Genital Herpes

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

Local symptoms in and around genitals or buttocks include:

• Small blisters, ulcers or sores
• Painful urination
• Unusual vaginal discharge
• Unusual discharge from the urethra
• Extreme or severe painful urination (Dysuria) when sores and ulcers are at the tip of the penis

Although rare, swelling of the whole penile shaft can occur. Scabs and scarring may form as a result of the ulcers and blisters healing.

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)

Genital herpes sores typically go through several stages as they develop. The first outbreak is usually the most severe and often starts with flu-like symptoms, including fever, body aches, and swollen lymph nodes in the groin area. These symptoms are followed by itching, tingling, or burning sensations in the genital area.

As the virus becomes active and starts to replicate in the skin cells, the affected area may become red, swollen, and tender. Small, fluid-filled blisters begin to form and are often grouped together and can be very painful.

The blisters will eventually rupture or break open, releasing the fluid inside. This results in the formation of shallow, painful ulcers or sores. These sores can be quite uncomfortable, making activities like urination and sexual intercourse painful.

After a few days, the ulcers start to crust over and develop a scab. This is a sign that the body's immune system responds to the infection and works to heal the sores. The scabs gradually fall off over the next week or two, and the sores heal. During this time, the skin may be sensitive and tender.

It is important to note that not everyone with genital herpes will experience all of these stages, and the severity of symptoms can vary widely from person to person. Additionally, subsequent outbreaks of genital herpes (if they occur) tend to be milder and shorter in duration compared to the initial outbreak.

It is very common for individuals with Genital Herpes to not develop any symptoms. Only about a third of individuals will develop symptoms that may be mild, or appear months or even years after transmission.

Several factors can trigger genital herpes outbreaks, such as:

• The first half of your menstrual cycle
• Surgery on your genital area
• Stress
• Being ill
• Weakened immune system (e.g. due to chemotherapy treatment)
• Drinking alcohol
• Smoking
• Friction in your genital area (e.g. tight clothes or sex)
• Ultraviolet light (e.g. tanning beds or sunbathing)

Yes. The severity of symptoms and the frequency and duration of an outbreak can vary from person to person. Some patients may notice painful sores that last a while, whilst others may notice mild itching and discomfort that clears up within a few days.

Genital herpes is different for each person. The signs and symptoms may recur, on and off, for years. Some people experience numerous outbreaks 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 less painful than the original outbreak, and sores heal more quickly.

When symptoms of genital herpes (or any herpes type) are present, it is vital to abstain from all forms of sexual activity, including oral, anal, and vaginal sex, as well as any kind of skin-to-skin contact, such as humping.

Engaging in sexual activity during a symptomatic phase not only significantly raises the risk of transmitting the virus to your sexual partners but can also intensify your discomfort and pain due to the sensitivity of the affected area.

It is essential to be aware that even with condom use, herpes can still be transmitted to your partners. This is because the virus spreads through direct skin-to-skin contact with open sores or ulcers.

Here are some conditions that can mimic genital herpes symptoms:

• Yeast Infections (Candidiasis): Yeast infections are caused by an overgrowth of Candida fungi, typically Candida albicans. Symptoms include itching, burning, redness, and a white, cottage cheese-like discharge. While yeast infections primarily affect women, they can also occur in men.
• Bacterial Infections: Various bacterial infections, such as folliculitis, can cause redness, pain, and pimple-like bumps in the genital area. These infections are typically treated with antibiotics.
• Contact Dermatitis: Contact dermatitis occurs when the skin reacts to irritants or allergens, leading to redness, itching, and sometimes blistering. Exposure to certain chemicals, soaps, or latex can trigger contact dermatitis in the genital area.
• Syphilis: Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum. Early syphilis can present with genital sores that may resemble herpes sores. However, syphilis sores often differ in appearance and characteristics.
• Irritation or Chafing: Sometimes, simple irritation or chafing due to clothing or friction can lead to redness, discomfort, and small sores in the genital area.
• Other Skin Conditions: Various skin conditions, such as eczema or psoriasis, can affect the genital area and cause itching and redness.
• Allergic Reactions: Allergic reactions to products like lubricants, condoms, or topical medications can lead to localised skin irritation.

It is crucial to seek medical evaluation and testing for an accurate diagnosis. If you suspect you have a genital herpes outbreak or experience any unusual symptoms in the genital area, it is advisable to consult a clinician for evaluation and guidance.

Genital herpes can be caused by two types of herpesviruses - herpes simplex virus type-1 (HSV-1) and herpes simplex virus type-2 (HSV-2).

