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23 November, 2009

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Genital herpes

Genital herpes is a common sexually transmissible infection (STI) caused by the herpes simplex virus. There are two forms of the herpes simplex virus – HSV1 or HSV2. HSV1 more commonly occurs around the mouth but can also occur on the genitals. HSV2 occurs mainly on the genital area.

It is estimated that about one in eight people have the virus that causes genital herpes and about 80 per cent of those infected may be unaware they have this infection. There is no cure for genital herpes but medication can help manage symptoms and prevent recurrences.

Pregnant women with genital herpes should discuss this with their doctor, as herpes infection can be transmitted to the baby during delivery, leading to serious illness.

The virus is spread by skin-to-skin contact
The herpes virus is spread by skin-to-skin contact and can be transmitted during genital, oral or anal sex. The infection can occur anywhere on the genitals, in areas around the groin or 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 already have the cold sore virus.

The virus can be spread when there is an episode (when there is a sore, blister, ulcer or skin split) or between episodes (when there is no sore, blister, ulcer or skin split present). This is called viral shedding. During viral shedding, you may not be aware that the virus is on the skin surface and can be spread through genital skin-to-skin contact or from the mouth or face to genital skin during contact.

Symptoms
Many people who have genital herpes are not aware they have the infection because they may not have any symptoms.

The first episode of herpes can cause considerable pain and distress. Symptoms associated with the first episode of genital herpes may include:

Flu-like symptoms – such as feeling unwell, headaches and pains in the back and legs
Small blisters around the genitals – these break open to form shallow, painful ulcers, which scab over and heal after one to two weeks
Small cracks in the skin
Redness or a distinct rash.

Recurrent episodes
Recurrences are usually less painful and shorter in duration than the first episode. Over time, recurrent episodes become less frequent and may eventually stop altogether. Infections caused by HSV1 are less likely to recur than infections caused by HSV2.

Recurrences may be triggered by:

Stress
Menstruation
Sexual activity
General illness.

Diagnosing herpes infection
If you think you have herpes, your doctor will need to take a swab from the affected area to confirm the diagnosis. In certain circumstances, a blood test is performed to assist with the diagnosis. You should discuss this with your doctor.

Treatment
There are no medications to rid your body of the herpes virus. Treatment is aimed at easing symptoms and preventing recurrences. Symptoms can be improved by:

Salt baths
Pain-relieving medicines – such as paracetamol
Antiviral drugs – such as acyclovir, famciclovir and valaciclovir. These drugs can reduce the severity of an attack if taken early enough (preferably within three days of symptoms appearing).

Preventing recurrences
If you have frequent episodes, antiviral medications may be taken daily to reduce the likelihood of symptoms.

Preventing the spread of herpes
The best protection against STIs is to always use barrier protection such as condoms, female condoms and dams (a thin piece of latex placed over the anal or vulval area during oral sex). Remember that herpes transmission can occur when symptoms are present (such as a sore or blister), but may also occur even if there are no genital symptoms.

Condoms for men can be bought from supermarkets, pharmacists and other outlets. Female condoms and dams are available through Family Planning Victoria and may be available from selected shops. Latex free condoms are also available from some outlets. Male condoms and lubricant are available free from the Melbourne Sexual Health Centre, along with female condoms and dams on request.

Antiviral medication, taken daily, helps to reduce transmission of herpes to a sexual partner.

If you become pregnant after developing genital herpes
Herpes infection may be transmitted to the baby during delivery, leading to serious illness. Although this is not common, let your midwife or obstetrician know if you have had a diagnosis of genital herpes.

Support and advice
If you have just found out you have genital herpes, you may feel shocked and may have a lot of questions. It is important to gather as much information as you can about herpes. This can help you to make fully informed decisions about your treatment, safe sex and preventing further recurrences. Talking to a counsellor about your concerns may also help.

Where to get help

Melbourne Sexual Health Centre Tel. (03) 9341 6200 or 1800 032 017 or TTY (for the hearing impaired) (03) 9347 8619
Your doctor
Nurse on Call Tel. 1300 606 024 – for expert health information and advice (24 hours, 7 days)
Your school nurse or school welfare coordinator
Youth worker, welfare worker or social worker
Your local community health centre
The Centre Clinic, Northcote Tel. (03) 9481 7155
The Centre Clinic, St Kilda Tel. (03) 9525 5866
Family Planning Victoria Tel. 1800 013 952 or (03) 9257 0100 www.fpv.org.au
The Action Centre (for young people less than 25 years) Tel. 1800 013 952 or (03) 9654 4766
The Annexe Sexual Health Clinic Ballarat Tel. (03) 5320 7500
BBV/STI Clinic Bendigo Tel. (03) 5434 4330
Geelong Sexual Health Clinic Tel. (03) 5221 4735
STD Clinic Wodonga Tel. (03) 6051 7535
STD/AIDS Clinic Traralgon Tel. (03) 5173 8111

Things to remember

Genital herpes can be spread by genital, oral or anal sex.
Recurrences of genital herpes usually become less frequent and painful over time.
There is no cure for herpes, but treatment helps ease symptoms and prevent recurrences.
Pregnant women with genital herpes should discuss this with their doctor.

You might also be interested in:
Genital warts.
Infections - bacterial and viral.
Sexually transmissible infections - avoid the risk.
Sexually transmissible infections - overview.
Sexually transmissible infections - signs and symptoms.
Vulval conditions.

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