A reader is distressed about his genital herpes symptoms.

Goodmorning Doctor, I want to come clean with you. My name is Kunle, am 24 years old and sexually active with multiple sexual partners. I woke up one morning to notice a very painful blister and other small ulcers on my penis. At first i thought it was nothing and i just took pain killers and rubbed bactroban cream on the shaft and went to work. The paim was still there but i managed myself through work and closed for the day. When i got home i took more pain killers and continued with the bactroban. I must tell you, i didnt sleep that night. The ulcers on my penis were painful and the pain got worse when i touched it. It was burning me, itching me and i developed fever, muscle pains, headache and felt sick. That was my worst night ever since my adult life. I could not sleep. The following morning the ulcers on my penis have increased in size and had spread to my anus (I am straight anyway). I felt pain when i tried to pass stool and irritation and pain in my anus. I had difficulty passing urine because of the pain i feel whenever i wanted to urinate.

I thought i was about to die. Being a yoruba man and an African man, i took local yoruba herbs and other forms of agbo but no relief of symptoms. I was getting worse, i ran to a nearby hospital to see the doctor. He interviewed me, did a couple of tests like HIV test (It was negative) and also took some swabs from my penile ulcer wounds for what he could ‘culture’. He thereafter told me I had genital herpes- a disease he said was common with people with multiple sexual partners and those practicing risky sexual acts. He thereafter placed me on medications for 10 days.

I have started taking the medications. There is some relief i must confess. But doctor what is genital herpes and what is the treatment for genital herpes? Can it be cured.

My reply…

Thank you Mr.Kunle. Thank you for seeking expert care and thank you for seeking and expert second opinion. I can imagine what you went through.

Genital herpes is a sexually transmitted infection that affects but males and females plus even children(from sexual abuse). It is caused by a virus called Herpes simplex hominis type 2 (HSV-2) virus which is the commonest and and in some cases herpes simplex virus type 1 (HSV-1). HSV-2 has been associated with carcinoma of the cervix and sometimes penile cancer- Don’t be scared, it has not be proven for men. In pregnancy it can cause abortion, chorionamnionitis and preterm labour. Neonatal herpes, which has a mortality of up to 50 percent and causes some form of brain damage in those who survive has also been recorded.

Various anti-viral agents such as idoxuridine, vidarabin (Ara-A) or acyclovir can shorten duration of symptoms and viral shedding, prevent formation of new ulcers, and reduce systemic symptoms like fever but do not offer cure of the disease. Also treatment does not prevent later recurrences. The common antiviral agent used is acyclovir (oral, topical and intravenous preparations) are available).

The usual dose of oral acyclovir is 200mg five times daily or 400mg three times daily for 7 to 10 days for symptomatic herpes. Acyclovir 400mg five times daily or 800mg three times a day for 7 to 10 days is recommended for herpes proctitis (anal herpes).

Genital herpes
Herpes on the penile shaft
Credit: Science Photo

Additional measures include sitz bath with warm water ( sitting on salted mildly warm water twice daily for 1 week), cleaning of ulcers with antiseptic solution like savlon and topical application if acyclovir cream. In cases of very severe herpes you may be admitted in the hospital and given intraveneous acyclovir.

Healing takes four to six weeks.

Please do not have sexual intercouse during treatment and until ulcers are well healed. Be aware that herpes can recur, can be given to others and can affect the throat also.

It will be nice for your doctor to screen you for other forms of STDs and please endeavour to practice safe sex and be faithful to your partner.

Thank you Kunle..

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