Genital Herpes
What is it?
The herpes simplex virus is the cause of cold sores and genital herpes. It can also cause infections around the bottom (anus/rectum), eyes (herpes conjunctivitis) and fingers (whitlows).
How does it show itself?
Initial herpes simplex
This is when it occurs for the first time in the genital area. You may experience `flu-like` symptoms such as fever, tiredness, headache, aches and pains of the lower back and down the legs or in the groin. Small blisters can appear anywhere in the genital region which quickly burst leaving red, punched out ulcers tender to touch and may be painful. Several crops of blisters may appear one after another. Passing urine can be very painful. Left untreated these symptoms will last for 2 to 3 weeks after which the ulcers will heal without leaving a scar.
Recurrent herpes simplex
Not everyone gets further episodes after the first one. In those who do the symptoms are usually much milder and clear up more quickly (within 3 to 5 days). Often there is an early warning tingling sensation before a recurrence happens. This is due to the virus travelling down the nerve to the skin. Recurrences eventually stop altogether for most people although this may take several years to achieve.
Some things that might bring on an episode are:
- feeling run down or under stress
- menstruation (periods)
- damage to the genital area
- sunlight (natural or artificial) on the affected area
- tight clothing
- nylon underwear.
Where does it come from?
There are two types of this virus;
Herpes simplex virus type I - This commonly causes cold sores around the mouth and nose. It can also affect the eyes, genitals and anal areas.
Herpes simplex virus type II - This is responsible largely for sores in the genital and anal region but may also affect the mouth and eyes.
Only laboratory tests will tell what type virus is causing an infection. Genital infection caused by type I is usually milder and less likely to recur than that caused by type II.
How is it spread?
The virus is spread mainly in the following ways:
- sexual intercourse with someone with genital herpes. A condom may not provide adequate protection if skin to skin contact has occurred before or after its use.
- oral sex with someone who has active cold or genital sores.
- it is quite possible to get herpes from sexual contact with someone with the virus but without them having any signs of it being there. Most adults have it in the mouth area.
Much rarer means are:
- self-infection by transferring the virus to other parts of the body via a towel (wet). However the virus can only live for a short period away from the body so this is a very unlikely source of infection .
Symptoms may develop as early as 4 or 5 days after contact with the virus but it could also be several weeks or even months later.
Can it be treated?
Treatments (such as acyclovir) are available to slow down the virus multiplying. At the present time nothing is available to get rid of the virus completely. The drugs work well when herpes is first experienced but appear to have little or no effect if it returns. People who experience it frequently may take continuous treatment to try to reduce this. A GP may be able to prescribe this.
What about sexual partners?
Sexual intercourse and oral sex should be avoided when herpes simplex symptoms are being experienced (i.e. when the virus is active). The virus is often passed on by someone who does not even know they have it so it often helps to be open about a herpes infection. There is a small risk of passing on the infection between episodes so informing a new partner about having herpes is a difficulty to face up to. Some people find it easier to wait until a relationship has developed and strengthened before disclosing this sensitive information whilst at the same time being careful to practice safer sex (using protection).
Anything else?
Cancer of the cervix (neck of the womb) is not caused by herpes infection. It does not affect fertility. It may be possible to pass it on to a baby during pregnancy or delivery. It is therefore recommended that a doctor is informed during pregnancy if the infection has been present.
People often feel very down when told they have herpes. It helps to talk to someone who is both knowledgeable and sympathetic. Apart from the staff at a GUM clinic it may be useful to contact ‘The Herpes Virus Association’ on 020 6099061. 41 North Road, London, N7 9DP. They would be happy to send more information if a SAE is enclosed.
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More info
Medical Guidelines for Professionals: www.agum.org.uk