Genital herpes is a sexually transmitted infection caused by a virus called the herpes simplex virus (HSV). There are two types of the herpes simplex virus which can infect the genital area as well as the mouth area: these are called HSV 1 and HSV 2.
HSV 1 causes most oral infections (cold sores) but can also cause genital herpes. Genital HSV 1 tends to be a milder infection with less frequent and severe outbreaks.
HSV 2 is more common in the genital area and occurs less in the mouth area. Genital HSV 2 infection tends to be more severe, with more frequent and painful outbreaks.
Having one type of HSV (such as HSV 1 causing cold sores) may reduce your risk of getting another type but does not fully protect you from it.
How common is genital Herpes?
The herpes simplex virus is a common virus. 80% of people are infected with the virus in their lifetime, usually as children through exposure to HSV 1 in the community. While we do not have accurate figures for the number of genital HSV infections we know that it is a common infection.
How do you get Herpes?
Genital HSV is a sexually transmitted infection which is passed on through skin to skin contact—most often during vaginal, anal and oral sex. The most likely time for the infection to be passed on is when there is an outbreak, however the virus can be present when there are no symptoms (called viral shedding) so it can be passed on at other times, often without people knowing.
What are the symptoms of genital herpes?
The symptoms of genital HSV can be quite variable. Most people infected with HSV have no symptoms or have mild symptoms such as a small area of irritation or itching that comes and goes.
This means that many people with the virus don’t know they have it.
If people do have symptoms these can vary. Typically symptoms involve painful sores in the genital area including the groin, thighs, anus and buttocks. These start with the appearance of single or multiple small blisters filled with clear fluid. These blisters then burst and develop into sores which then forms a crust. The crust then dries up and falls off. This process takes usually about 10 to 14 days, but may be longer. During this time there may be significant discomfort and pain, some people experience pain just from the sores, others may experience pain in the general area or radiating away from it as well.
If someone does experience symptoms the first time they have an outbreak is usually the most painful and can include multiple sore, difficulty passing urine, flu like symptoms such as fever, aches and pains, and swollen glands.
Some people may have just one mild outbreak of genital HSV and never have another, others might have occasional outbreaks and some might have frequent and severe outbreaks. Most commonly if people do have symptoms the outbreaks become less severe and less frequent over time.
Is there a test for herpes?
Genital HSV can be diagnosed by a doctor with visual inspection of the area when a sore is present and taking a history of symptoms. If someone has an active herpes sore with fluid present a swab can be taken which will test for the virus. The virus can be difficult to detect so while the test is usually fairly accurate it is not 100%.
There is no useful test for herpes when you do not have an active sore. While there is a blood test available for HSV antibodies, it is not a very accurate test, a positive result just tells you that you have been exposed to the virus at some time in your life, as 80% of people have, possibly through cold sores. It does not tell you if you have genital HSV.
Is herpes curable?
There is currently no cure for herpes, the infection remains in the body indefinitely. It is manageable however.
How is genital herpes treated?
Genital HSV can be treated with oral anti-viral medications. These medication can be used to reduce recurrences (suppressive treatment) or to reduce symptoms with an outbreak (episodic treatment). These medications are safe and well tolerated and can be used for long periods. Discuss treatment options with your doctor.
Genital herpes and pregnancy
Genital herpes is usually not a problem in pregnancy, however there is a small chance that the virus may be passed on to the baby during birth if the baby is born vaginally and there is an outbreak at the time. Women who experience a first outbreak of genital herpes in the last trimester are at increased risk of transmitting the virus to their child and in that case caesarean section may be discussed as an option. Pregnant women with genital herpes may also benefit from suppressive antiviral therapy in the last weeks of pregnancy.
If you or your partner have genital herpes and you are pregnant or thinking of becoming pregnant, it is important to discuss this with your doctor.
If I already have herpes are there things I can do to reduce the number of outbreaks I have?
Looking after yourself can reduce your risk of any infection. Ensuring you are eating a balanced diet, exercising regularly, getting enough sleep, and managing stress will all help. Avoiding sunburn or skin trauma to the affected area will also help (using a lubricant during sex helps with this).
Are there ways to lower my chances of getting herpes or giving my partner herpes?
- Using condoms may lower the risk of being infected with the herpes virus by about 50%. Condoms do not protect fully against herpes because it can infect areas that are not covered by a condom
- Reducing the number of sexual partners you have will reduce the risk of becoming infected.
- If you or your partner have herpes, avoiding sex during an outbreak will help reduce transmission. This means from the first symptom until a week after the area has healed.
- If you or your partner has herpes using an anti-viral medication as suppressive treatment will reduce the risk of transmission when no symptoms are present by 50%.
- Avoiding oral sex when you or your partner has a cold sore, and for a week afterwards, is important and can reduce the risk of passing the infection from the mouth to the genitals.
- Because herpes is common and can sometimes have no symptoms, the only sure way to prevent it is not to have sexual contact.
I have just been diagnosed with genital herpes: now what?
A diagnosis of genital herpes can be confronting and difficult and can feel very distressing for some people. The first thing to do is to discuss your treatment options with your doctor. If you are in a current relationship discussing a herpes diagnosis with a partner is important. If your partner needs more information, discussing it with a doctor or nurse working in sexual health can be helpful and can answer questions and dispel myths.
If you are diagnosed and are not in a current relationship, the thought of telling a new partner can be a worrying concern for many people. There are ways to manage this which can be helpful. Letting a new partner know that you prefer not to start having sex immediately and prefer to wait a while to have sex in a relationship is often a good idea, this can allow time for the person to get to know you and for closeness to develop before disclosure. When you do then tell them and explain your reasons this can be received much better than an early disclosure. Talking to an appropriately trained sexual counsellor about managing this may also be very helpful.
Many people find it useful to find support through forums, support groups, and interactive websites. Some people find that using a dating service for people with herpes can also be helpful.
Herpes Hangout: http://au.groups.yahoo.com/group/herpeshangout/
This is a support forum for people living with herpes
The Facts: www.thefacts.com.au/
This website is produced by a group of drug companies -Aspen Pharmacare Australia. It has comprehensive information on genital herpes concerning its symptoms, testing and treatment.
The Living Sphere: http://www.livingsphere.com/
This site provides support, information, blog, posts, stories and more.
Australian Singles With Herpes: http://au.groups.yahoo.com/group/HSingles/
An Australian Herpes Singles Yahoo group