What is genital herpes?
Genital herpes is a highly contagious sexually transmitted infection that affects millions of men and women worldwide. It is caused by the herpex simplex virus and can be transmitted via skin contact with an infected body part on a sexual partner. Although wearing a condom may reduce the likelihood of infection, it may not prevent it as the HSV virus can be present on uncovered skin. Genital herpes can also be spread via the fingers or mouth during sexual activity. The symptoms of genital herpes can be very unpleasant, they may include blisters, raw sores and cracked skin around the genitals, anus and pelvic region. The sores are often painful and you may find urination painful, as well as experiencing tingling and irritation in infected areas. Some patients also experience flu-like symptoms and swollen lymph nodes.
It is possible to be infected with the HSV virus and show no symptoms of genital herpes. The virus may remain dormant in your nervous system and never cause an active outbreak of the disease. It is also possible to experience your first symptoms months, or even years after you were first infected. Genital herpes cannot currently be cured, although the symptoms may be treated with antiviral medications like Valaciclovir and Aciclovir, and some pain relief can be provided. Once you are infected with the herpes simplex virus, outbreaks of genital herpes can recur at any time. Recurring outbreaks often get milder over time.
What are the causes of genital herpes?
Genital herpes is caused by the herpes simplex virus (HSV). There are two types of this virus, HSV-1 and HSV-2, both can cause genital herpes, although HSV -1 is more commonly associated with oral herpes (cold sores around the mouth). The herpes simplex virus is spread through direct skin contact with an infected area of your partner’s body. This can happen during vaginal, oral, or anal sex, and the virus can also be spread via fingers and shared sex toys.
The HSV virus enters your nerves through the exposed skin and can remain dormant for a period of time. Most patients will experience and initial outbreak of genital herpes within 2-12 days of being infected, but it might take months or even over a year for the usual herpes symptoms to appear. Some people will carry the virus but will either never develop genital herpes or will experience barely noticeable symptoms. It is possible to infect a sexual partner unknowingly, even when practicing safe sex.
Genital herpes cannot be spread through contact with inanimate surfaces like toilet seats, bedding, or towels. The HSV virus does not survive away from the human body.
What are the symptoms of genital herpes?
The symptoms of genital herpes will usually appear within 2-12 days of being infected, although they may suddenly appear months or occasionally years later. The possible symptoms are broadly similar for both men and women, although they can range from almost unnoticeable to severe, depending on the individual. Symptoms usually last around a month.
- Small clear blisters on the genitals, pelvic region, or anal area. These can burst and become raw painful sores or cracked skin.
- A tingling, burning, itching, or irritated feeling around the infected areas.
- Pain when you urinate (this is more common in women patients).
- Swollen lymph nodes.
- Fever and associated symptoms like fatigue, malaise, and an aching body.
There is no permanent cure for genital herpes, all treatments are focused on treating symptoms and easing discomfort. Antiviral drugs like Valaciclovir and Aciclovir can be combined with topical treatments and other remedies to reduce pain. Once you are infected with the HSV virus, the symptoms can suddenly reappear at any time during your life. Doctors do not know exactly what triggers new outbreaks, but it is believed that stress, fatigue, or a depleted immune system may be the cause. The good news is that over time the frequency and severity of new outbreaks diminishes. This may be because your body develops a stronger immune response.
How is genital herpes diagnosed?
An initial diagnosis of genital herpes can often be made on the basis of the symptoms that are present, particularly if you have suffered from previous outbreaks of herpes. Symptoms in both men and women may include:
- Blisters, sores, lesions or cracked skin on the genitals, thighs, pelvic, or anal areas.
- An unpleasant or painful burning or tingling sensation around the infected area.
- Pain (sometimes severe) when you urinate. This affects female patients in particular.
- Swollen lymph nodes.
- Fever or feverish symptoms, including tiredness, body pain, and generally feeling low.
It is possible to experience all of these symptoms, just a few of them, or even none at all. A final diagnosis may be made using a blood test for the antigens or by taking swabs from any blisters or lesions that appear. You may also be advised to undergo testing for a range of other sexually transmitted infections if you experience an initial outbreak of herpes.
What are the treatments for genital herpes?
There is no cure for genital herpes. Once you are infected with the HSV virus, it remains in your nerves and may cause a fresh outbreak of herpes at any time. Over 80% of patients infected with HSV - 2 will experience another outbreak within one year. Some patients will experience repeated outbreaks.
Although genital herpes cannot be cured, the symptoms of an outbreak can be treated. Antiviral drugs like Valaciclovir and Aciclovir are used to target the HSV virus, slowing its growth and helping the body to cope. Antivirals can also reduce your chances of infecting a partner with herpes. While you are waiting for the antiviral medications to take effect, you can use topical anaesthetic creams to reduce the pain of sores and cracked skin.
If you are also suffering from fever or associated symptoms as a result of a herpes outbreak, our online GP may recommend additional treatment to alleviate these symptoms.
How do I prevent herpes?
According to the World Health Organisation, HSV (the virus that causes herpes) is a major global problem.
- An estimated 3.7 billion people under age 50 (67%) have HSV-1 infection globally.
- An estimated 417 million people aged 15-49 (11%) worldwide have HSV-2 infection.
- Most oral and genital herpes infections are asymptomatic.
Given these figures, preventing herpes is potentially very difficult if you are a sexually active man or woman. The only guaranteed way to avoid genital herpes is to never have sex. A more realistic approach is to follow these guidelines:
- Have a monogamous relationship with a trusted partner who doesn’t have HSV.
- Avoid promiscuous sex and sex with strangers. People who have multiple partners themselves, are more likely to be infected.
- Don’t have unprotected sex outsided a monogamous relationship. Use a condom for all penetrative sex, including oral sex (use a dental dam if the recipient is female).
- Wash and dry your hands thoroughly immediately after sex. Don’t touch your eyes or other body parts until you have done so.
- Be honest and open with prospective partners if you have herpes - even if your last outbreak was a long time ago.
You cannot get infected from touching inanimate surfaces like toilet seats, door handles, towels or bed linen. The HSV virus does not survive away from the human body.