Genital herpes is a sexually transmitted infection caused by a virus called herpes simplex. It is one of the most common infections in humans (as many as one in six people have the virus). There are two herpes simplex viruses: HSV-1, which is the usual cause of cold sores; and HSV-2. Both can cause genital herpes although most genital infections are caused by HSV-2.
You can get genital herpes by having genital skin contact (vaginal, oral or anal sex) with someone who has the infection. Most transmissions occur when herpes blisters or sores are not present. This can happen in two ways:
- People who have recurrent (repeated episodes of) genital herpes can transmit the virus at the time of or between recurrences.
- Many people exposed to the virus never develop any signs or symptoms of the infection. They may ‘shed’ the virus from time to time without showing symptoms and may transmit the virus to their sexual partner if they have sex at that time.
Herpes affects different people in different ways. Following exposure, some individuals will develop symptoms within two to fourteen days. However, most people have mild or no clinical symptoms of herpes.
The symptoms of the first episode of genital herpes may include a flu-like illness (fever, headache, muscle aches and general feelings of ill health), painful enlarged glands in the groin, pain in the genital area and pain on urinating. Occasionally the pain of urinating can be severe. Redness in the genital area may be noticed first, followed by painful blisters. The blisters occur in crops over about two weeks and burst to leave painful sores. Without treatment the entire episode can last from ten days to four weeks. The first episode will heal without any long term problems.
For most people the first episode is usually more severe than recurrences. However, the frequency of subsequent episodes can vary from one or two to twelve or more episodes a year.
Recurrences generally last only a few days. The symptoms are usually minor, consisting of pain or tingling.
Some individuals have warning symptoms before the actual recurrences. These symptoms may include ‘nerve’ pain in the thigh, buttock or groin, tingling in the area where the sores will develop and general irritability. These usually last 24-48 hours.
With recurrences, the blisters usually last a few hours and then burst to leave ulcers mostly on the external genitalia, thighs or buttocks.
The best way of confirming a diagnosis is to go to your doctor when blisters or sores are present. A specimen will be taken from one of the sores or blisters and sent to the laboratory. Your doctor may also recommend tests to rule out other sexually transmissible infections.
Try to keep the area clean and dry – it will speed up the healing time and reduce the severity and duration of symptoms. Bathing affected areas with a diluted salt solution two or three times a day can provide relief. If the pain is severe, aspirin or paracetamol may be helpful.
Antiviral drugs are available that help to manage genital herpes.
Occasionally, babies will become infected with herpes, but this is rare. It’s important to see your doctor if you have recurrent genital herpes and are thinking of becoming pregnant or are already pregnant, or if you’re pregnant and develop herpes for the first time.