HSV-1 usually causes oral herpes (known more commonly as a cold sore) and can be caused by non-sexual contact with saliva, such as kissing, when a cold sore is present in the mouth. Oral herpes can be spread to the genitals by receiving oral sex from someone with a cold sore.

Several factors can increase the risk of getting genital herpes, such as:

• Having unprotected sex, particularly vaginal, anal, or oral sex, with a partner experiencing an outbreak. Condoms and dental dams can reduce the risk but do not eliminate it entirely.
• Having multiple sexual partners.
• Having sex with a partner who is experiencing an outbreak.
• Engaging in oral sex with someone who has a cold sore on their mouth.
• A weakened immune system can increase the risk of herpes outbreaks and transmission.
• Having skin-to-skin contact with the infected area, even if there are no visible sores. This is known as asymptomatic shedding.
• Sharing personal items like razors, towels, or utensils with an infected person can increase the risk of transmission, especially with oral herpes (HSV-1).
• Pregnant women with genital herpes can pass the virus to their babies during childbirth, resulting in serious complications. In such cases, doctors may recommend a Caesarean section to reduce the risk of transmission.

Yes. Herpes can be passed on through skin-to-skin contact. Even if a condom protects your genitals, you risk transmitting or acquiring herpes due to the close skin contact that occurs during sex.

Yes, it is possible to contract genital herpes through oral sex. HSV-1 can be transmitted to the genital area through oral-to-genital contact, resulting in genital herpes.

It is difficult to say who gave you genital herpes. Symptoms may be mild or not appear for months or years after transmission, making it hard to pinpoint the source.

The best way to prevent genital herpes is to avoid intercourse or any sexual skin-to-skin contact if either partner has an outbreak of herpes in the genital area or anywhere else.

Genital herpes during pregnancy is easily acquired due to a compromised immune system. If you have genital herpes and you are pregnant, it is essential to speak to your midwife or doctor as genital herpes can easily be transmitted to the child during a vaginal birth. In extreme cases, herpes can affect the eyes, brain and lungs. This requires specialist care.

When herpes is effectively managed, most people can live a normal, healthy lifestyle.

If you are diagnosed with herpes, you will have herpes for the rest of your life. However, it can be effectively managed with the right medications.

The most effective method to prevent outbreaks from returning is by consulting your clinician about suppressive therapy. Suppressive therapy works by keeping the herpes virus dormant within your body. You can also maintain a healthy lifestyle and diet which helps keep your immune system healthy and lowers the chances of frequent herpes outbreaks.

The most significant concern over herpes during pregnancy is transmission to the baby. If you have active sores during delivery, the virus can be passed to your baby during a vaginal birth. This is known as neonatal herpes and can be life-threatening for your baby. In this situation, your midwife or doctor will suggest having a caesarean section.

If you do have herpes while you are pregnant, speak to your midwife or doctor regarding suppressive therapy and whether you are eligible.

Your children should not get genital herpes, as genital herpes is passed on through sexual intercourse.

Individuals with genital herpes are allowed to donate blood if they are not experiencing an active outbreak. Here are key points to consider:

1. Active Outbreak: Do not donate blood during an active outbreak to avoid potential virus transmission.
2. Medications: If you use antiviral medications, discuss this with the donation centre staff, as they may have specific guidelines regarding donation eligibility.
3. Donor Screening: Be honest during the screening process about your health, medical history, and recent infections as this helps to ensure the safety of the blood supply.
4. Deferral Period: Some centres may have a temporary deferral if you have had a recent outbreak.

Contact your local donation centre for their specific policies as guidelines may change over time.

According to the World Health Organisation, no vaccines are currently available for the Herpes virus. However, research in the field of herpes vaccines is ongoing, and clinical trials are being conducted to develop vaccines for both herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2).

Genital herpes is primarily caused by two types of herpes simplex viruses: herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). While these viruses are commonly associated with genital herpes (HSV-2) and oral herpes (HSV-1), the virus can infect other areas of the body through a process known as autoinoculation.

For example, if someone touches their sores during an active genital herpes outbreak, and then touches another area of their body (such as their eyes), this can cause the herpes virus to spread to their eyes. This is relatively rare. The virus is most contagious during active outbreaks when sores or blisters are present, but it can also be shed from the skin even when no symptoms are visible.

It is important to note that whether sex is protected or unprotected, the risk of herpes transmission remains the same due to skin-to-skin contact. However, it is advisable to abstain from all sexual activity during an active outbreak. Exploring HSV suppressive therapy is an option worth considering if you are worried about frequent outbreaks.