Women's Bodies, Women's Wisdom (62 page)

Common Concerns About Herpes

Where Did I Get Herpes? Can I Give It to Someone Else?
How Can I Minimize My Chances of Recurrence?

The answer to the first question is the same as for HPV: The virus can be dormant for years, so a person who has a primary outbreak may have “caught” it twenty or more years ago! I’ve seen first-time genital herpes outbreaks in eighty-five-year-old women who’ve been celibate and widowed for twenty years.

Most sexual transmission of HSV occurs when the virus is reactivated but asymptomatic among people with unrecognized infections. Recent studies indicate that virtually all HSV-2 seropositive persons shed the virus intermittently from mucosal surfaces, and it can be spread by either intercourse or oral-genital contact.
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In response to the second question, it is generally recommended that people with herpes use condoms to cut the risk of infecting someone else.

In general, herpes outbreaks are associated with the following stressors: anxiety and depression, lack of sleep, overexertion, and mi croabrasions of the vagina from sexual intercourse. These outbreaks can be greatly decreased or eliminated by following the nutritional and herbal advice below. The emotional ramifications of having a herpes diagnosis are usually far more troubling than the actual infection. There’s good advice on this website:
www.datingwithherpes.org
.

What Are the Risks of Herpes If I’m Pregnant?

Neonatal herpes is the most severe complication of genital herpes and is caused by the newborn’s contact with infected genital secretions at the time of labor. Herpes does not pose any risk for the baby during pregnancy itself unless a woman is first exposed to it when she is pregnant and the virus reaches high enough levels in the blood (known as viremia) and also crosses the placenta to infect the baby. Getting herpes for the very first time during the last four months of pregnancy carries the biggest risk for neonatal herpes because the mother’s body hasn’t yet had a chance to produce antibodies to the virus.

Though no one actually knows how many babies are exposed to the herpes virus during labor, we do know that neonatal herpes occurs in up to 1 in 3,200 live births with an estimated incidence of 1,500 cases annually in the United States.
³⁶

To give you an idea of how rare it is for a baby to actually get herpes, consider the fact that there are a little over 4 million births per year in the United States. And given the large number of women with undiagnosed herpes infections at the time of labor, it’s clear that the immune system of mothers offers protection most of the time. Here’s the problem, however: When a newborn does get infected with herpes, it can cause disseminated or central nervous system disease about 50 percent of the time. Of these cases, up to 30 percent will die and up to 40 percent will have some kind of long-term neurological damage. And that’s why it’s important to do everything possible to minimize the risk of a baby getting infected with herpes during labor. This is why most women with active herpes lesions who are in labor almost always deliver by C-section, a decision that I feel should be questioned more (see below).

If You Are Pregnant or Considering Pregnancy

If you are considering getting pregnant, it’s a good idea for both you and your partner to be tested for herpes. (About 2 percent of pregnant women will become in fected during pregnancy.) If you know that your partner is seropositive for herpes and you aren’t, then you can use condoms during intercourse or rubber dams during oral sex to prevent genital transmission.

Make every effort to remain as well nourished and healthy as possible during your pregnancy. Worrying for an entire pregnancy about having an active herpes sore at the time of labor may, in my view, in crease the chances for an outbreak.

Follow the steps in this section on treatment to prevent an out break, such as taking supplements like garlic and a good multivitamin.

Note: Antivirals such as valacyclovir and acyclovir (see below) can be used in pregnancy for those with severe or recurrent lesions. No significant adverse effects have been found in newborns exposed to this drug.
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Herpes Doesn’t Mean an Automatic C-section

If you have a history of herpes but have no lesions during labor, then you can safely deliver vaginally. The major sites of entry of the virus into the newborn include the skin, so any procedure that damages the baby’s skin could increase the risk of transmission. Among newborns exposed to herpes at delivery, studies have shown that 10 percent of those delivered with the use of fe tal scalp electrode, vacuum, or forceps were infected, compared to only 2 percent of those who did not have invasive obstetrical procedures.
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Because the risk of transmitting the virus to the baby is so low even for HSV-2 seropositive women with active herpes lesions, some experts are suggesting that it’s safe for these women to deliver vaginally.
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I certainly agree with this. After all, once you’ve been exposed to herpes, your body makes antibodies against herpes that cross the placenta and help protect the baby. Despite this evidence, however, the current standard of care in most centers is delivery by C-section for those who have active herpes lesions when they go into labor. The main reason for this is fear of litigation.

Treatment

Medication

A variety of antivirals (e.g., acyclovir [Zovirax] and valacy clovir [Val-trex]) are widely available for treatment of herpes. Acyclovir comes in both pill and ointment form, and some people take it on a long-term basis (for two to three years). When taken orally, this antiviral medication works like any antibiotic in the system. Within twenty-four hours of taking the pills, the virus is inactivated. The topical ointment for actual out breaks takes a bit longer to work. Antivirals are available only by prescription.

Though antivirals are very helpful in primary (first-time) outbreaks, I’m con cerned that chronic use of them may result in resistant viral strains that will be even stronger and harder to treat later. This has happened with other disease-causing organisms over the fifty years that doctors have been prescribing antibiotics and antivirals. Routinely giving antibiotics or antivirals when they are not indicated and failing to look at other ways to support the immune system’s own ability to fight germs has resulted in our current battle against “superbug” strains of tuberculosis, pneumonia, and staphylococcus. For that reason, I prefer an approach that bolsters a woman’s inherent ability to keep the virus under control.

