Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Genital herpes is a viral infection that causes clear blisters that overlie
ulcers on the skin or mucosa (lining of the
body's openings) of sexually exposed areas. Two types of herpes viruses are associated with genital lesions; herpes
simplex virus-1 (HSV-1) and herpes simplex virus-2 (HSV-2). HSV-1 more often
causes blisters of the mouth area while HSV-2 more often causes genital sores or
lesions in the area around the anus (perianal region).
Most people infected with HSV-2 have not been diagnosed as being infected. If
symptoms occur, they appear approximately 3 to 7 days after an initial exposure
to herpes. Many men experience mild symptoms, which resolve spontaneously.
Others can develop severe bouts of painful blisters on the penis that can be
accompanied by fever and headache.
Once a herpes infection occurs, it is life-long and can be characterized by
recurrent sporadic outbreaks. The outbreaks occur because the dormant HSV is
activated. Outbreaks occur at different rates in different individuals. The
recurrences can be associated with stress or other infections. They also occur
with increased frequency in those who have weakened immune systems, such as with
HIV infection. These outbreaks usually are characterized by mildly to moderately
painful clusters of blisters over the infected area. The recurrences usually
resolve spontaneously, with the blisters disappearing in about 5 days. HSV in
HIV-infected individuals, however, can cause more severe disease, which often causes ulcers rather than blisters
and persists for a longer time.
Estimates are that as many as 50 million persons in the United States are
infected with genital HSV. Genital herpes is spread only by direct person-to-person contact. Again, most infected people have not been diagnosed. Most
genital herpes is passed on by people who do not have active signs of disease at
the time of transmission.
How is herpes diagnosed?
The suspicion for genital herpes is usually based upon
the appearance of multiple, painful clusters of small blisters over the penis or
anal area. The definitive diagnosis is based on a culture of the virus. The
culture is done by opening a blister, swabbing the base of the ulcer, and
sending the swabbed material to the laboratory for culture.
Blood tests that detect antibodies to the HSV reveal
whether someone is infected with herpes. These antibodies are proteins that are
produced by the body in an immunological (defensive) response specifically
targeted against this virus. The antibodies, however, do not indicate whether
the person's current lesions are actually due to the herpes or another disease.
The antibody test,
therefore, is of minimal value in diagnosing genital herpes.
What should persons infected with genital herpes know?
Patients who are newly diagnosed with genital herpes should be aware that:
there is no cure for the infection,
recurrent episodes can occur, and
even when there are no obvious lesions, HSV can be spread to others.
Affected individuals should notify their sex partners
that they are infected with HSV. They should avoid sexual activity not only when
the blisters are present, but also when a pre-outbreak tingling, which sometimes
is felt over the involved skin, occurs. Since HSV can be spread even during
periods when there are no symptoms, condoms or other latex barriers should be
used routinely during sexual contact with an infected person. This should be
done even if the condoms are not needed at that time to prevent other STDs or to
avoid pregnancy. Also, women with genital herpes should be aware of the
possibility of that HSV can be spread to a newborn if the mother has an outbreak
at the time of delivery. Finally, people with HSV infection should understand
the clear, but limited role, of antiviral medications for the initial outbreak
and for subsequent outbreaks and for suppressive therapy to prevent recurrences in patients with
frequent outbreaks.
How is genital herpes treated?
Several antiviral drugs have been used to treat HSV
infection, including acyclovir, famciclovir, and valacyclovir. Although topical
(applied directly on the lesions) agents exist, they are generally less
effective than other medications and are not routinely used. Medication that is taken by mouth, or in
severe cases intravenously, is more effective. Affected individuals need to understand,
however, that there is no cure for genital herpes and that these treatments only
reduce the severity and duration of outbreaks.
Since the initial infection with HSV tends to be the
most severe episode, an antiviral medication usually is warranted. These
medications can significantly reduce pain and decrease the length of time until the sores heal, but treatment
of the first infection does not appear to reduce the frequency of recurrent
episodes.
In contrast to a new outbreak of genital herpes,
recurrent herpes episodes tend to be mild, and the benefit of antiviral
medications is only derived if therapy is started immediately prior to the
outbreak or within the first 24 hours of the outbreak. Thus, the antiviral drug
must be provided for the patient in advance. The patient is instructed to begin
treatment as soon as the familiar pre-outbreak "tingling" sensation occurs or at the very onset of blister
formation.
Finally, suppressive therapy to prevent frequent recurrences may be indicated
for those with more than 6 outbreaks in a given year.
500mg
once/day (may be given twice daily)
or
1000 mg once/day in persons with 10 or more outbreaks/year)
What should a person do if exposed to someone with genital herpes?
People who have been exposed to someone with genital
herpes should obtain counseling about herpes symptoms, the nature of the outbreaks, and how to
prevent acquiring or transmitting herpes in the future. If the exposed person
experiences an outbreak of herpes, he or she should be further evaluated.
