Genital herpes

What is genital herpes?

Similar to oral herpes, genital herpes is characterised by an initial infection followed by recurrent outbreaks of symptoms. Once infected, the virus stays dormant in your nerve cells for the rest of your life. It can be reactivated by stress, fatigue, hormonal changes, or immune deficiency and so recurrent outbreaks of symptoms are common. The frequency of these will vary from person to person. 

What are the symptoms of genital herpes?

For the first episode of genital herpes, symptoms are only present in one-third of cases. Symptoms begin with small, red, painful blisters that appear around the genitals, anus or bottom. These blisters can then form ulcers with a white crust and can take several weeks to heal. The first outbreak of herpes can be extremely painful and is also associated with flu-like symptoms (e.g. fever, a runny nose) and problems peeing. 

Subsequent outbreaks typically start with a burning, tingling or itching sensation in the affected area. These symptoms can appear several hours before blisters start to appear. These outbreaks tend to be less painful and heal faster in only 7-10 days. 

Genital herpes and pregnancy

If you get genital herpes in the third trimester of pregnancy (week 28 and onwards), there’s a risk your baby could also develop herpes during the delivery. The infection is typically transmitted to the baby via direct contact with the sores during labour. A herpes infection in a baby is serious; it can cause severe brain damage or even death if it is widespread. 

There are things you can do to avoid your baby from getting an infection. For example, genital herpes can be treated with antiviral therapy during pregnancy. A caesarean section is also recommended in some cases in order to reduce the chances of transmission.  

What causes of genital herpes?

Both HSV1 and 2 can cause genital herpes. HSV1 is also responsible for oral herpes.

How do you pass on genital herpes?

Transmission mode

HSV1 and HSV2 are highly contagious viruses. They’re spread via contact with the skin or mucous membranes of a person infected with the virus. This means that sexual contact is one of the most common modes of transmission. Asymptomatic people can also pass on the virus so it can be hard to know if you are infectious or not. 

Recurrent herpes infection 

During your first infection, the virus enters the body and travels along sensory nerve endings and remains in your nerve cells permanently. Later on, external triggers like fatigue, stress, changes in hormones, or a weakened immune system can reactivate the dormant virus. The virus can then travel back along sensory pathways to your skin, where it can start rapidly reproducing and cause sores to develop. 

Risk factors for HSV2 infection

Risk factors for an infection include:

•  Having sex at a younger age

• Having a history of sexually transmitted infections

• Having multiple sexual partners

How are genital herpes treated?

The first time you get genital herpes, you’ll be advised to take oral antiviral medicine for between 5 to 10 days. It’s important tp start treatment within 5 days of getting the sores. You’ll also be advised to take pain relief This includes cleaning the sores with soap and water and then drying the area thoroughly so that bacteria doesn’t infect the sores. You might be advised to see a specialist in sexual health so that other STI infections can be tested for. 

Self help measures can be useful in recurrent episodes. It may help to use topical anaesthetic cream and painkillers to ease any pain. It is important to keep the sores clean and try and reduce the virus spreading by avoiding sharing towels with others. 

If self help measures are not effective then the outbreak can be treated with oral antiviral medicine for 5 days. For best results, these treatments should be started within 48 hours ofhe first symptom appearing. That’s why your doctor may give you a prescription for antivirals to be used if you have a future outbreak. If you have more than 6 outbreaks a year, you may benefit from a preventative treatment with oral antivirals.

When genital herpes is diagnosed, you’ll be offered screening for other STIs.

How to prevent genital herpes

While herpes is highly contagious, there are some things you can do to protect against infection. These include:

• Washing your hands after touching any sores

• Avoiding sex during an outbreak

• If you’ve had genital herpes, using a condom during sex when you’re not having an outbreak to avoid the chances of asymptomatic transmission.

When should you get medical advice?

You should seek medical advice as soon as you notice symptoms such as burning and tingling, rather than waiting for blisters to appear. 

Get medical advice urgently if:

• You’re pregnant

• Your outbreaks are worse than usual

• You have a high temperature

• You have a weakened immune system or are immunosuppressed 

What can Livi do for you?

Our online doctors can help you if you have genital herpes, and can give you a prescription for your treatment if it is clinically needed. They will also be able to help you with screening for other sexually transmitted infections. 

If you have any atypical symptoms or are immunocompromised, they will refer you for a face-to-face consultation.