Long-Term Stress May Trigger Herpes Outbreaks
Nov. 11, 1999 (Atlanta) -- For women afflicted with genital herpes,
persistent life stress can be a predictor of recurrence. A new study reported
in the November 8 issue of the Archives of Internal Medicine shows that
the greater a woman's stress, the more likely it is that she will suffer an
outbreak of the herpes lesions.
Herpes is caused by one of two viruses: herpes simplex type 1 (HSV-1) or
herpes simplex type 2 (HSV-2). Herpes is different from many other common viral
infections. Most importantly, it doesn't go away. The virus tends to lie
dormant in the nerve root causing no symptoms whatsoever. But, at any time, it
can travel the nerve pathways in a particular part of the body and cause an
outbreak. This means that even though HSV may not be causing "cold
sores" or genital signs and symptoms at a given time, it can still cause
symptoms later. Some believe the outbreaks are related to certain events such
as sun exposure, extreme short-lived stress, and menstrual periods.
Although it's well known that people can contract herpes from skin-to-skin
contact with an infected person, herpes's triggers are poorly understood by
scientists. According to the American Social Health Association, based at
Research Triangle Park in North Carolina, known triggers for genital herpes
include surgical trauma and excessive friction in the genital area, as well as
Previous clinical studies have suggested there was a link between stress and
moods and the recurrence of oral or genital herpes simplex virus (HSV) lesions.
However, the study's lead researcher, Frances Cohen, PhD, tells WebMD, "It
is long-term stress that can cause outbreaks." Cohen is an associate
professor at the department of psychiatry at the University of California, San
Francisco, School of Medicine.
To determine whether short- and long-term stress or negative moods could
trigger genital herpes outbreaks in women, the researchers studied 58 women,
aged 20-44 years, with a one- to ten-year history of visible genital herpes and
at least one outbreak in the previous six months. The researchers used weekly
assessments of stress levels and mood, monthly assessments of life-altering
events, and diary reports of genital herpes recurrences confirmed by medical
examination when feasible.
Examples of short-term stressors reported included flying on an airplane,
being a victim of vandalism, and breaking a leg. Examples of long-term
stressors included being worried about relatives, job security, or
Researchers discovered that the more persistent stress reported, the greater
the likelihood of a herpes outbreak the following week. Also, an increased
recurrence rate occurred after participants experienced their highest levels of
anxiety the previous month. "There were no significant associations between
recurrence and short-term stress, life events, depressive mood, anger, or phase
of menstrual cycle," says Cohen. "Persistent stressors and highest
level of anxiety [caused] genital herpes recurrence, whereas transient mood
states, short-term stressors, and life-changing events did not."