Description, causes, prevention, treatment and medicines
What is genital herpes?
Genital herpes is a viral infection characterised by outbreaks of blisters and sores around your genital area. You can catch it through having sex (usually vaginal or anal intercourse, or oral sex) with someone who is infected with one of the viruses that cause genital herpes.
Once you are infected with a genital herpes virus, it stays in your body forever, even after the blisters have gone. Some people with genital herpes have outbreaks of genital sores that keep coming back, due to the virus becoming active again, while other people have no symptoms at all and don’t even know they have the virus in their body. So it’s possible to transmit the virus to sexual partners even if you don’t have symptoms (though this is less likely than when you have active lesions).
Causes
Genital herpes is caused by a virus — either herpes simplex virus type 2 (HSV-2) or herpes simplex virus type 1 (HSV-1).
HSV-2 is the virus that most commonly causes genital herpes. This virus is usually spread through close skin-to-skin contact or via genital secretions during sex, e.g. during vaginal intercourse or anal intercourse.
HSV-1 is the virus that normally causes cold sores, but it can also cause genital herpes. The virus can spread during oral sex from the skin around the mouth, where it has caused cold sores, to the skin on or around another person’s genitals, where it can cause genital sores.
Symptoms
Once the virus enters the skin on or around your genitals, it travels to cells in the roots of the nerves of your spinal cord, where it remains permanently.
Many people who are infected with a genital herpes virus do not develop any symptoms, or they might have some symptoms that they or their doctor do not recognise as genital herpes, so they might remain unaware that they have a genital herpes virus in their body.
When symptoms of genital herpes occur for the first time, they usually appear 2 to 10 days after you become infected with the virus, although occasionally, the first outbreak may not occur until months or even years later.
Symptoms during an outbreak of genital herpes
- Flu-like symptoms can occur with the first attack.
- A tingling or burning sensation of the skin on or near the genitals or anus.
- Aching in the buttocks, legs or genitals.
- A fluid discharge from the vagina.
- An area of small red lumps near the area that the virus has entered the body, such as on the penis, near the anus or on the vulva (the female genital region).
- These red lumps turn to blisters filled with clear fluid that break open to leave painful sores.
- These sores form a crust after a few days and heal within about one to 2 weeks, without leaving scars.
Usually the first outbreak lasts for 2 or 3 weeks and is often the most severe, so it’s important to see your doctor for treatment as soon as possible to minimise the pain and complications associated with this attack. Later outbreaks are usually less severe and tend not to last as long as the first outbreak, but the length and severity of outbreaks varies from person to person. Genital herpes symptoms can settle and never re-occur, or they can keep coming back — either several times a year, or just once or twice in a lifetime. If you have any symptoms that you suspect may be genital herpes, see your doctor promptly.
Tests and diagnosis
If you have genital sores, see your doctor, who can work out if you have genital herpes by taking a swab from one of the sores.
Treatment
Although there is no cure for genital herpes, your doctor can prescribe antiviral medicines that can help make the symptoms of an outbreak less severe and last a shorter time.
If outbreaks are very frequent or severe, suppressive treatment (treatment to suppress an outbreak) may be an option. This is when the antiviral medicines are taken continuously for several months. Taking antiviral medicines as suppressive treatment, along with condom use during sex, can help reduce the risk of transmitting the virus to a non-infected partner.
Is genital herpes an uncommon condition?
Genital herpes is a common virus infection that affects one in 8 adults. However, many people with genital herpes have no symptoms or have not recognised their symptoms as herpes infection.
Do only promiscuous people get genital herpes?
Genital herpes is a sexually transmitted infection (STI), and your chance of contracting it does increase with the number of sexual partners you have had in your life. However, you can catch it even if you have had just one or two sexual partners. In contrast to other STIs, the genital herpes virus persists in the body indefinitely and can be transmitted for many years, perhaps for life.
Do condoms prevent genital herpes?
Condoms REDUCE the risk of transmitting genital herpes, and should be used, but they do not entirely remove the risk. This is because the condom may not cover all sites where the virus is being shed, or it may not remain in place during sex or it may break.
Do we always know when we have genital herpes because we have lesions?
Genital herpes affects different people in different ways – some people have lesions or ulcers but others have no symptoms at all. Only a small proportion of people affected by genital herpes have recognised infection. Most people with genital herpes infection have some symptoms but have not recognised the cause as herpes, and others have completely asymptomatic infection (no symptoms present).
Can genital herpes be treated?
Although genital herpes cannot be cured, it is a manageable condition that can be treated. Antiviral tablets can help stop the genital herpes virus multiplying and can be used to shorten outbreaks, to prevent outbreaks recurring and to reduce the chance of transmitting genital herpes to your partner.
Can genital herpes cause cervical cancer?
Genital herpes is not associated with cervical cancer. Cervical cancer is linked with another virus – the genital wart or human papilloma virus (HPV). This virus is also sexually transmitted. Women should have regular Pap smears to detect early signs of cervical cancer. A vaccine is available against some strains of HPV.
Does a full STI test detect genital herpes?
A full STI test does not routinely include a test for genital herpes. The best way of making a diagnosis of genital herpes is to see a doctor when symptoms are present. A specimen will be taken and sent to a laboratory for analysis.
Can genital herpes be transmitted via penetrative sex only?
The genital herpes virus is transmitted through close physical (skin to skin) contact. This can be genital to genital contact or other skin contact with the genital area, not necessarily vaginal or anal sex. Genital herpes can also be transmitted through oral sex if one partner has cold sores. This is because the cold sore virus belongs to the same family as the genital herpes virus (herpes virus family) and can cause sores in the genital area as well as on the face. Oral sex should therefore be avoided until sores have healed. Using condoms or dental dams during oral sex may reduce the risk of transmission.
Can genital herpes be transmitted when you have lesions only?
Herpes virus is easily transmitted when there are ulcers or blisters. However, many transmissions occur when herpes blisters or sores are not present. This is because the herpes virus is often shed from the skin without any symptoms (asymptomatic viral shedding). It is thus important to use condoms or dental dams during sex if you have genital herpes, even when you have no lesions.
Herpes in a monogamous relationship
This doesn’t necessarily mean your partner has been having sex with someone else. You or your partner may have contracted genital herpes from a sexual partner a long time ago and not realised it. The symptoms of genital herpes can be very mild and go unnoticed. The virus persists in the body and can be transmitted, perhaps for life.