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Genital herpes

Published by Bupa's health information team, March 2008.

This factsheet is for people who have genital herpes, or who would like more information about it.

Genital herpes is a common sexually transmitted infection caused by the herpes simplex virus (HSV); the same virus which causes cold sores around your mouth. Anyone who is sexually active can get genital herpes but it's most common in men and women aged between 20 and 24.

About genital herpes

Genital herpes is a sexually transmitted infection which causes blisters and sores on the skin around the genitals.

You can get genital herpes through skin-to-skin contact with someone who has the herpes virus. Once you have genital herpes, the virus stays in your body for the rest of your life but is inactive (dormant) most of the time. However, the virus can sometimes become active again and cause an outbreak of genital herpes.

Symptoms

Many people who have a HSV infection don't have any symptoms. If you do get symptoms, these may occur within four to five days after you get the virus or they can appear weeks, months or sometimes years later. This is known as first episode genital herpes.

In both men and women, symptoms of the first episode of genital herpes can include:

  • blisters (usually in clusters) around your genitals, thighs and inside or around your anus, which form dry scabs usually around two weeks after the symptoms start
  • redness, discomfort, itching or tingling around the infected area
  • feeling generally unwell with flu-like symptoms such as a fever and a headache
  • a painful or burning sensation when passing urine or finding it difficult to urinate
  • an unusual discharge from the urethra (tube that passes urine from the bladder), vagina or anus
  • pain when passing a bowel movement (if you have an anal infection)

After the symptoms from the first episode clear up, the virus lies dormant in your body but can become active from time to time. These are called recurrent episodes or outbreaks. Not everyone will get recurrent episodes of genital herpes. If you do, symptoms tend to be milder than during the first episode. You may have tingling or itching in the infected area up to two days before any blisters or sores are visible on your skin. There are usually fewer blisters which are less painful and which clear up faster.

Complications

Complications as a result of genital herpes can include:

  • spread of the infection to non-genital areas such as the lips, nipples, buttocks, fingers and eyes
  • a stiff neck and difficulty looking at light - rarely, this can develop into meningitis so seek medical advice if you have these symptoms (see Related topics)
  • passing the herpes simplex virus onto your baby during birth - see Special considerations.

Having herpes also makes it more likely that someone might get or pass on HIV, particularly if there are blisters.

Causes

Genital herpes is caused by the herpes simplex virus (HSV), the same virus that causes cold sores around your mouth. There are two types of this virus, HSV-1 and HSV-2, both of which can cause genital herpes.

You can get genital herpes if you have unprotected vaginal or anal sex, share sex toys or have genital contact with someone who has the infection. The virus can also be transferred through oral sex with someone who gets cold sores. It can also be passed to the genital area on the fingers.

The herpes virus leaves the skin (this is called shedding) just before a blister appears, while it's is visible and until the blister is totally healed; it's more likely to be passed on during these times. However, it's also possible for the virus to shed (and infect another person) when there are no signs of an outbreak.

You can get genital herpes if you are sexually active, but you are at greater risk if you have unprotected sex (without a condom), especially if you have more than one sexual partner.

Diagnosis

If you have any symptoms of genital herpes, you should see your GP or visit a genitor-urinary medicine (GUM) or sexual health clinic. Sexual health clinics are completely confidential. You won't be routinely screened for genital herpes if you don't have any signs of symptoms of the infection.

The doctor or nurse will take a swab sample of fluid from the infected area. He or she may have to gently break a blister to do this. This sample will be sent to a laboratory to confirm that you have the herpes virus.

A blood test can also show if someone has got the herpes virus but they tend not to be used as they can't pick up signs of very recent infection. If the blood test shows you have had an HSV infection, it could be identifying an infection from years ago, for example a cold sore virus from childhood.

Treatment

Self-help

There are things that you can do to help relieve any pain or discomfort from genital herpes.

