Genital Herpes

What is genital herpes?

Genital herpes is a common sexually transmitted infection (STI) caused by the herpes simplex virus (HSV). There are two types of herpes simplex virus.

• HSV-1 (type 1) - this is the virus that most commonly causes cold sores on the lips or face. Up to 80% of Australian adults carry HSV-1
• HSV-2 (type 2) - this is the virus responsible for most genital herpes and is most commonly passed on through sexual contact

Approximately one in eight sexually active Australians has genital herpes.

How do you get genital herpes?

Genital herpes is passed on through close skin-to-skin contact. It can sometimes be spread even when the person with the infection has no symptoms of the virus (no blisters or sores). HSV can also be passed on during oral sex from cold sores on the mouth to the genital area. The virus enters the body through small cracks in the skin or through the soft lining of the mouth, vagina, anus, urethra (the urine passage) and under the foreskin.

Genital herpes is most infectious from the first signs of sores developing (including tingling and numbness) until the scabs have gone. You cannot pass genital herpes on or catch it unless you have skin-to-skin contact with the infected area.

Genital herpes can be inactive in the body for a long time, and many people do not realise they carry the virus. This means that you may never know who you caught genital herpes from. Genital herpes can occur even in a long-term monogamous relationship and does not mean that you or your partner has been unfaithful.

How can I protect myself or my partner from genital herpes?

The best way to prevent getting genital herpes and other STIs is to have safe sex.

• use a condom every time you have vaginal, oral or anal sex to stop you catching or passing it on (even if you don't have any symptoms)
• avoid skin to skin contact with someone if you notice blisters on their genitals, mouth or anus
• sometimes people take antiviral therapy to help stop passing the virus on - you can talk to your doctor about this in more detail
• you cannot catch genital herpes from hugging, sharing baths or towels, from swimming pools, toilet seats or from sharing cups, plates or cutlery

What are the symptoms of genital herpes?

Most people who have herpes have mild symptoms or no symptoms at all, but some people are badly affected.

Symptoms vary from person to person, but the classic symptoms of genital herpes are:

• stinging or tingling in the affected area
• small fluid-filled blisters which usually burst within a couple of days, leaving small painful red sores

Blisters, cracked skin or a rash are found in areas where there is skin-to-skin contact during sex, on the penis in men and on the labia, clitoris and vulva in women. Infections can also occur in the anus or on the buttocks and inner thighs.

The first outbreak of genital herpes can be the worst, with flu-like symptoms such as fever, headache and swollen glands and sometimes difficulty passing urine. Episodes after the first one are usually milder and clear up more quickly.

HSV-1 tends to be associated with less severe and less frequent episodes compared to HSV-2. Episodes can last for 7-10 days. Most people find that episodes tend to become milder and less frequent over time, and many people will eventually have no symptoms at all.

How do I get tested for genital herpes?

There are treatments for genital herpes and its symptoms, but there is no cure. Although the sores heal, the virus stays in the nerves of the infected area of your skin and you can have more outbreaks. A first episode of genital herpes is usually treated with antiviral tablets prescribed by your doctor. It is best to start these within 72 hours of the symptoms starting to help clear them quickly.

For most people, the symptoms will come back at least once in their lifetime. When symptoms come back, you may not need treatment if they are mild. If the symptoms return often and severely, your doctor will prescribe antiviral tablets to control them. Antiviral tablets may be taken only at the time of an outbreak, or a low dose taken daily for people who are having frequent outbreaks.

The following measures can help when symptoms are present:

• salt baths up to four times daily
• local anaesthetic gel – pat on gently, do not rub
• sitting in warm water (e.g. bath) to pass urine if painful
• simple pain relief medications if needed (e.g. paracetamol or ibuprofen)

What about pregnancy and genital herpes?

Having herpes will not affect your chance of getting pregnant - it has no effect on fertility. Herpes which has come back during pregnancy or a first outbreak before 34 weeks gestation usually causes no problems. Tell your obstetrician that you have had herpes, so that they can monitor you for any outbreaks and advise on whether to take antiviral tablets and whether to have a vaginal or caesarean delivery. Most women in Australia with genital herpes have vaginal deliveries.

For more information

Family Planning NSW Talkline – www.fpnsw.org.au/talkline or 1300 658 886
National Relay Service (for deaf people) – 13 36 77
TIS National's interpreting service – 131 450
Visit your nearest Family Planning NSW clinic – www.fpnsw.org.au/clinics
NSW Sexual Health Infolink – www.shil.nsw.gov.au or 1800 451 624