Genital herpes

Genital herpes is a sexually transmitted infection caused by a virus called herpes simplex virus (HSV).

There are two different types of the virus (type 1 and type 2), both of which can affect the genitals. One of the types is the same virus that causes cold sores around the mouth (type 1).

Genital herpes causes painful blisters and sores on and around the genitals. It can also sometimes cause problems if it's caught for the first time either very early or very late in pregnancy.

How do I get genital herpes?

The herpes virus (HSV) is easily passed from person to person by close, direct contact including:

• kissing
• unprotected vaginal, anal or oral sex (without a condom)
• sharing sex toys that aren't washed or covered with a new condom each time they're used
• your genitals coming into contact with your partner's genitals – this means you can get genital herpes from someone even if there is no penetration, orgasm or ejaculation

Sometimes you can catch herpes when your sexual partner has no visible sores or symptoms. This is because the virus can become active on the skin without causing any visible blisters or sores. This is sometimes called 'asymptomatic shedding’.

Herpes can also be passed to a newborn baby during childbirth. This is less common if the first episode of herpes is diagnosed before or at the beginning of pregnancy, and if there are no visible ulcers at time of delivery. Sometimes medications are started towards the end of pregnancy to reduce this risk.

Symptoms of genital herpes

Many people with the herpes virus do not experience any symptoms when first infected.

If symptoms do occur they usually take between two and twelve days after contact to appear.

Sometimes symptoms may not be noticed until months, or sometimes years, after being in contact with the virus.

Once you have the herpes infection, the virus stays in your body. It can lie dormant for long periods, but can reactivate in the area that was originally infected. If the virus reactivates, the sores and blisters can reappear. This is known as a ‘recurrent episode’ of genital herpes.

This first episode of genital herpes may last from two to four weeks. Repeated episodes are not usually as severe, or long, as the first and you may never have a repeat episode.

Symptoms of the first infection can include spots or red bumps around the genital area. These can be very painful. In time, these swellings can break open and form sores or ulcers which gradually crust over, forming new skin as they heal. 

Other symptoms include:

• pain inside the vagina, head of penis or back passage (rectum)
• vaginal discharge
• pain peeing or being unable to pee
• fever
• flu-like symptoms, backache, headache and a temperature
• mild swelling of the lymph glands in the groin, armpits and neck

If you have a recurrent infection, your symptoms may include:

• a tingling or burning sensation before blisters appear (this can signal the start of a recurrent infection)
• painful red blisters, which soon burst to leave ulcers
• pain inside the vagina, head of penis or back passage 

Testing for genital herpes

If you think you may have genital herpes you should make an appointment with your GP or local sexual health services.

If there are symptoms present such as blisters, sores and ulcers, your doctor or nurse may be able to make a diagnosis straight away.

If you have visible blisters, your doctor or nurse may take a swab for testing, to check if this is herpes and what type. This swab can also test for another STI which causes blisters called syphilis.

The genital herpes swab tests is very reliable, though if the ulcer is too dry then the result may be less likely to find a positive result.

Treating genital herpes

Although there is no known cure for herpes, the symptoms of genital herpes can be treated.

The symptoms of recurrent genital herpes will usually clear up without any treatment. There's also medication to help speed up the healing process and reduce the severity of an episode, if needed.

If you start taking the medication as soon as an outbreak begins, you may shorten or even stop the episode.

Some people experience many recurrences of genital herpes. In these cases, a longer course of tablets should prevent any recurrent episodes.

Talk to your doctor or nurse at the sexual health service, or to your GP about possible treatment options that may suit you.

If you're pregnant and find out you have a genital herpes infection, tell your midwife as soon as possible.

As there's no screening test for herpes, partners are only advised to have a test of they also have symptoms.

Avoiding passing genital herpes to a partner

If you have herpes, you can follow some simple measures to avoid passing the virus on to your partner(s), and to continue to have a healthy and happy sex life. These include:

• telling your partner if you have herpes
• learning to recognise the warning signs (tingling, itching or inflammation) that an episode is starting
• not have sex during an episode of herpes
• avoiding direct contact with your sores or blisters and another person
• avoiding kissing and oral sex when you or your partner has cold sores around the mouth

If you have frequent episodes of herpes then it is worth talking to your GP or sexual health clinic about longer term treatment which may also reduce the chance of you passing on the virus to your partner.

Preventing recurring episodes

Keep a record of when you have an episode of genital herpes. You may see a pattern developing, and be able to identify your trigger factors.

Many people find that episodes occur when they’re run-down, under stress, around the time of menstruation or when the skin gets irritated due to friction or tight clothing.

If you do see a pattern of trigger factors, try to adjust your lifestyle to avoid or reduce your exposure to them or speak to your healthcare professional for advice.

Reducing the risk of genital herpes

The best way to prevent all sexually transmitted infections is to practice safer sex. This means using a condom for vaginal, anal or oral sex.

The herpes virus can’t pass through a condom. However, if the virus is present and active on the skin in areas around the genitals not covered by the condom (as is often the case), infection may still occur. Therefore condoms are not 100% protective against the herpes virus.

If your partner has herpes, avoiding sex when they have visible sores reduces your risk of getting herpes.

Other STI's

If you’ve been diagnosed with herpes it’s recommended that you are tested for all STI's including:

• chlamydia
• gonorrhoea
• syphilis
• HIV

This is even more important if you have recurrent episodes.