Scabies are itch mites that burrow under the skin and produce intense itching that's usually worse at night. Symptoms of scabies are small bumps and blisters on the wrists, knees, between the fingers, on the back of the elbows, in the groin and on the buttocks. Treatment involves applying a mite-killing cream, antihistamines for itch relief, washing bedclothes and linens.
Lymph nodes help the body's immune system fight infections. Causes of swollen lymph nodes (glands) may include infection (viral, bacterial, fungal, parasites). Symptoms of swollen lymph nodes vary greatly. They can sometimes be tender, painful or disfiguring. The treatment of swollen lymph nodes depends upon the cause.
HIV (human immunodeficiency virus) is the cause of AIDS (acquired immunodeficiency syndrome). HIV is a type of virus called a retrovirus, which infects humans when it comes in contact with a break in the skin or tissues such as those that line the vagina, anal area, mouth, or eyes.
Genital herpes, a viral infection by the herpes simplex virus (HSV), is transmitted during sexual contact with the mucous-covered linings of the mouth, vagina, or the genital skin. A typical outbreak begins with an itching or tingling sensation followed by redness of the skin and blister formation. The blisters and ulcers that form when the blisters break are painful to the touch, and last from 7 days to 2 weeks. Though there is no cure for herpes, there are ways to treat outbreaks.
Hepatitis C is an inflammation of the liver due to the hepatitis C virus (HCV), which is usually spread by
blood transfusion, hemodialysis, and needle sticks, especially with intravenous
drug abuse. Chronic hepatitis C may be treated with interferon, usually in combination with anti-virals.
Prostatitis is a painful condition of the prostate gland. There are four types of prostatitis, acute bacterial, chronic bacterial, chronic pelvic pain syndrome, and asymptomatic inflammatory prostatitis. Diagnosis is made with a digital rectal exam, urinalysis, ultrasound, MRI, biopsy, or blood test. Treatment depends upon the type of prostatitis.
Chlamydia, a type of bacteria that causes an infection, is spread through sexual contact. Most of the time, women with chlamydia have no symptoms. Antibiotics are an effective treatment for chlamydia.
Sexually transmitted diseases, or STDs,
are infections that are transmitted during any type of sexual exposure,
including intercourse (vaginal or anal), oral sex, and the sharing of sexual
devices, such as vibrators. Women can contract all of the STDs, but may have no symptoms, or have different symptoms than men do.
Abdominal aortic aneurysm is a ballooning or widening of the main artery (the aorta) as it courses down through the abdomen. The most common cause of aortic aneurysms is
"hardening of the arteries" called arteriosclerosis.
Dementia is a significant loss of intellectual abilities such as memory capacity, severe enough to interfere with social or occupational functioning. There are different criteria classification schemes for dementias such as cortical, subcortical, progressive, primary, and secondary dementias. Other conditions and medication reactions can also cause dementia. Dementia is diagnosed based on a certain set of criteria. Treatment for dementia is generally focused on the symptoms of the disease.
The hepatitis B virus is a unique, coated DNA virus belonging to the Hepadnaviridae family of viruses. The course of the virus is determined primarily by the age at which the infection is acquired and the interaction between the virus and the body's immune system. Successful treatment is associated with a reduction in liver injury and fibrosis (scarring), a decreased likelihood of developing cirrhosis and its complications, including liver cancer, and a prolonged survival.
Pelvic inflammatory disease (PID) is the most common and serious complication of sexually transmitted diseases (STDs), aside from AIDS, among women. The signs and symptoms of pelvic inflammatory disease include: fever, vaginal discharge with a foul odor, abdominal pain, including pain during intercourse, and irregular vaginal bleeding. Pelvic inflammatory disease can scar the Fallopian tubes, ovaries, and related structures and lead to ectopic pregnancies, infertility, chronic pelvic pain, and other serious consequences. Pelvic inflammatory disease treatment includes several types of antibiotics.
Cervical dysplasia is a condition in which the cells of the inner lining of the cervix have precancerous changes. There are two types of cervical dysplasia; 1) squamous intraepithelial lesion, and 2) cervical intraepithelial neoplasia. Cervical dysplasia is caused by infection of the cervix with HPV (human papillomavirus). There are various diagnostic measures for cervical dysplasia. Treatment generally depends upon the progression of the dysplasia, mild, moderate, or severe.
E. coli is the most common cause of bladder infections. Bladder infection symptoms and signs include frequent urination, burning urination, and foul smelling urine. Mild bladder infections may go away by increasing one's intake of fluid. More severe infections may be treated with a few days of antibiotics.
Blood in semen is also known as hematospermia. Blood in semen can be caused by many conditions affecting the tubes that distribute semen from the testicles (seminal vesicles) or the prostate gland. Symptoms that may accompany blood in semen include blood in the urine, fever, painful urination, pain with ejaculation, tenderness, and swelling in the testes or groin area. Urinalysis, ultrasound, and MRI may be used to diagnose blood in the semen. Treatment depends upon the underlying cause of blood in the semen.
