WHAT IS GENITAL HERPES?
Genital herpes is a common infection caused by a virus called the Herpes Simplex Virus (HSV). There are two types of this virus: HSV 1 and HSV 2. It usually occurs on the genitals but can also occur around the anus, the buttocks, or the upper thighs. HSV can also occur around the mouth (cold sores).
ARE HSV 1 AND HSV 2 THE SAME?
HSV 1 and HSV 2 are different strains of the same virus. Both types can cause genital herpes but the infections tend to take a different course. Genital infection with HSV 1 can cause a painful first episode, however recurrences tend to be less frequent and less severe. HSV 1 causes almost all cases of oral cold sores. Genital infection with HSV 2 usually causes a more severe first episode, more frequent recurrences, more viral shedding, and is more likely to need treatment. Genital infection with HSV 1 and HSV 2 are equally common. HSV 2 very rarely causes oral infection.
HOW DO YOU GET GENITAL HERPES?
HSV is transmitted during close skin to skin contact with someone who has the virus. The virus enters the skin through tiny abrasions in the skin (micro abrasions) which are usually not noticeable.
WHAT ARE THE SYMPTOMS?
Many people who have genital herpes have no symptoms. If symptoms do occur they tend to be most severe with the first episode and can include painful blisters, flu like symptoms, and problems passing urine. With recurrent episodes symptoms become less severe and typically will involve areas of small painful blisters which turn into ulcers. Flu like symptoms can occur with recurrent episodes but are usually milder. HSV 2 is likely to cause more frequent and more severe recurrences. Recurrent outbreaks of herpes are often preceded by warning signs, often called prodrome symptoms. These include tingling or itching in the area and pain in the genital area, legs, or buttocks. These prodrome symptoms can occur from as long as five days to as little as 30 minutes before an outbreak.
HOW LONG AFTER I HAVE BEEN INFECTED CAN SYMPTOMS DEVELOP?
If symptoms do occur they usually develop from between 2 and 12 days after exposure.
TESTING FOR GENITAL HERPES
HSV is diagnosed visually by a doctor or nurse practitioner looking at the area, and taking a swab of the ulcer/sore to confirm if possible. A blood test for HSV is not advised because it is not useful. As HSV is such a common infection in the community (cold sores) the majority of people will already have antibodies to HSV in their blood.
HOW IS GENITAL HERPES TREATED?
Genital herpes is not curable, however it can be managed well with anti-viral medication (Valtrex®, Famvir®, Zovirax®). These medications are considered safe and are well tolerated by most people. Treatment for an initial outbreak is usually given for 10 days. People who only have one or two episodes may not require treatment, however if there are ongoing episodes treatment is advised.
Ongoing treatment can be used in one of two ways: Episodic treatment where a short course of the medication is used at the first sign of symptoms. Suppressive treatment where the antiviral medication is taken daily on an ongoing basis. Suppressive treatment can also reduce the risk of transmission to a partner.
How can the transmission of genital herpes be reduced?
- Using condoms provides 50% protection from genital herpes.
- If the partner with herpes uses suppressive therapy this reduces the risk of transmission by 50%.
- Using a good silicone lubricant for sex may also reduce the risk of transmission by avoiding skin trauma and micro abrasions.
- If someone has a cold sore they should not give a partner oral sex from the first symptom until a week after the symptoms of the cold sore have gone.
HERPES AND PREGNANCY
HSV can cause rare but serious infections in newborn babies. This is most likely to occur in women who have an initial episode of genital herpes in the last 3 months of pregnancy. The risk of infection of a newborn in a woman who has had herpes for some time is rare, most women with genital herpes have vaginal deliveries without any problem. If a woman has frequent outbreaks her doctor will most likely advise her to use suppressive treatment in pregnancy. If a herpes outbreak is present at the time of delivery then the woman’s doctor may discuss the possibility of a caesarean section. If a pregnant woman’s partner has herpes and the woman does not know if she has it, then it is very important that she discuss this with her doctor to avoid initial infection during pregnancy.
WHAT SHOULD I DO IF I THINK I HAVE GENITAL HERPES?
The first thing to do is to see a doctor or nurse practitioner when the symptoms are present. Then an accurate diagnosis can be made and treatment options discussed.
WHAT SHOULD I DO IF I HAVE BEEN DIAGNOSED WITH GENITAL HERPES?
A diagnosis of genital herpes can be distressing and people can have a lot of questions about it. Seeing a sexual health doctor, nurse practitioner or nurse to ask questions and get accurate information is a good idea. It can also be very helpful to see a sexual counsellor who is informed about herpes and can assist you in dealing with a diagnosis and with the feelings and concerns you may have
FOR FURTHER INFORMATION SEE THE FACTS: THEFACTS.COM.AU
GENITAL HERPES BROCHURE PDF
Last updated September 2018
Melbourne Sexual Health Centre: Australian STI Management Guidelines: for use in primary care. CDC Herpes Factsheet.