Genital Herpes

Herpes Simplex Viruses (HSV) are a group of viruses which can cause infections that present as small often painful blisters on the skin of the mouth, lips, eyes or genitals. 

They can be categorised as either Type 1 Herpes (Oral Herpes) or Type 2 Herpes (Genital Herpes). Type 1 Herpes can cause sores on the mouth or lips. Type 2 herpes can cause sores or blisters on the genitals or in the genital area. This is not concrete however, as Type 1 can sometimes cause genital herpes.

Of those with the Herpes virus, 67% of the global population under 50 have Type 1 Herpes.

Management Guidelines

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Further Readings

Related Conditions

At a glance

Symptoms
Noticebly appear as lesions in/around the genitalia.

See specific symptoms >

Causes
Herpes is a sexually transmitted infection, caused by unprotected sex.

See specific causes >

Prevalence
In England, 42% of those diagnosed with genital herpes are aged 15-24.

More statistics coming!

Testing & Treatment
Testing and treating of Genital Herpes is painless and straightforward.

Learn more >

Symptoms

What are the symptoms of Genital Herpes?

Primary Genital Herpes Outbreak
During your first genital herpes outbreak, you may experience flu-like signs and symptoms. These may include:

  • Sore throat
  • Swollen lymph nodes in the neck and groin
  • Headaches
  • Muscle ache
  • Fever

Women may develop sores and ulcers on their:

  • Vulva
  • Vaginal wall
  • Cervix
  • Anus
  • Buttocks
  • Upper thighs
  • Lips and surrounding area
  • (and rarely the face)

Men may develop sores and ulcers on their:

  • Foreskin
  • Penile shaft
  • Glans penis
  • Urethra
  • Scrotum
  • Anus
  • Buttocks
  • Upper thighs
  • Lips and surrounding area
  • (and rarely the face)

Men and Women may experience at the site of sores and ulcers:

  • Ulcers
  • Fluid-filled blisters
  • Rawness of the affected area
  • Pain, itching or tingling in the anal or genital area
  • Small red bumps
  • Ulcers and blisters which join together to form a larger area
  • Scabs and scarring may form as a result of the ulcers and blisters healing
  • Swelling and tenderness of lymph nodes in groin

Women may experience:

  • Symptoms which mimic cystitis, a UTI or thrush
  • Sudden increase in copious, thin vaginal discharge (generally due to the presence of ulcers in the cervix and vaginal wall along with ulcers on the external genitalia)

Men may experience:

  • Extreme or severe pain on passing urine when sores and ulcers are at the tip of the penis
  • Rarely there can be massive swelling of whole penile shaft

Can I get Genital Herpes again?

Genital herpes is different for each person. The signs and symptoms may recur, off and on, for years. Some people experience numerous episodes each year. For many people, however, the outbreaks are less frequent as time passes.

During a recurrence, shortly before sores appear, you may feel:

  • Burning, tingling and itching where the infection first entered your body
  • Pain in your lower back, buttocks and legs

However, recurrences are generally less painful than the original outbreak, and sores generally heal more quickly.

Can I have Genital Herpes without knowing it?

Genital Herpes (or cold sores) are caused by the Herpes Simplex Virus (HSV). It is common to speak of a herpes ‘outbreak’ when signs and symptoms present themselves.

Most people infected with Genital Herpes don’t know they have it. This is because the signs of symptoms of HSV are not easily noticeable.

The symptoms of genital herpes can be variable as well as latent.

Symptoms of genital herpes may be variable as some may experience signs and symptoms from 2 to 12 days after exposure, but others may only have an outbreak weeks or months (and even decades) after exposure to the virus.

The fact that many people don’t show signs or symptoms of the virus is because of a property known as latency. This is where the virus is sitting idly inside the body without causing any problems.

What if i’m pregnant and have Genital Herpes?

Please tell your doctor.