  • Take an over-the-counter painkiller, such as paracetamol or ibuprofen.
  • Bathe in salt water (add half a cup of household salt to your bath).
  • Put an ice pack onto the affected area (you shouldn't apply ice directly to your skin - place a cloth between the ice and your skin).
  • Apply petroleum jelly (such as Vaseline) to the infected area.
  • Apply a mild anaesthetic cream or lotion, such as lidocaine, around your urethra if urinating is painful. Sitting in warm water when you urinate can also ease some discomfort.
  • Wear loose fitting underwear and clothes around the infected area.
  • Try not to touch the sores and if you do, wash your hands thoroughly to prevent spreading the infection.
  • Don't have sex until your symptoms have cleared up.

Always follow the instructions in the patient information leaflet that comes with the medicine and ask your pharmacist for advice on whether it's suitable for your individual circumstances.

Medicines

There is no treatment to remove the herpes virus from your body. Once you are infected it will remain in your body, even if you never have another episode.

However, your doctor can prescribe antiviral tablets, which can help the outbreak clear up faster and reduce the severity of the symptoms. You will probably need this the first time you have the infection.

Recurrent episodes of genital herpes tend to be milder and you may not need treatment. The self-help methods listed may help to ease any mild discomfort. However, your doctor can prescribe antiviral tablets if you have a severe recurrent episode.

If you have regular episodes of genital herpes, you may wish to ask your doctor about suppressive treatment. This is where you take a dose of antiviral medicine over a longer period of time to prevent the infection recurring.

Special considerations

If you are pregnant

If you develop genital herpes or have a recurrent outbreak when you are pregnant, you should go and see your doctor or your obstetrician (a doctor specialising in pregnancy and childbirth) for treatment and advice. There can be a risk of passing the infection onto your baby during the birth. This is known as neonatal herpes and can cause your baby to be seriously ill. However, it is very rare in the UK.

Your doctor will prescribe antiviral medicine to reduce the severity of your symptoms and the length of time you have them during the first episode, or if you have severe recurrent outbreaks. Your doctor will advise you on how long you need to take the medicine for.

If you get a first episode of genital herpes in the last three months of your pregnancy (the third trimester), there is an increased chance of passing the virus onto your baby and you may need to have a planned caesarean section (see Related topics).

However, if you have a first episode of genital herpes in the first six months of your pregnancy, you are not likely to pass the virus onto your baby during the birth.

If you have had genital herpes before getting pregnant and have a recurrent episode at any time during your pregnancy, the risk of passing the virus onto your baby during birth is very low.

Prevention

There are ways that you can lower your risk of getting or passing on genital herpes.

  • Don't have sex, or genital or anal skin-to-skin contact while you or your partner has symptoms of genital herpes, particularly blisters and sores.
  • Don't kiss or have oral sex while either you or your partner has a cold sore around the mouth.
  • Use condoms when having sex.
  • Limit the number of sexual partners you have and the frequency you change your sexual partners.

Living with genital herpes

Many people who get recurrent genital herpes find some things trigger their herpes episodes, such as sunbathing, being run down, stress and friction against the skin. Being aware of these and taking measures to prevent them can help reduce outbreaks.

Further information

Related topics

Sources

  • National Guideline for the Management of Genital Herpes. The Clinical Effectiveness Group, 2001. The British Association of Sexual Health and HIV. www.bashh.org
  • Herpes simplex - genital. Clinical Knowledge Summaries. www.cks.library.nhs.uk, 2005
  • General Information - genital herpes. The Health Protection Agency. www.hpa.org.uk, accessed 7 January 2008
  • Genital Herpes. American Academy of Family Physicians. familydoctor.org, accessed 07 January 2008
  • Genital Herpes. fpa. www.fpa.org.uk, accessed 7 January 2008
  • Genital Herpes. Terrence Higgins Trust. www.tht.org.uk, accessed 7 January 2008

This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. It has been patient reviewed by Terrence Higgins Trust. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: March 2008.

 

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