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STIs

Genital herpes

Genital herpes is caused by the virus Herpes Simplex (HSV). There are two types, HSV 1 and HSV 2 and both can infect the genital and anal area and also the mouth and nose (cold sores).

Signs and symptoms of genital herpes

Many people with HSV don’t have any visible signs or symptoms. If you do get symptoms they may include the following:

  • Flu like symptoms such as fever, headache, aches and pains
  • Stinging, tingling or itching in the genital or anal area
  • Small fluid-filled blisters appear anywhere in the genital or anal area, as well as the buttocks or tops of the thighs – these burst leaving small, red sores which can be very painful
  • Pain when passing urine – due to the urine passing over the sores
  • May have vaginal or urethral discharge

The first outbreak can last up to two to four weeks with the sores generally healing within 5 to 10 days. The sores will eventually scab and heal without scarring.

There is no cure for genital herpes so you may get further outbreaks. However, they are usually less severe and heal more quickly because your body will have had an opportunity to produce antibodies that fight infection. Some people find that certain things can trigger an outbreak, such as:

  • Being unwell or run down
  • Stress
  • Certain times in your menstrual cycle
  • Friction from sex or masturbation
  • Sunbeds or sunbathing
  • Tight non-cotton underwear
  • Drinking and smoking too much

The causes and how it is passed on

The virus is highly contagious and enters the body through small cracks in the skin or through the soft, moist lining of the mouth, vagina, rectum, urethra (where urine comes out) and under the foreskin.

WARNING

Herpes is passed on during sexual contact and is most likely to be passed on before, during or immediately after an outbreak.

It is easiest to pass on when someone has blisters or sores. In some people the virus can be present without any symptoms of genital herpes and can be passed on (known as asymptomatic shedding).

It is passed from one person to another through:

  • Unprotected vaginal sex
  • Unprotected anal sex
  • Unprotected oral sex
  • If you receive oral sex from someone who has a cold sore or is about to get one
  • Your genitals coming into contact with your partners genitals
  • Skin-to-skin contact during sex if the virus is active on the skin outside the area protected by a condom
  • Sharing sex toys without washing them or covering them with a condom with each use
  • If a person with whitlows (herpes on the hand) touches a partner’s vagina, genitals or anal area

You cannot get herpes from hugging, sharing baths or towels, swimming pools, toilet seats or from sharing cups, plates or cutlery.

Testing for genital herpes

You can only have a check-up for herpes when you have, or start to develop signs or symptoms. The doctor or nurse may be able to diagnose genital herpes by looking at the affected area but they will need to confirm this by taking a swab of fluid from the blisters in the affected area.

This involves:

  • Brushing a swab (similar to a cotton bud) over the blisters
  • It may sting a little but shouldn’t be painful
  • The swab will be sent to a lab for testing
  • You will normally get your result within one to two weeks.

Genital herpes testing is free and you can get one at Brook services, GUM or sexual health clinics or at some GP surgeries. Find your nearest using our find a service tool.

Cervical smear tests and routine blood tests will not detect herpes.

Treatment of genital herpes

Genital herpes will clear by itself however, seeking treatment early can significantly reduce the time the outbreak lasts and can help the healing process. It also reduces the risk of you passing it on to someone else.

You will be given antivirals which work by preventing the virus from multiplying but it does not clear the virus from your body completely.

Treatment is usually started within five days of the start of the first outbreak. Treatment involves taking antiviral tablets daily for five days. There are various types of antivirals that may be prescribed, common ones include aciclovir, famciclovir and valaciclovir.

INFORMATION

Antibiotics will not work because genital herpes is a virus not a bacteria. The treatment you buy for oral cold sores will not work either.

Some people find that another course of antivirals helps with further outbreaks. For people who have multiple outbreaks (usually more than six a year), they may be given longer courses of medication. This is known as suppressive treatment. This means taking antiviral medication for a longer time period.

Things you can do to help

Antivirals are only designed to stop the virus multiplying and will not help your discomfort in the short term. For this, there are a few simple things you can do to ease the discomfort and speed up the healing process:

DOS

  • Apply an ice pack or ice cubes in a plastic bag (do not apply ice directly to skin)
  • Take a cool shower to soothe the blisters
  • Apply a local, over-the-counter anaesthetic cream such as lidocaine
  • Gently bathe the area with warm salt water (dilute one teaspoon to one pint of water)
  • Carefully pat the area dry
  • If weeing is painful, go to the toilet in a warm bath or shower
  • Wash your hands before and after touching the infected area to avoid introducing bacteria
  • Keep hydrated and drink extra fluids
  • Wear loose, cotton clothing
  • Use an over-the-counter painkiller to help with pain and discomfort

DON’TS

  • Don’t wash too often

WARNING

It is strongly advised that you do not have any sexual contact before or during an outbreak and for a week after your symptoms have completely gone.

The antivirals are safe to use with hormonal contraception (like the pill, patch, injection or implant) but talk to the person prescribing the treatment to make sure.

Genital herpes can be safely treated during pregnancy. It is important to discuss with your midwife if you have, or have had, herpes infections. The treatment you receive may depend on whether it is your first herpes infection and also where in the pregnancy you are but your midwife will advise you.

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