Genital herpes

Genital herpes is a common viral infection. It can cause painful blisters on and around the genitals.

How do you get genital herpes?

Genital herpes can be easily passed on even when there are no symptoms or visible signs of infection.

It can be passed on:

  • by skin-to-skin contact with an infected area, including oral, vaginal or anal sex

  • through small cracks in the skin, or through the mouth, vagina, rectum, urethra (the tube we pee through) and under the foreskin

  • by sharing sex toys with someone who has the virus

It’s caused by the herpes simplex virus (HSV). There are two types of HSV, type 1 and type 2. Both types can cause genital herpes or cold sores around the mouth.

Many people with the virus will have caught it during childhood, as it’s easily passed on through saliva or close skin contact.

But you cannot get genital herpes from sharing baths or towels, swimming pools, toilet seats or cups, plates or cutlery. The virus dies quickly when away from the skin.

The virus will not pass through a condom. But as condoms do not cover all of the genital area, it's possible to infect genital skin that is not covered.

If you already have one type of HSV it’s still possible to get the other type.

Getting tested for genital herpes

You can only be certain you have genital herpes if you take a test while you can see blisters or sores.

You can visit a sexual health clinic or your GP. A clinician can take a swab sample if you have ulcers or blisters. Once you have a diagnosis, the clinician will be able to offer you advice for managing outbreaks.

Symptoms of herpes

Not everyone who has the virus will get symptoms. Many people do not know they’re infected. Only 10-20% of people who carry the infection will have been diagnosed, even though the World Health Organisation (WHO) estimates that 69% of women and 61% of men in Europe carry the type 1 virus.

Some people will get symptoms within 4 or 5 days of coming into contact with the virus. Others may have it for weeks, months or possibly years before they get symptoms.

Getting symptoms for the first time doesn’t automatically mean you’ve only just come into contact with the virus.

If you do get symptoms, they can be mild or severe. You may get:

  • flu-like symptoms such as fever, tiredness, headache, swollen glands, aches and pains in the lower back and down the legs or in the groin

  • stinging, tingling or itching in the genital or anal area

  • small, fluid-filled blisters anywhere in the genital or anal area, on the buttocks and on the tops of the thighs (these burst within a day or two leaving small, red sores which can be very painful)

  • pain when peeing, caused by urine touching the sores

The first outbreak of sores is often the worst. Usually, they’re milder when they recur and clear up more quickly (in about a week). You may experience, on average, 4 outbreaks a year. And that’s likely to reduce over time.

If you have symptoms of herpes, you may want to visit your GP or local sexual health clinic, especially if you’re in pain.

If you’re pregnant and have symptoms of genital herpes, it’s important to let your doctor or midwife know.

How to avoid genital herpes

Using condoms reduces the risk of contracting all sexually transmitted infections including genital herpes.

You can get free condoms at sexual health clinics.

Genital herpes can be passed on even when there are no symptoms. But the blisters and sores are highly infectious, so if you or a partner have cold sores or genital herpes:

  • avoid kissing when you, or a partner, have cold sores around the mouth

  • avoid oral sex when you, or a partner, have mouth or genital sores

  • avoid any genital or anal contact when you, or a partner, have genital sores or blisters, or if you feel an outbreak starting (many people can feel a tingling or itching before a blister – called a prodrome – appears)

Regular testing helps reduce the spread of STIs. We recommend you test at least once a year. If you regularly have sex with new partners, we recommend testing every 3 months.

Is herpes serious?

Any sexually transmitted infection could become serious if it’s left untreated. But it’s rare for genital herpes to cause any long-term health problems.

Outbreaks can get worse or happen more when your immune system is weaker. Your system can be less able to keep the virus under control when you feel ill or run down, or when you’re pregnant. It’s important to tell your midwife or doctor if you get signs of genital herpes during pregnancy.

Treatment for genital herpes

Once you have the virus, it remains in your body. There’s no cure that clears it. But there are treatments to help to manage outbreaks and relieve the symptoms.

Many people have very few outbreaks and will not need treatment at all.

Some people can take antiviral medicine designed to reduce the length and severity of outbreaks. This is usually a short 5-day course of tablets. It only works if you start it within 48 hours of the blisters forming, or while new blisters are still forming.

Over-the-counter painkillers like paracetamol may be enough to help while ulcers heal. You can also:

  • use an anaesthetic gel or cream such as lidocaine to numb the skin where the sores are and ease pain

  • apply vaseline to sores to keep them moist and less likely to stick to clothing

  • avoid overwashing, as this can cause irritation and delay healing (once a day is enough)

  • if peeing is painful, try weeing in the shower or pouring warm water over the sore area when you pee

  • if you cannot pee, it’s important to see a healthcare professional straight away.

Some people use longer ‘suppressive’ treatment courses if they’re:

  • getting repeated, severe outbreaks (usually more than six in a year)

  • with a new partner and want to reduce the chances of passing the infection on

  • in late pregnancy, to avoid passing infection on during birth

The treatment you can buy for facial cold sores is not recommended for genital herpes. Treatments applied to the skin (topical treatments like creams or gels) are less effective than oral treatments.

Telling your sexual partners

If you’ve had a new diagnosis of genital herpes, you should tell your partner.

Genital herpes is most likely to be passed on just before, during or after an outbreak so you should not have sex during these times. But even when you do not have symptoms, there’s still a small risk you can pass on the virus to a partner. Using a condom can lower the risk further.

You might not need to tell previous partners but if you’re unsure, it may help to talk with someone at your local sexual health clinic.

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