What is it?
Genital herpes is caused by one of the herpes simplex viruses (HSV). There are two types, HSV-1 and HSV-2. Both types can infect the genital and anal area (genital herpes), the mouth and nose (cold sores) and fingers and hand (whitlows). The virus can enter the body through small cracks in the skin or through the moist soft linings (mucous membranes) of the mouth, vagina, rectum, urethra and under the foreskin.
Following an infection by the herpes simplex virus, some people will experience an outbreak of genital herpes. The virus then becomes dormant (inactive) but it remains in the area of the body where you were infected. In many people, the virus will become active again from time to time and cause further outbreaks of genital herpes. These are known as recurrent outbreaks
How do I get it?
Genital herpes is passed from one person to another during sex. Anyone who’s sexually active can get the virus and pass it on. Herpes simplex is most likely to be passed on just before, during or straight after an outbreak.
Genital herpes can be passed on:
- from one person to another during vaginal or anal sex, or by sharing sex toys
- by direct genital contact – you don’t need to have penetrative sex (vaginal or anal)
- by skin to skin contact with the affected area during sex, if the virus is active on the skin outside of the area protected by a condom or dam (a latex or plastic square)
- if you receive oral sex from someone who has a cold sore or is just about to get one
- if a person with an active herpes sore on the hand or finger touches a partner’s vagina, genitals or anal area.
If you’re pregnant it’s possible to pass the virus to the baby if you’re having your first outbreak at the time of giving birth.
If you already have one type of herpes simplex virus it’s still possible for you to get the other type although you may not notice symptoms.
You can’t get genital herpes from hugging, sharing baths or towels, from clothing, from swimming pools, toilet seats or from sharing cups, plates or cutlery.
Signs and Symptoms
Many people won’t have any visible signs or symptoms at all, or won’t be aware of them. Some people will get symptoms within 2-14 days of coming into contact with the virus. In others, the virus may be in the body for several weeks, months or years before any signs or symptoms appear. So if you do get symptoms it doesn’t necessarily mean you’ve only just become infected.
If you do get signs or symptoms, they usually follow a pattern.You may feel generally unwell with flu-like symptoms, which might include fever, tiredness, headache, swollen glands, aches and pains in the lower back and down the legs or in the groin. This may be followed by:
- stinging, tingling or itching in the genital or anal area
- discharge from the vagina
- discharge from the urethra (tube where urine comes out)
- small, fluid-filled blisters which could be in the genital or anal area, on the buttocks, or at the top of your thighs; these burst within a day or two, leaving small, red sores which can be very painful
- pain when passing urine (peeing) caused by urine flowing over the sores.
In many cases, a doctor or nurse may diagnose herpes by looking at the affected skin and can only tell if you have the virus if you have signs or symptoms of Herpes. They’ll want to confirm this by taking a swab of fluid from the infected area, if they can. The swab will be sent to a laboratory. The result will usually be known within 1–3 weeks. A swab looks a bit like a cotton bud but is smaller and rounded. It’s wiped over the parts of the body that could be infected and easily picks up samples of fluid. This only takes a few seconds and may sting for a moment if the blisters and sores are tender. There’s a specific blood test that can be done to look for antibodies to the virus. This isn’t used as a routine test for genital herpes and may not be reliable.
The aim of the treatment is to relieve the pain, and to prevent the virus from multiplying. You cannot stop the virus from being present in the skin.
- Treatment is recommended when you have the first outbreak as this may provide some relief.
- Treatment is usually started within five days of the start of the first outbreak and while new blisters or sores are still forming. You take antiviral tablets daily (usually two or three times a day) for five days. There are several different antiviral tablets that can be used.
- As genital herpes is caused by a virus and not bacteria, antibiotics won't help.
- Some people find it helpful to take antiviral treatment when they get another outbreak of genital herpes. These need to be started as soon as the outbreak begins and are usually taken for 1–3 days.
- People who have repeated outbreaks (usually more than five in a year) may be given a long course of the tablets to reduce the number of outbreaks. This is known as suppressive therapy. It also reduces asymptomatic shedding and for most people, it stops outbreaks completely, while you’re taking the tablets.
- If you're pregnant or trying to get pregnant, tell the doctor or nurse so they can talk to you about pregnancy and herpes simplex. If you have an outbreak of herpes in pregnancy it can be safely treated.
- The treatment you can buy for facial cold sores isn't suitable for genital herpes.
Further Guidance: Genital Herpes