Testicular pain, or pain in the testicle or testicles are caused by a variety of diseases or conditions such as testicular trauma, testicular torsion, testicular cancer, epididymitis, and orchitis. Common symptoms of pain in the testicle or testicles are abdominal pain, urinary pain or incontinence, fever, nausea, vomiting, and pain in the scrotum or testicle. Treatment depends on the cause of the testicular pain or pain in the testicles.
Anal cancer, cancer located at the end of the large intestine, has symptoms that include anal or rectal bleeding, anal pain or pressure, anal discharge or itching, a change in bowel movements, and/or a lump in the anal region. Treatment for anal cancer may involve radiation, chemotherapy, or surgery and depends upon the stage of the cancer, its location, whether cancer is eradicated after the first treatment, and whether the patient has HIV.
Pubic lice (crabs) are parasitic insects found in the genital area, and are primarily spread through sexual contact. Symptoms of crabs include itching and visible nits (lice eggs) and crawling lice. Treatment includes using lice-killing shampoo and washing bedding and clothing in hot water.
Trichomoniasis is a sexually transmitted disease (STD) caused by a parasite passed from person to person. Trichomoniasis can be picked up from contact with damp, moist objects like towels, wet clothing, or toilet seat. Symptoms include yellow, green, or gray vaginal discharge with a strong odor, painful intercourse or urination, genital irritation and itching, and lower abdominal pain. Medication is the only treatment for trichomoniasis.
The time when boys and girls begin the process of sexual maturation is called puberty. During this time, both sexes undergo a series of biological changes that include a rapid increase in height, bone growth, weight increase, the growth of pubic hair, breast development and the onset of menstruation in girls, and testicle, penis, and muscle enlargement in boys.
Reactive arthritis is a chronic, systemic rheumatic disease characterized by three conditions, including conjunctivitis, joint inflammation, and genital, urinary or gastrointestinal system inflammation. Inflammation leads to pain, swelling, warmth, redness, and stiffness of the affected joints. Non-joint areas may experience irritation and pain. Treatment for reactive arthritis depends on which area of the body is affected. Joint inflammation is treated with antiinflammatory medications.
The HPV virus (genital warts) in men can cause health problems. Genital warts are confined primarily to the moist skin of the genitals or around the anus. Genital warts are caused by the human papillomaviruses (HPVs), which are transmitted through sexual contact.
Aortic dissection is a small tear in the large blood vessel that leads from the heart and supplies blood to the body. There are two types of aortic dissection, type 1 and type 2. Signs and symptoms of aortic dissection include a tearing or ripping pain, nausea, sweating, weakness, shortness of breath, sweating, or fainting. Treatment depends on the type of aortic dissection, and the severity of the tear in the aorta.
Abdominal adhesions (scar tissue) bands of scar tissue that form between abdominal organs and tissues. Symptoms of abdominal adhesions are pelvic or abdominal pain. Abdominal adhesions on the intestines can cause bowel obstruction, which is a medical emergency. Treatment for abdominal adhesions is generally surgery to cut the adhesions away from the internal tissues and organs. There is no way to prevent abdominal adhesions.
Enjoying a satisfying sex life as we age is important to both physical and mental health. As we age, diseases and conditions may pose challenges in our sexual health, and sexual experiences. Learn how to manage your conditions and still have a gratifying sex life as you age.
Sexual health information including birth control, impotence, herpes, sexually transmitted diseases, staying healthy, women's sexual health concerns, and men's sexual health concerns. Learn about the most common sexual conditions affecting men and women.
A urethral stricture, or narrowing of the urethra, may cause decreased urine output. Symptoms include painful urination, urinary retention, and pelvic pain. Surgery is the only treatment for people with uncontrolled symptoms of urethral narrowing.
AIDS is the advanced stage of HIV infection. Symptoms and signs of AIDS include pneumonia due to Pneumocystis jiroveci, tuberculosis, toxoplasmosis, seizures, weakness, meningitis, yeast infection of the esophagus, and Kaposi's sarcoma. Anti-retroviral therapy (HAART) is used in the treatment of AIDS.
Drug resistance (antimicrobial resistance) is the ability of bacteria, fungi, parasites, and viruses to grow, even in the presence of a drug that would normally kill it (or limit it's growth). Drug resistance is a growing problem, particularly for infections such as MRSA, VRE (vancomycin-resistant enterococci), tuberculosis, HIV, STDs, gonorrhea, flu, pneumonia, malaria, E. coli, salmonella, Campylobacter, which causes diarrhea and gastroenteritis. Learn how to protect yourself from resistance to drugs.
Sexual Health RSS
Healthy Living Tips
