initial outbreaks may also involve flu-like symptoms such as fever, body aches, and swollen lymph nodes in the pelvic area. Small bumps or blisters can form on the cervix, vagina, or vulva, rupturing into painful ulcers before healing. Diagnosis involves a pelvic exam, where a healthcare provider may visually identify lesions or signs of inflammation on the cervix. A Pap test might show cellular changes suggestive of herpes, though definitive confirmation requires a viral culture or a polymerase chain reaction (PCR) swab test.
Associated Health Conditions
Cervical herpes can directly lead to cervicitis, an inflammation of the cervix caused by HSV. Symptoms of cervicitis may include persistent vaginal discharge, pelvic pressure, or pain during intercourse, although it can also be asymptomatic.
The human papillomavirus (HPV) is the primary cause of cervical cancer, not the herpes simplex virus. While HSV does not directly cause cervical cancer, it can cause inflammation or lesions on the cervix that might appear abnormal during a Pap test, leading to further investigation. Some research suggests that individuals with both HPV and HSV-2 infections may have a modestly increased risk of invasive cervical cancer, but HPV remains the established causative agent.
Treatment and Management Approaches
Treatment for cervical herpes involves antiviral medications that interfere with the virus’s ability to replicate. Antiviral drugs like acyclovir, valacyclovir, and famciclovir, used for other forms of genital herpes, are effective for cervical herpes. These medications do not eliminate the virus from the body but help manage its symptoms and reduce the frequency of outbreaks.
Two main treatment strategies are used: episodic therapy and suppressive therapy. Episodic therapy involves taking antiviral medication at the first sign of an outbreak, such as tingling or itching, to shorten its duration and reduce symptom severity. Suppressive therapy involves taking a daily low dose of antiviral medication to prevent or significantly reduce outbreaks. This long-term approach can decrease outbreak frequency by 70% to 80% and may also reduce viral shedding, potentially lowering the risk of transmission to sexual partners.
Pregnancy and Childbirth Protocols
For pregnant individuals with a history of genital or cervical herpes, protocols minimize the risk of transmission to the baby. The primary concern is neonatal herpes, a serious infection transmitted to the baby during vaginal delivery. It can lead to severe health complications for the infant, including central nervous system damage, and can even be fatal.
To reduce this risk, suppressive antiviral therapy is typically recommended, usually starting around 36 weeks of gestation and continuing until labor begins. This medication helps prevent an active outbreak at delivery, reducing the baby’s exposure risk. If no active lesions or symptoms are present when labor begins, a vaginal delivery is generally considered safe. However, if an active herpes outbreak is visible or if prodromal symptoms are present at the onset of labor, a Cesarean section (C-section) is recommended to avoid exposing the infant to the virus during birth.