Genital herpes is generally considered to be a sexually transmitted infection, because it is more frequently transmitted through sexual contact.
At least 8 out of 10 people who carry the virus are unaware that they do, due to the lack of initial symptoms. Genital herpes is common in the UK and in 2013 alone, 32,000 people attended a clinic with the first clinical attack of herpes.
Symptoms sometimes do not appear for some time after you contract HSV (months or sometimes years). If you do notice symptoms when initially infected, these will occur 4 – 7 days after initial exposure to the virus. This is known as primary infection, and symptoms these tend to be more severe than those of recurrent infections.
The symptoms of a first-time outbreak of genital herpes include:
- Flu-like symptoms, including aches, pains, fever, and a general feeling of being unwell
- Small, red or clear blisters that eventually burst open, leaving red, open sores (these can appear on the genitals, anus, thighs or buttocks)
- Blisters or ulcers on the cervix
- Vaginal discharge
- Pain on urination (dysuria)
These initial symptoms can last up to 20 days. The sores will eventually scab and heal without scarring.
A recurrent outbreak of genital herpes will be shorter and less severe than the initial reaction, as your body has produced antibodies to fight the infection. Symptoms in this case last for around 10 days and may include:
- A tingling, burning or itching sensation around your genitals, and sometimes down your leg, a day or few days before blisters appear
- Painful blisters that burst open, leaving sores around the genitals, rectum, thighs and buttocks
- Blisters and ulcers on the cervix
The treatment for the genital herpes virus (HSV) is different depending on whether it is your first time having symptoms (primary infection), or a recurrent outbreak.
Acyclovir, an antiviral, can be prescribed in tablet form for first-time infections. Acyclovir prevents the herpes virus from multiplying, although it cannot completely clear the virus from your body. These tablets are taken five times per day. Side effects may include nausea, vomiting, or headache. Other antivirals commonly used to treat HSV include famciclovir and valaciclovir.
If you are experiencing recurrent outbreaks, it is advised that you come and speak to a doctor about antiviral tablets, or other methods that may help you to manage your symptoms.
Some helpful ongoing methods for treating mild outbreaks include:
- Wear loose clothing to prevent irritation of the affected areas, and wear cotton underwear to allow the skin to breathe.
- Keep the blisters or sores clean with water or salt water. This will reduce the chance of infection and can help the healing process.
- A cooling pack of ice wrapped in a clean washcloth and applied to the area can soothe the pain.
- Anaesthetic cream such as 5% lidocaine can soothe the pain of blisters and ulcers.
- Drinking plenty of fluids can help to make passing urine less painful.”
The virus lives in the nervous system of the body, and is dormant most of the time, becoming active at different periods. On average, people with HSV suffer outbreaks of sores 4 – 5 times a year for the first two years after being infected, but the virus typically becomes less active in subsequent years, with less frequent and less severe outbreaks. The main symptoms of an outbreak are painful blisters on the genitals and surrounding areas.
There is no fail-safe way to prevent transmission of the virus, the way that there is with other STIs, because barrier methods (condoms) do not work. It is much more likely that the virus will be transmitted when you have an outbreak of sores, so the best way to avoid passing the infection on is to avoid sexual contact altogether during these times.
What to do next
Our sexual health team is here to help you with any concerns about treating an existing case of herpes or diagnosing symptoms. You can book with us online, or give us a call to make an appointment.
It can be hard to tell whether you have the HSV virus because symptoms vary, although the typical presentation is a cluster of fluid-filled blisters on or around the genital area, which develop into sores that heal over several days. Some people may have very mild symptoms, resembling a rash or ingrown hair.
There is no sure-fire way of preventing the spread of the virus except complete abstention from sexual contact, although you will decrease the risk by avoiding intimate sexual contact during outbreaks.
Outbreaks of genital herpes are typically triggered by the immune system coming under pressure, whether due to stress, illness, being ‘run down’, or other factors.