Genital herpes
Genital herpes
Genital herpes and its causes
Genital herpes (also known as herpes) is a
common sexually transmitted infection (STI)
caused by the herpes simplex virus (HSV).
There are 2 forms of HSV:
HSV-1
– occurs more commonly around the mouth (as a
cold sore
), but it can also occur on the genitals. Usually if this happens, a person with the cold sore virus performs
oral sex
on someone with no previous exposure to the virus.
HSV-2
– occurs mainly in and around the genital area. It may also occur on the mouth of someone who has not previously been exposed to the virus performs oral sex on someone who has HSV-2. (However, this is uncommon and recurrence almost never happens in healthy people.)
Image of genital herpes - blisters and ulcer, courtesy DermNet
Genital herpes is common
Around 75% of the Australian population have been exposed to the HSV-1 virus and about one in 8 people have HSV-2. It is difficult to be certain as many people do not experience symptoms.
Also, it’s often not possible to tell when a person first acquired the HSV infection as symptoms may appear weeks to years later, if at all.
Many people are anxious about genital herpes. It’s important to remember that it only affects the skin for short periods of time. Most people only have a few recurrences.
How genital herpes spreads
The herpes virus spreads by skin-to-skin contact and can be transmitted during:
vaginal, oral or anal sex
genital rubbing
mouth to anus sex.
The infection can occur anywhere on the genitals (including the groin and pubic area) and in or around the anus.
Cold sores on the mouth can cause genital infection during oral sex for those who do not have the cold sore virus.
When genital herpes is most contagious
The virus is most contagious when someone with HSV has an ‘episode’ or an outbreak. This occurs by having a sore, blister, ulcer or skin split (known as viral shedding).
During viral shedding, the virus is on the skin surface and can spread through:
genital skin-to-skin contact
from the mouth or face to genital skin during contact.
Genital herpes can also spread between episodes – when there is no sore, blister, ulcer or skin split present (known as asymptomatic viral shedding).
Genital herpes symptoms
Many people who have genital herpes may not be aware they have the infection, because they have no symptoms.
The first episode of herpes can cause considerable pain and distress. Symptoms of the first episode may include:
Flu-like symptoms
(such as feeling unwell, headache, pain in the back and legs, enlarged glands in the groin).
Small blisters around the genitals – these break open to form shallow, painful ulcers, which scab over and heal after 1 to 2 weeks.
Small cracks in the skin (with or without an itch or tingling).
Skin redness or a distinct rash.
Considerable pain and swelling in the genital area – that may cause discomfort and difficulty passing urine.
Recurrent episodes of genital herpes
Recurrences are usually less painful and shorter in duration than the first episode of genital herpes. Over time, episodes usually become less frequent and may eventually stop altogether.
Infections caused by HSV-1 are less likely to recur in the genital area than infections caused by HSV-2.
Recurrences may be triggered by:
stress
menstruation
sexual activity
general illness
low immunity (such as during
cancer treatment
)
In some, there may be no apparent reason.
Diagnosing genital herpes
If you think you have genital herpes, your doctor will take a swab to confirm the diagnosis.
Sometimes a
blood test
for HSV may be offered. This method is not very reliable for people without symptoms. If you have any concerns, discuss them with your doctor.
Genital herpes treatment
Although there is no cure for genital herpes, medication can help manage and reduce the severity of symptoms.
Medication can also reduce the frequency of further infections and spreading the virus.
Genital herpes symptoms can be improved by:
salt baths
ice packs to the affected area
pain-relieving medication (such as paracetamol)
antiviral medications (such as acyclovir, famciclovir and valaciclovir). These reduce the severity of an episode if taken early (as soon as any symptoms appear).
Topical antivirals used for cold sores on the lips or face are not suitable for use on the genitals.
Preventing recurrences of genital herpes
If you get herpes frequently, taking a daily antiviral medication can reduce the likelihood of symptoms recurring. This is called suppressive therapy. It has the added advantage of reducing the risk of spreading the virus to your sexual partners.
You will need a prescription from your GP.
Preventing genital herpes
The best
protection against STIs
is to use barrier methods. This includes
external condoms
,
internal condoms
and dams (a thin piece of latex placed over the anal or vulvar area during oral sex).
Keep in mind that condoms do not cover the entire genital skin area, so there is a chance you can catch the virus.
It’s a good idea to use lubricant with a condom during sex will also reduce the risk of trauma to the genital skin. This has been shown to reduce HSV transmission, especially in the first 6 months of a sexual relationship. Silicone-based lubricants are recommended.
Herpes transmission can occur when symptoms are present (such as a sore or blister). Transmission may also occur without genital symptoms through asymptomatic viral shedding.
For those who have frequent episodes of genital herpes, antiviral medicines (taken as prescribed) will help to reduce transmission to sexual partners.
Pregnancy and genital herpes
Herpes infection can pass on to a baby during
pregnancy
and
labour
and may cause serious illness. This is not common.
Let your
midwife
or
obstetrician
know if you have ever been diagnosed with genital herpes (in the past or during your pregnancy). They may support you to take suppressive therapy through the last weeks of pregnancy to prevent recurrence.
Ways to reduce the risk of herpes infection during your partner’s pregnancy include:
Don’t perform oral sex on your pregnant partner if you have a cold sore. Unless the pregnant partner has had a known HSV-1 infection.
Taking suppressive antivirals
Use barrier protection during sex.
Support and advice for genital herpes
If you have found out you have genital herpes, you may feel shocked and may have a lot of questions.
Try to gather as much information as you can about herpes. This can help you to make an informed decision about treatment, sex and preventing further recurrences.
Talking to a counsellor about your concerns may also help.
Where to get help
Your GP (doctor)
Your school nurse or school welfare coordinator (Some secondary schools provide access to an adolescent health trained GP on site)
Your pharmacist
Sexual Health Victoria
(SHV)
External Link
. To book an appointment call SHV Melbourne CBD Clinic:
(03) 9660 4700
or call SHV Box Hill Clinic:
(03) 9257 0100
or (free call)
1800 013 952
. These services are youth friendly.
Melbourne Sexual Health
Centre
External Link
Tel.
(03) 9341 6200
or
1800 032 017
Victorian Sexual Health Network – where to get
tested
External Link
– visit Melbourne Sexual Health Centre’s GP partner clinics for STI check-ups and treatment
Thorne Harbour
Health
External Link
(formerly Victorian AIDS Council) Tel.
(03) 9865 6700
or
1800 134 840
Ballarat Community Health Sexual Health
Clinic
External Link
Tel.
(03) 5338 4500
Bendigo Community Health Sexual Health
Clinic
External Link
Tel.
(03) 5434 4300
Or
(03) 5448 1600
Gateway Health Clinic
35
External Link
, Wodonga Tel.
(02) 6022 8888
or
1800 657 573
Sunraysia Community Health
Services
External Link
Tel.
(03) 5022 5444
Barwon Health Sexual Health
Clinic
External Link
Tel.
(03) 5226 7489
Victorian Aboriginal Health
Service
External Link
Tel.
(03) 9419 3000
Women’s sexual and reproductive health hubs
(throughout Victoria)
1800MyOptions
External Link
Tel.
1800 696 784
is a statewide phone service for information about sexual health as well as contraception and pregnancy options