Genital Herpes

It's a virus so there is no cure for genital herpes, however, it can be managed. There are two types of herpes virus – the HSV 1 and HSV 2. Genital herpes is caused by both types. Although the main symptoms of genital herpes are sores and blisters, it's not always possible to identify if a partner has it when the virus is dormant.

It's estimated that one out of every eight Australians has genital herpes. 85% of Australians carry HSV 1, the type that usually produces cold sores but can transfer to the genitals via oral sex, and 20% have HSV 2 the virus that affects the genitals.

It's more common in women, although this may be because more women seek treatment than men. Younger Australians are more likely to have HSV and it's more common in urban areas.

When you contract genital herpes the symptoms don't always appear straight away. It can take months for blisters to appear. Some people develop symptoms within four to seven days after contact with an infected partner.

The main symptoms are:

• Blisters around the vagina, penis, rectum, thighs and buttocks. These can burst leaving painful open sores
• Pain when urinating
• Feeling generally unwell with flu–like symptoms
• Women may develop ulcers or blisters on their cervix and experience vaginal discharge
• Tingling, burning or itching on the genitals

Genital herpes are not always present. They tend to appear in waves. You may only experience a few outbreaks each year. Usually, the first outbreak is the most painful or disruptive. It can take twenty days for the first outbreak of symptoms to heal.

Many individuals notice early warning signs before an outbreak of genital herpes. There may be a tingling or burning feeling in the genital area or in the legs as the virus travels along the nerves where it usually lies dormant. This can give you the time to arrange treatments.

Usually following outbreaks are shorter and less severe in terms of blistering as your immune system tries to fight off the infection. Later outbreaks become less painful, which may be of comfort to individuals experiencing their first painful outbreak.

Long-term effects of genital herpes

No-one knows how many outbreaks you may experience over a lifetime, but good management can reduce their severity. The average rate is four to five times in the first two years.

Genital herpes, whilst being painful, can also cause psychological issues. Living with an incurable STI can cause anxiety and depression. If you find yourself feeling stressed, tearful, upset or worried about genital herpes you can find support from your doctor or herpes nurse. Online forums are also good sources of psychological support. Sharing your experiences with others can help you feel less isolated.

Unprotected sex is the main cause of genital herpes. It's spread through skin contact so a condom, whilst helping to reduce the risk, won't always protect you. The virus can spread even when there are no symptoms. Skin-to-skin contact can transfer the herpes virus to any open or moist skin.

Although the HSV1 virus usually causes cold sores on the mouth, it can lead to genital herpes through oral sex. Using a dental dam or opened condom can reduce this risk significantly.

Causes of HSV-1 herpes - HSV 1 is spread through kissing, sharing toothbrushes and razors. Giving a person infected with genital herpes oral sex can lead to cold sores.

Causes of HSV-2 herpes - Genital herpes is spread via the genitals. It's more common when blisters are present but can happen at any time.

Once the herpes virus has been contracted it's not possible to eliminate it, but you won't always have blisters and pain. The virus will retreat into a dormant phase. It can be reactivated and flare up for certain reasons.

It's not known exactly why herpes flares up but some suggested causes are stress, being ill, UV light, excessive alcohol, having a weakened immune system or genital friction.

It is straightforward to diagnose herpes when blisters, sore and scabs are present. Try to see your doctor or STI clinic when you have symptoms so you can have treatment immediately.

Herpes tests are done with a swab by your doctor or clinic. This is usually a large cotton wool bud or a looped instrument. The test doesn't hurt and is done quickly. The swab collects fluid from a blister that can be diagnosed in a laboratory.

Symptoms can last up to twenty days but will eventually heal by scabbing over.

Currently there is no cure, but over time the symptoms will lessen in severity. Antivirals are successfully used to manage outbreaks of herpes. The sooner you can start taking antivirals the better the outcome.

The first outbreak is usually the most painful. You may be prescribed antivirals that are taken five times a day. These antivirals suppress the virus and stop it multiplying.

Following outbreaks can often be managed with self-help, but if they are particularly painful or severe an antiviral can be prescribed. If you experience multiple outbreaks in a year, usually more than six, you may be prescribed long-term antiviral medication to suppress the virus. This can work very successfully, reducing the severity of outbreaks of genital herpes.

Self help remedies include:

• Icepacks to relieve pain
• Washing with salt water to stop blisters sticking
• Using Vaseline to cover blisters
• Drinking fluids to reduce the acidity of urine
• Avoiding tight clothes that rub
• Using a pain relieving cream

Episodic treatments for less than six outbreaks a year may be prescribed. This is generally a course of antivirals to prevent HSV multiplying. Suppressive treatment can be taken long term if you have more than six outbreaks a year. Suppressive treatment seeks to prevent outbreaks rather than contain them.

Where to get treated

If you develop genital herpes getting treatment will help you cope with outbreaks which can be painful and distressing. Treatment also reduces the amount of time you have open sores.

Your doctor can help you manage genital herpes, and your local STI clinic will have nurses with experience in managing the condition. Don't be afraid to ask for help, genital herpes is a common condition experienced by many.

If you get the treatment you are less likely to pass the virus onto your partner. There is less chance of it spreading when the virus is dormant, reducing the amount of time you have visible blisters also helps with the psychological aspects of genital herpes.

If you are pregnant you must seek treatment. Herpes can lead to pregnancy and birth complications. If you contract herpes when you are pregnant it can lead to miscarriage in some cases. Always protect yourself with condoms and dental dams.

It is possible to buy herbals remedies over the counter to help the symptoms of genital herpes, but these are not clinically proven and should be used with caution. If they soothe blisters they can be helpful, but remember that genital herpes is not curable and the only way to manage them successfully is with antiviral medications.

Preventing genital herpes

All sexually active adults are at risk of transmitting and contracting herpes. A man or women does not need to ejaculate or exchange fluids in order to pass on or pick up an infection.

Here are some ways to protect yourself in future:

• Always use a male or female condom
• Use a dental dam for oral sex
• Do not share sex toys
• Get regular screenings to ensure you are STI free
• Limit your number of sexual partners
• Seek immediate treatment if you think you have an STI

Genital herpes is incurable but it can be managed to minimise symptoms and improve your quality of life. Follow the self-help measures and use antivirals if you need them.