Nutritional and Herbal Treatments

Garlic is a highly effective remedy for herpes recurrence, and it has no known side effects. It also works for cold sores. Garlic has been shown to have a number of antiviral, antibacterial, and antifungal properties.
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For women with recurrent herpes, I recommend the following: When the familiar tingling sensation starts, signaling that an outbreak is about to occur, take twelve capsules of deodorized garlic (available in health food stores) immediately.
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Then take three capsules every four hours while you are awake, for the next three days. In almost every case, the herpes outbreak will be prevented. Take the deodorized variety of garlic, to prevent the bad breath that is the only downside to garlic’s use. I generally recommend brands that contain allicin (such as Garlitrin 4000 and Kyolic, both widely available from most health food stores).

For women with a history of herpes who are planning a pregnancy or who are already pregnant, I recommend they take two garlic capsules every day. This can be increased to six to eight capsules per day if they are under more stress than usual. In my clinical experience, women who do this don’t get herpes outbreaks.

Other Herpes Treatments

Medavir is a patented, nonprescription topical gel made with stannous compounds that has well-documented antiviral and antibacterial properties. It is applied the moment any symptoms occur. In clinical studies, most users were able to prevent sores from occurring, and if they did occur, the sores healed 50 percent faster and were far milder than usual.
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Regular use also decreases recurrence rates. It is also useful for shingles (a type of herpes recurrence of the chicken pox virus). For more information, see
www.medavir.com
.

Melissa extract
(Melissa officinalis),
also known as lemon balm, has been scientifically shown to have antiviral activity against herpes infections. It can prevent ulcers and speed healing if used at the onset of symptoms.
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A cream form of this extract can be purchased at natural food stores under the brand name Herpalieve. It should be applied to the affected area two to four times daily for five to ten days.

Tea tree oil, from the Australian tea tree, can be applied directly to the tingling area just prior to a herpes outbreak, using either a Q-tip or your finger. In most cases, this topical treatment will prevent an outbreak.
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Finally, it also helps to change your perception. Neither herpes nor genital warts need be a big deal. In the vast majority of cases your immune system will take care of them and they won’t cause you or anyone else any harm. The problem is the perception that you are somehow bad or tainted if you get them. You can “cure” this through celebrating your genitals and your sexuality as something good. (See Louise Hay’s affirmation on page 273.) Here’s an example from one of my newsletter subscribers who took my advice and subsequently healed her herpes—in both mind and body—simultaneously.

I went through a divorce five years ago after a monogamous marriage that lasted twenty-three years. It took me about four years to even have a date. I finally found a guy I really liked. We both got ourselves tested for AIDS before having sex. And neither of us had a history of anything else. So we had sex. It felt so good to be making love again with someone I like and trust. But four days later, I came down with herpes. At first I was horrified. I felt like such a fool. How could I have let this happen? My lover also felt so badly that he had “made me sick.” But then I read your book and realized that my attitude and shame weren’t helping my immunity a bit. So I took your advice. I started to eat better and take a good multivitamin every day. I also started to affirm the goodness of my own sexuality. I realized that I hadn’t done anything wrong. I wasn’t bad or tainted—and neither was my lover. The herpes sores healed in about ten days. And now my lovemaking is more pleasurable than ever. I found a guy who really cares, is a wonderful lover, and who affirms my beauty and desirability every day. Believe me, herpes was a small price to pay. I’m certain that it will never recur now that I feel better about my genitals and my sexuality than ever before!

I applaud my reader for her courageous turnaround of a situation that is devastating to many women. And it is my fervent hope that she really never does get a recurrence! If she does, she’ll know what to do about it.

CERVICITIS

True cervicitis is an inflammation of the cervix caused by the same infectious agents that cause vaginitis, such as trichomonas or yeast. Cervicitis and vaginitis are usually present at the same time, and treat ment for them is the same. (See section on vaginitis, page 296.)

In some women, the mucus-secreting cells of the endocervix sometimes extend out onto the outer cervix (the exocervix). This is a normal anatomical variation and is not true cervicitis. Though these women sometimes experience a bit more vaginal discharge than usual, this only rarely requires treatment. In cases in which the discharge is truly a problem, cryocautery (freezing) of the cervix or LEEP cautery can be done. (See page 272.)

CERVICAL DYSPLASIA (ABNORMAL PAP SMEARS)

Cervical dysplasia is the name given to cellular abnormalities that arise in the endocervical canal or on the cervix itself:
Dysplasia
simply means “abnormal.” It is diagnosed by a Pap smear, and the cells are then classified, according to nationally agreed-upon standards, as either
cervical in
traepithelial neoplasia
(CIN), which means abnormal cells in the epithelial layer of cells covering the cervix, or
squamous intraepithelial lesions
(SIL), which means abnormal cells in the squamous layer covering the cervix, vagina, or vulva. (Some medical centers don’t distinguish between SIL and CIN and use SIL as the all-purpose term.) The pathologist who reads the Pap smear ranks these cells numerically, according to the degree of the cellular change. Thus CIN 1 or SIL 1 is considered mild, while CIN 3 or 4 or SIL 3 or 4 is severe.

When a Pap smear comes back as abnormal, I know that a woman is likely to immediately jump to the worst-case scenario: “Oh, no, I have cancer!” Prompt investigation of the abnormal Pap smear generally results in her being reassured. Most abnormal Pap smears
do not
mean cervical cancer, though a certain percentage of dysplasias will go on to become cervical cancer if they are not diagnosed and treated. Some CIN abnormalities, particularly the mild ones, will go away by themselves. This is because the majority of mild dysplasias are actually HPV infections that are self-limiting. Self-limiting infections are those that the body’s immune system takes care of on its own.

Symptoms

Cervical dysplasias are not usually associated with symptoms, though some women who have had abnormal Pap smears have told me that they knew something was wrong because they felt a “burning” sensation in the cervical area. (Cervical cancer can be asymptomatic as well, but its symptoms usually include bleeding between periods, pelvic pain, foul discharge, and/or bleeding after intercourse.)