The problem started after their last sexual encounter when Jane developed wounds that she thought were bruises. They were painful and formed blisters, and she had unbearable burning pain, especially whenever urine touched the wounds. It took over a month for the wounds to heal. Jane vowed never to have sex with her husband of eight years again unless he promised to be gentle. The man vehemently refuted the accusations.
“But that is now water under the bridge doctor,” David explained when they came to the sexology clinic six months after the incident. “Nature has proved me right; the wounds are back despite the six months of forced abstinence and false accusations.”
“You talk as if you are too happy to prove a point. Does it excite you that I have recurrent painful wounds in my private parts? You are a sadist!” Jane sobbed. I quickly intervened to bring the situation under control.
I took the couple’s medical and sexual history and examined Jane’s wounds. There was a blister and an open wound. These were typical herpes simplex lesions but I took a swab from the wounds for a confirmatory lab test.
Herpes simplex is a virus. It is the same virus that causes cold sores on the lips and around the mouth. Once in the body, the blisters can show up anywhere. Incidentally, when it affects the mouth, it is not taken as a big deal, unlike when it affects the genitals.
The virus is quite contagious. It is spread when the wounds in an affected person get into contact with the skin, lips or genitals of an uninfected person.
Rarely, it can also be spread in the absence of wounds. Once infected, a person continues to be a carrier of the virus.
Under suitable conditions, e.g. when one has a fever, stress, change of weather, or reduced immunity, the infection flares up, causing blisters which burst into painful wounds. In the genitals, contact of the wounds with urine causes irritation, worsening the pain. Jane’s test was positive for genital herpes.
“Did you say that this infection is for life? So it is like HIV and I will live with it forever? And is it my husband who infected me? Will it damage my womb? Can I ever have sex again?” Jane went on and on, tears rolling down her cheeks.
Herpes simplex is spread easily and can stay in the body for long before a flare-up happens. It is therefore difficult to know the source of one’s infection – it could be sexual transmission, a peck from a friend, kiss from a parent, etc.
Though the infection is a nuisance, it should not be equated with HIV. Other than the cold sores on the lips or in the genitals, herpes causes no other damage to the body and should not cause worry.
The exception is where immunity is depressed in conditions such as HIV and cancer where the disease can be unusually severe with complications. Pregnant women with active infection should also get more intensive treatment because infection in the newborn can cause serious complications, and even death of the baby.
Under normal circumstances, however, flare-ups can be controlled and easily managed with medicine. There are drugs that kill the virus and although they do not clear the virus from the body, are used to limit the effect or even prevent the occurrence of the wounds if they are too frequent.
Wounds are easily managed by cleaning, applying anaesthetic creams and taking pain killers. Within no time the wounds heal and life should not be disrupted.
“So can you tell my wife that we are free to have sex? That I am gentle and cannot injure her?” David said with renewed confidence.
“Well, I have no proof of your gentleness unless I observe you in action!” I joked. We all burst out laughing. On a serious note, sex should resume as soon as the affected person is pain-free and the wounds have dried up. Jane and David embarked on caring for the wounds. It was another week