What is genital herpes?
Genital herpes is a common sexually transmitted viral infection. It can be painful, repeated, and inconvenient but has no long term effect on a person’s general health or fertility.
There are two types of the herpes simplex virus (HSV): HSV-1 and HSV-2.
HSV-1 is the cause of “cold sores” on the lips. More than half of adults may have come into contact with the virus during childhood. In adults, it can be passed to the genitals through oral sex or through genital to genital contact.
Most genital infections are caused by HSV-2 through sexual contact. People infected with HSV may not be aware they have it since it frequently causes no symptoms.
How is genital herpes passed?
• Direct sexual skin contact with an infected area. There may be a visible blister / sore but herpes can be passed on even when there are no symptoms.
• Sometimes mother-to-child transmission during birth.
Having genital herpes does not mean that either of you have been unfaithful to each other. The infection could have been picked up in the past and not cause any symptoms until much later, if at all.
Using condoms all the time during sexual activities may help reduce the risk of spreading or getting genital herpes (but it does not give 100% protection).
What are the signs and symptoms?
First episode genital herpes
• Usually more painful and severe
• Lasts up to 2 to 3 weeks
• Small blisters which break down to form ulcers in the genital / anal area
• Swelling of groin lymph glands
Recurrent/repeated genital herpes
• Usually mild, less painful and only on one side of the genitals
• Heals within a week, with or without medication
• There may be itch and irritation in the area where blisters have not yet appeared
• Herpes hides in the deep nerves between attacks and when it reactivates causes symptoms on the skin
• The outbreaks tend to become less frequent with time
• Not everyone gets repeated outbreaks and there is no way of predicting how often they will occur
Note: Asymptomatic viral shedding is when there are no signs/symptoms of herpes but active virus is on the skin. There is no way of telling that this is happening – using condoms all the time may help reduce the risk of passing the infection during these times.
When do signs and symptoms appear?
Most infected individuals have no symptoms or have mild symptoms that go unnoticed.
When symptoms appear, they may occur 2 to 12 days after initial exposure, or even months or years later.
Avoid all sexual activities until sores have healed.
Who should get tested?
You are advised to get tested if you or your partner(s) have symptoms of genital herpes.
How is genital herpes diagnosed?
• By its characteristic appearance.
• By a cotton tipped swab from the blister or sore.
• By the Type Specific Serological Tests for HSV, which is a blood test that indicates previous exposure to HSV.
*A person who is infected for the first time may not give a positive blood test until 6 weeks later.
Interpretation of HSV Type-Specific Serological Test (TSST) Results
||Not infected with either of the viruses OR you may be infected but the test was done too soon after exposure*.|
The results will not be reliable if there has been sexual exposure within the previous 6 weeks.
||Infected with HSV-1, possibly during childhood and involves the lips and mouth. |
However, genital infection with HSV-1 is increasingly common because of oral sex. The test cannot tell you where the infection is.
||Infected with HSV-1 and HSV-2. It is most likely that the person was infected with HSV-1 (on the mouth) as a child and then genital HSV-2 as an adult.|
||Infected with HSV-2 at some time in the past. Infection is sexually transmitted and on the genitals. |
Can genital herpes be treated?
If there are no symptoms of genital herpes, treatment is not required.
Although genital herpes is not curable, it is not life-threatening in adults. Treatment is aimed at keeping symptoms under control.
Oral anti-viral medications are useful in reducing the severity of outbreaks, if taken early. They are usually given for the more severe first outbreaks. Suppressive treatment (taking medication daily) may be given to those who have very frequent outbreaks to prevent them from occurring so frequently.
Can genital herpes cause other problems?
Infection can be severe and persistent in people with weakened immune systems, such as people living with HIV. With first outbreaks, sometimes the person can have difficulties passing urine.
Genital herpes in pregnancy
Infected women may pass on the infection to their babies during delivery. They should tell their obstetrician to determine the best method of delivery.
Herpes infection in newborns can be serious e.g. blindness, brain damage.
Note: Women who already have herpes before they get pregnant have a low risk of complications. Women who get herpes for the first time after they are pregnant are at highest risk. It does not affect fertility.
How will having genital herpes affect my relationship?
Honesty in a relationship helps to ease unnecessary worry, stress and guilt as to whether you will or have passed the infection to your partner, or that they have passed it to you.
Telling your partner that you have genital herpes shows that you care about them and want to protect them from getting genital herpes, leading the way towards a healthy and trusting relationship.
How to tell my partner?
If it is a new partner, it is best to give it some time before telling. Allow your relationship to develop a little. It will be easier to talk about it if both find comfort and trust in each other’s company first.
Your partner might take the news badly no matter how well you try to deliver it. If so, give them some time to think it over in private, calm down and come to terms with it.
How can I reduce my partner’s chances of getting infected?
The first step is to get your partner tested with a blood test.
If he/she has not been infected with genital herpes, then there are a number of safer sex practices to adopt such as using condoms all the time and avoiding sexual intercourse during outbreaks.
If an outbreak occurs, couples should try to avoid skin-to-skin contact because this is when the virus is most likely to be passed from person to person. This period includes the time from when your partner first show signs of an outbreak such as a tingling or burning until the last of the sores has healed.
If you both have the same type of HSV, you will not continue to pass the infection back to each other since both of you already have the infection.
Seek medical attention as early as possible to reduce the severity and duration of the outbreak.
Practice safer sex
• Sex without exchange of body fluids (vaginal secretions or semen).
• Use condoms correctly and every time you have sex.
• Avoid drinking excessive amounts of alcohol before or during sex, as this may impair your judgment.
We have attempted to provide full, accurate and up to date information in this patient information leaflet, based on current medical evidence and opinion. However, information and advice may vary from different sources, and over time. If you have any further questions, see your doctor or healthcare provider.
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