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 and HSV2. HSV1 more commonly occurs around the mouth, but it can also occur on the genitals. HSV2 occurs mainly on and around 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. It is often not possible to tell when a person first acquired the HSV infection as the first symptoms may appear weeks to years later, if at all.
There is no cure for genital herpes, but medication can help manage and reduce the severity of symptoms, and also reduce the frequency of recurrences.
Many people feel great anxiety about herpes, but it is important to remember that it only affects the skin for relatively short periods of time, and most people only have a few recurrences.
Pregnant women with genital herpes should discuss this with their antenatal care provider, as very rarely, herpes infection can be transmitted to the baby during delivery, leading to serious illness.
Genital herpes is spread by skin-to-skin contact
The herpes virus is spread by skin-to-skin contact and can be transmitted during vaginal, 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 (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 of genital herpes
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 of the first episode may include:
- flu-like symptoms – such as feeling unwell, headaches and pains in the back and legs, with or without enlarged glands in the groin
- 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 with or without an itch or tingling
- redness or a distinct rash
- that some people also have considerable pain and swelling in the genital area, and may have additional pain and difficulty passing urine.
Recurrent episodes of genital herpes
Recurrences are usually less painful and shorter in duration than the first episode. Over time, episodes usually become less frequent and may eventually stop altogether. Infections caused by HSV1 are less likely to recur in the genital area than infections caused by HSV2.
Recurrences may be triggered by:
- sexual activity
- general illness.
Diagnosis of genital herpes
If you think you have herpes, your doctor will need to take a swab from the affected area to confirm the diagnosis. Sometimes, your doctor will also do a blood test to help with the diagnosis. You should discuss this with your doctor.
Treatment for genital herpes
There is no medication to cure your body of the herpes virus. Treatment is aimed at easing symptoms and reducing the frequency of recurrences. Symptoms can be improved by:
- salt baths
- ice packs to the affected area
- pain-relieving medication – such as paracetamol
- antiviral medication – such as Acyclovir, Famciclovir and Valaciclovir. These can reduce the severity of an episode if taken early enough (preferably as soon as you become aware of any symptoms appearing). Topical antivirals usually used for cold sores on the lips or face are not appropriate for use on the genitals.
Preventing recurrences of genital herpes
If you have frequent episodes, antiviral medication may be taken daily to reduce the likelihood of symptoms. This is available from a pharmacy, but you need a prescription from a doctor.
Prevention of genital 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). Because herpes is spread by skin-to-skin contact, condoms will reduce the risk of transmission, but it will not protect sexual partners completely.
Using 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 six months of a sexual relationship. Silicone-based lubricants are recommended, but tend to be only available at sex shops or online.
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, as are female condoms.
For people who have frequent episodes of genital herpes, antiviral medication, taken daily, helps to reduce transmission of herpes to a sexual partner.
Pregnancy and genital herpes
Very rarely, 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 ever had a diagnosis of genital herpes, in the past or during your pregnancy.
Support and advice for genital herpes
If you have just found out you have genital herpes, you may feel shocked and may have a lot of questions. It may help you 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 60 60 24 – for expert health information and advice (24 hours, 7 days)
- School nurse or school welfare worker
- Local community health centre
- Family Planning Victoria Tel. (03) 9257 0100 or 1800 013 952
- Family Planning Victoria Action Centre (for people under 25 years) Tel. (03) 9660 4700
- The Annexe Sexual Health Clinic Ballarat Tel. (03) 5338 4541
- BBV/STI Clinic Bendigo Tel. (03) 5434 4330
- Barwon Health – Sexual Health Information and Screening Tel. (03) 4215 1489
Things to remember
- Genital herpes can be spread by vaginal, 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 antenatal care provider.