Your doctor may recommend that you start taking herpes antiviral medications late in pregnancy to try to prevent an outbreak around the time of delivery. If you’re experiencing an outbreak when you go into labour, your doctor will probably suggest a cesarean section to reduce the risk of passing the virus to your baby.

Complications

Pregnancy
Herpes can be acquired during pregnancy because of an altered immune system.

The third trimester of pregnancy is the most important as the mother can pass on the herpes virus to the child if she has a vaginal birth.

We recommend this to be discussed with your midwife or obstetrician if HSV is suspected or confirmed during this trimester, as a caesarean section may be recommended to prevent passing on the virus to the child.

HIV & Genital Herpes
Genital herpes can be more serious with those living with HIV.

In the most extreme of cases, herpes can affect the eyes, brain and lungs. This requires specialist care.

If you are experiencing symptoms of Genital Herpes, we would recommend getting tested and begin treatment without delay.

Causes

How do I get Herpes Type 1?

HSV-1 is the type of herpes that usually produces cold sores or blisters around your mouth.

HSV-1 is most commonly gotten by anal, oral or vaginal sex. Also via intimate social contact.

HSV-1 is typically spread through skin-to-skin contact and can also be spread from the genital area during oral sex.

HSV-1 is less likely to be the cause of recurrence.

How do I get Herpes Type 2?

This is the type of Herpes that causes genital herpes. Can be common and highly contagious, whether or not you have an open sore.

  • Anal, oral and vaginal sex
  • Intimate social contact

Can I get Genital Herpes even if I use a condom?

You can still get the virus even with condom use, because a condom only covers the penis, and if the virus is in another area you can acquire it without knowing.

Can I get Genital Herpes from sitting on a toilet seat?

Because the virus dies quickly outside of the body, it’s nearly impossible to get the infection through contact with toilets, towels or other objects used by an infected person.

    Can I find out who gave me Genital Herpes?

    Sometimes because symptoms might not appear for months to even years, it might be difficult to determine when you contracted the virus.

    There is a greater likelihood of catching Genital Herpes if you:

    • Are a women
    • Have multiple sexual partners (like with other STIs)

    How can I prevent getting Genital Herpes?

    One of the key ways of protecting yourself against herpes is having protected anal, oral and vaginal sex. However, this cannot guarantee protection because condoms do not provide sufficient coverage of herpetic ulcers.

    • Use, or have your partner use, a latex condom during every sexual contact
    • Avoid intercourse if either partner has an outbreak of herpes in the genital area or anywhere else

    How can I prevent getting Genital Herpes again?

    There are two things that may help in preventing a recurrence of Genital Herpes:

    • Avoid ultraviolet light
    • Friction in your genital area

    However, some other triggers which may cause a recurrence are unavoidable. These may include:

    • Being unwell
    • Having a period
    • Surgery on your genital area
    • A weakened immune system

    Testing

    There are two types of tests available for Genital Herpes (1&2):

    When you have symptoms, we look for the presence of the Herpes virus itself (i.e. Herpes DNA) from the lesions.

    Herpes Swab Test >

    When you want to look for previous exposure, we look for the presence of Herpes antibodies in your blood.

    Herpes Blood Test >

    Treatment

    Method of treatment

    Oral antibiotics

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    Length of Treatment:

    For Outbreak: 5 days
    For Suppressive Therapy: approx. 6-12 months

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    Further actions:

    No sex until blisters disappear
    + salt water bath

    Page reviewed by Dr. Manoj Malu (Clinical Director)

    Last reviewed date: 3 March 2020
    Next review due: 3 March 2023

    Whilst this content is written and reviewed by sexual health specialists, it is for general guidance only. It is not intended to replace the advice of your clinician.

    If you think you may have Genital Herpes

    It is important to refer to a healthcare provider as soon as possible. Our experience combined with timely detection can help put you on the right track without delay and avoid complications in the future.

    Book an appointment >