Herpes

There are eight types of human herpes virus. It is the herpes simplex viruses types I and II - known as HSV-1 and HSV-2 - that are responsible for genital herpes. HSV-2 is more frequently transmitted by sexual contact and is one of the most prevalent STDs worldwide.

In general:

HSV-1 infects the mouth, lips or nose, causing cold sores.
HSV-2 infects the genital and anal area.

An estimated 80% of people infected with HSV-2 are not aware they have the virus. This is because genital herpes will often produce mild symptoms or no symptoms at all. Many cases of genital herpes go undiagnosed and many people pass the virus on to their sexual partners without knowing of their infection.

Symptoms

If symptoms do occur, they will usually appear 2 to 7 days after exposure and will last 2 to 4 weeks. Both men and women may have one or more symptoms, including:

headaches
backache
itching or tingling sensations in the genital or anal area.
small fluid-filled blisters that burst leaving small painful sores.
pain when passing urine over the open sores (especially in women).
flu-like symptoms, including swollen glands or fever.

Subsequent outbreaks are usually milder and last for a shorter period of time, usually 3 to 5 days.

How It’s Passed On

Genital herpes is passed on through skin contact with a person infected with the virus, most frequently during sex. The virus affects the areas where it enters the body. This can occur during:

oral sex (HSV-1 or HSV-2)
kissing (HSV-1 only)
vaginal sex
anal sex

Herpes is most infectious during the period when itchy sores start to appear on the skin during an outbreak. But even if an outbreak causes no visible symptoms or breaks in the skin, there is still a risk of the virus being passed on to another person through skin contact.

Getting Help

If you have any symptoms or you are worried you may have been infected with an STD, you should discuss your worries with a doctor. They may be able to run tests or offer you treatment themselves, or else will refer you to someone who can.

The Diagnosis

To find out if someone has genital herpes, a doctor or nurse will usually carry out the following examinations and tests:

a sample of urine may be taken.
a clinical examination will be done of a patient’s genital area.
a sample will be taken, using a cotton wool or spongy swab, from any visible sores.
women may be given an internal pelvic examination (similar to a smear test).

If the patient’s symptoms have already disappeared, or if there were no symptoms to begin with, a blood test can be taken to look for the virus.

Treatment

There is no cure for the herpes simplex virus and treatment is not essential, as an outbreak of genital herpes will usually clear up by itself. A doctor may however prescribe a course of antiviral tablets that reduce the severity of an outbreak. The antiviral tablets work by preventing the herpes simplex virus from multiplying. These tablets are only effective when taken within 72 hours of the onset of symptoms, and will cease to have any effect once the patient stops taking them.

Recurrences of genital herpes vary from person to person in frequency. Some will never experience an outbreak again, whilst others may have milder recurrences more than 6 times a year. Because these recurrent infections are milder, they often do not require treatment.

Help During An Outbreak

If you are suffering from an outbreak of genital herpes, there are several things you can do that may help make it easier to cope with:

wear loose clothing so that the air can get to the sore areas.
place an ice-pack wrapped in a clean cloth or towel on the affected area.
take pain-killers (aspirin/paracetamol) for any pain.
gently bathe the sore areas with a salt solution (half a teaspoon of salt to half a pint of warm water) twice a day: it is soothing and helps the sores to dry out.
drink plenty of fluids, such as mineral water and soft drinks, to help neutralise the urine (it is important not to hold back from passing urine as this can cause further problems).
avoid sunbathing and using sunbeds.
get plenty of rest.

Taking Care Of Yourself And Your Partner

During an outbreak of genital herpes, the sores are highly infectious and the virus can be passed on to others by direct contact. To prevent this from happening, avoid:

kissing when you or your partner have cold sores around the mouth.
having oral sex when you or your partner have oral or genital sores.
using saliva to wet contact lenses if you have sores around your mouth.
having any genital or anal contact, even with a condom or dental dam, when you or your partner has genital sores.

Remember - wash your hands with soap before and after touching the sores.

Although the likelihood of transmitting genital herpes to your partner between outbreaks is much reduced, there is still some risk.

Remember, a condom will only protect against herpes infection if it covers all the sores. Herpes can also be transmitted by non-penetrative sex.