Sexual Health Advice - Patient Information Leaflets
Genital Herpes
What is genital herpes?
Genital herpes is an infection of the genitals (penis in men, vulva and vagina in women) and surrounding area of skin. It is caused by the herpes simplex virus. The buttocks and anus may also be affected. There are two types of herpes simplex virus:
Type 1 herpes simplex virus is the usual cause of cold sores around the mouth. It also causes up to half of the cases of genital herpes.
Type 2 herpes simplex virus usually only causes genital herpes. It can sometimes cause cold sores.
How is genital herpes passed on?
Genital herpes can be passed on during vaginal, anal or oral sex with someone who is having an outbreak of genital herpes at the time or by skin-to-skin contact with a herpes simplex sore.
The first time you are infected is called the primary infection. This may, or may not, cause symptoms. Following a primary infection, the virus remains in the body but lies inactive (dormant) in a nearby nerve. In some people the virus ‘activates' from time to time, and travels down the nerve to the nearby skin. This causes recurrent symptoms of genital herpes if the primary infection was in the genitals, or recurrent cold sores if the primary infection was around the mouth.
If you are infected, you can still pass the virus on to others even if you have not had symptoms. It is estimated that in at least half of people who develop genital herpes, the virus came from a sexual partner who did not know that they were infected with the virus.
What are the symptoms of genital herpes?
Four in 5 people who are infected with the virus never have visible signs or symptoms at all, or not be aware of them. They, however, can still pass the infection on to others.
In most people the first episode of symptoms/signs will appear 3 – 4 days after being first infected with the virus. However, t can take months or years. This is why a first episode of symptoms can occur during a current faithful sexual relationship. You may have been infected months or years ago from a previous sexual partner who did not know they were infected.
First episode of genital herpes
You may develop some or all of the following:
• Feeling generally unwell with flu-like symptoms such as fever, tiredness, headache, aches and pains.
• Stinging, tingling or itching in the genital/anal area
• Groups of small painful fluid-filled blisters around the genitals/anus which burst leaving small red sores which can be painful. These can last up to 10 – 14 days
• Pain on passing urine
• Swollen glands in groin and pains in groin and down the legs.
Recurrent genital herpes
• Many people will never get another episode after the first one. In those who do get a ‘recurrence', symptoms tend to be less severe and clear up more quickly (in about a week compared to 2 – 3 weeks for the first episode)
• Often there is an early warning tingling or itch in the genital area 12 – 24 hours before an episode, indicating a recurrence is starting
• In people who have recurrence, the time period between recurrences is variable.
How is genital herpes diagnosed?
• There is no routine test for herpes if you do not have signs or symptoms such as blisters
• In most cases, a doctor or nurse can tell if you have genital herpes simply by looking
• The doctor or nurse can confirm the infection is due to herpes by using a swab to collect a sample of fluid from the infected area. They may break a blister gently to get a sample of the fluid inside. This swab is then sent to the laboratory. It usually takes 6 days for the results to come back.
• (Tests for other infections can be done at the same time.)
What is the treatment for genital herpes?
General measures that may help to ease symptoms when they occur
• An ice pack (ice wrapped in a clean towel or flannel) placed over the sores for 5 – 10 minutes may be soothing. Do not put ice directly onto skin as this may cause an ‘ice burn'.
• Placing cold and wet tea-bags against the sores is soothing and speeds up healing.
• A cool shower may help to soothe the sores.
• Using scented soaps or bubble bath may cause irritation. Gentle cleaning of the sores with just cotton wool and water is best. Gentle drying with a hair dryer on its lowest setting may be more comfortable than with a towel.
• If it is painful when you pass urine, it is often less painful if you pass urine whilst sitting in a warm bath.
• Drinking extra fluids reduces the pain when passing urine.
• Wear loose clothing.
• Painkillers such as paracetamol may help to ease pain
• When you resume sexual activity after an episode has cleared, it is a good idea to use a lubricant as some people find the friction of having sex may trigger a recurrence.
Antiviral medication for genital herpes
Antiviral medication does not clear the virus from the body. It works by stopping the virus from multiplying. Antiviral medication is most useful for a first episode of symptoms. If it is started within five days of symptoms starting it helps reduce the severity and duration of symptoms and may help to stop it recurring. A five day course of treatment is usual, but may be extended until the blisters have started to crust.
Antiviral medication may not be needed to treat recurrence. This is because symptoms are often much milder than the first episode, and usually last just a few days. However, if you tend to get bad symptoms during recurrences then a five day course of medication can be useful. To reduce the duration and severity of a recurrence, medication should be started as soon as symptoms begin.
If you have frequent recurrences, an option is to take antiviral medication every day. This can either stop recurrences completely, or their frequency and severity are greatly reduced.
How can I protect myself / my partner from genital herpes?
Herpes simplex virus is very contagious when blisters and sores are present. Genital herpes is usually passed on by vaginal or anal sex. However, if you have a cold sore you may also pass on the virus to cause genital herpes by having oral sex (‘mouth to genital sex').
When you have symptoms (during a primary episode or recurrence)
There is a high chance of passing on the virus if you have sex. It is best not to have sex from the time symptoms first start until they are fully over. If you do have sex, using a condom may not fully protect against passing on the virus as the condom only protects the area that is covered. So, if you or your partner has cold sores/ genital herpes here are some guidelines to protect you:
• Avoid kissing when you/your partner has cold sores around the mouth
• Avoid oral sex when you/your partner has mouth or genital sores
• Avoid any genital/anal contact when you/your partner has genital sores
• Avoid vaginal, anal or oral sex if you feel an episode starting.
Does genital herpes affect fertility?
Herpes simplex does not affect fertility in men or women.
How will I know how long I have had the genital herpes virus for?
It can be impossible to know particularly if you don't get any symptoms or if they appear a long time after you have been exposed to genital herpes.
You or your partner may have been infected many years ago and not know about it.
You might not know whether you got genital herpes from your current partner or a previous sexual partner. These doubts often can be hard to handle.
Do not be afraid to talk to staff at the clinic about how you are feeling.
Should I tell my partner about my genital herpes?
If you have genital herpes
• You may want to discuss it with your current sexual partner
• It is up to you whether to tell future partners. If you do not tell the, it is important to protect them from contact with the part of your body that is affected when you have symptoms or can feel them starting up.
• The staff at the clinic can discuss with you how you might tell your partner(s).
