Topic: Genital Herpes
Description
Genital herpes is a common sexually transmitted infection (STI) caused by the herpes simplex virus (HSV). There are two types of HSV: HSV1 and HSV2. HSV1 is usually found around the lips and mouth and is often referred to as cold sores. HSV2 more commonly infects the genital and anal areas. However, both HSV1 and HSV2 can occur on either the lips, mouth, genital or anal areas, and one person can be infected by both HSV1 and HSV2.
It is estimated that around three-quarters of Australian adults are infected with HSV1, and around one in ten are infected with HSV2. Women are twice as likely as men to be affected by HSV2.
HSV enters the body through the skin of the genitals, mouth and anus, or through tiny cuts and abrasions in the skin anywhere on the body. It lives in the nerves beneath the skin and can remain there, inactive and unnoticed, for many years.
It is not completely understood what causes the virus to reactivate and cause blisters. Some factors that may trigger an outbreak include menstruation (periods), emotional upset and sexual activity. Sunburn can trigger a herpes episode (or cold sore) on the face or lips.
Symptoms
An outbreak of herpes usually occurs in several stages over seven to ten days. Usual stages are:
- a mild tingling or itching, which lasts 12 to 24 hours
- small blisters may form and there may be swelling and redness around the blisters, which may be irritating, painful and sore to touch
- after a couple of days, the blisters break and form shallow ulcers
- the glands in the groin may become swollen and tender
- the ulcers heal, leaving a patch of red or peeling skin for a few days.
If people are exposed to HSV 1 or HSV 2 during sexual or intimate skin to skin contact, there are three possible outcomes:
- Most of the time there will be no signs or symptoms where people will not know that they have the herpes virus and will never experience outbreaks. However, the virus may still be passed on to sexual partners.
- The second possibility is that people will get a primary episode of genital herpes. This can be painful and may make people feel generally unwell. Sometimes people have fevers and pains in their joints (similar to the flu), or painful blisters in their genital area, which then turn into ulcers. The ulcers appear in the vaginal opening or anus, or on the penis or scrotum and it can also be painful to pass urine or a bowel motion. In this situation, it may take more than three weeks for the blisters to heal and other discomforts to completely subside. It is worthwhile to attend a sexual health clinic or to see a doctor as soon as possible after the blisters have been noticed.
- Some people who are infected with the herpes virus will not experience the level of discomfort and illness of the primary episode described above. However, they will notice a smaller outbreak of blisters and irritation in the genital area.
Transmission
The risk of herpes spreading from person to person is high just before, during, and for the week following an outbreak of herpes. This means that even when a person is free of symptoms, the virus can still spread to another person if the infected person happens to be "shedding" herpes virus at the time of sexual intercourse.
Both viruses are passed from one person to another by close body contact. This means that:
- a cold sore on a lip could spread to the genital area of a sexual partner as a result of oral sex
- genital herpes may be passed on to the mouth of a sexual partner through oral sex, causing oral ‘cold sores’ – although this is not very common
- genital herpes can be spread through the rubbing of genital skin during sexual activity.
Treatment
Presently, there is no cure for herpes; however there are antiviral drugs available to treat it. If taken during an outbreak, these medications reduce the duration and severity of a herpes outbreak. If people experience frequent outbreaks of herpes, they may want to consider preventive antiviral drugs, which if taken continuously will stop recurrent outbreaks occurring. Antivirals do not kill the virus though they decrease the amount of virus being produced, therefore decreasing the likelihood of an outbreak as well as the risk of transmission of the virus to regular partners.
During an outbreak of genital herpes, it is also helpful to:
- keep the area as dry as possible
- wear loose, comfortable clothing (like a sarong)
- use anaesthetic gels to help reduce pain (closely monitor the skin as using creams around the genital area can irritate the skin).
- avoid using soap on the affected area, and bathe the area with salt water when lesions are present.
Health Outcome
It isn't possible to predict how often people will have outbreaks. Some people may only ever have one outbreak and others no more that two or three. Only a minority of people have frequent recurrences. Generally, as the years go by the frequency of outbreaks decreases. People with lowered immunity, such as people living with HIV, may incur more frequent outbreaks requiring them to seek preventive treatment from their doctor.
The amount of time between each outbreak of the herpes virus will be different for each person. In general, after an initial outbreak of blisters, each recurrence is less severe and heals more rapidly. Usually a longer period of time passes before the next outbreak.
Prevention
A person with herpes needs to be aware of symptoms of an outbreak to protect partners from infection. However, it is important to note that herpes can be passed on even if there are no symptoms or visible signs of an outbreak on the skin.
To help reduce the risk of transmission:
- ensure that herpes sores do not come into contact with another person
- avoid kissing and oral sex if there are herpes lesions on the mouth or lips
- avoid sex during an outbreak of genital herpes or as soon as they become aware of symptoms.
These suggestions should be followed until one week after the sores have completely gone.
Condoms help to prevent the transmission of herpes. However, because herpes is transmitted by skin to skin contact, transmission can still occur even when condoms are used because the condom may not cover affected areas.
When a person is giving a man oral sex (his penis in their mouth), then condoms should always be used. Also if a person’s mouth is coming into contact with their partner’s anus or vulva, dental dams should always be used by both men and women.
Apart from these factors, it is important to get enough sleep, have a healthy diet and to keep your stress levels manageable.
Help and Assistance
For more information on genital herpes, people can talk to:
- a local doctor
- a local sexual health clinic
- a local family planning clinic.
Other Resources
Queensland Health Sexual Health website
- Animated Movie - Herpes
Related Content
Herpes – can you have a sexual relationship?
Last Updated: 29th March, 2011
Date Valid to: 31st December, 2011
