Patient information from BMJ

Genital herpes

Last published:Aug 03, 2021

You might be upset to find out that you have genital herpes. But it isn't usually a serious illness. For many people genital herpes is nothing more than a nuisance. If you're one of the few people who get severe symptoms, having treatment can help relieve them and prevent further outbreaks.

What is genital herpes?

Genital herpes is a common infection caused by the herpes simplex virus.

There are two types of herpes simplex virus. Herpes simplex virus type 2 is the most common cause of genital herpes, but herpes simplex virus type 1 can cause it, too. The type 1 virus also often causes cold sores (blisters on your lips and around your mouth).

Genital herpes spreads through sex. You can catch genital herpes from a sexual partner even when they have no symptoms, or before they know they have the virus. You can also get it by receiving oral sex from someone with a cold sore or from someone who has had a cold sore in the past.

You might not be able to tell you've got genital herpes because it doesn't always cause symptoms. But you can still pass it on to someone else through sex.

If you are in a long-term relationship, being diagnosed with genital herpes doesn't necessarily mean that you or your partner has been unfaithful. One of you could have been carrying a herpes virus for a long time without knowing it.

It's possible to get a more serious illness from the herpes simplex virus, but this is rare. However, people who have a weak immune system have a greater chance of more serious problems.

If you have a weak immune system (for example, from HIV or from cancer treatment) and you get symptoms of herpes simplex infection, see your doctor.

What are the symptoms?

Many people with genital herpes have no symptoms. Others get outbreaks of painful spots, sores, or blisters in their genital area.

Symptoms are different for different people. You might get one or more of the following:

• Itching, tingling, pain, or burning around your genitals

• Painful blisters or ulcers on or around your genitals

• Painful blisters or ulcers on your thighs or buttocks

• Itchy red patches or cracks in and around your genitals

• Enlarged lymph nodes in your groin.

You might also have difficulty urinating if you're a woman.

Some people also get a mild fever or headache the first time they have an outbreak of genital herpes.

Whatever symptoms you get, they will usually be worst the first time you get them. If you get another outbreak of symptoms it will probably be milder than the first.

What treatments work?

If your symptoms are mild you could try simple treatments to relieve your discomfort, such as immersing your genitals in a warm, shallow bath (called a sitz bath) and taking pain medicines, such as paracetamol or ibuprofen. You might also try rubbing a pain-relieving gel called lidocaine on the affected area. These simple treatments might be all the treatment you need.

Antiviral drugs are the main treatment when genital herpes causes more severe symptoms. They can't get rid of the herpes virus from your body. But they can help your symptoms clear up more quickly. These medicines usually come as tablets or liquids.

Your doctor might suggest keeping some antiviral drugs at home and taking them as soon as you feel the symptoms coming on. This can help clear your symptoms more quickly. You will learn to recognise your early symptoms. The symptoms are different for different people.

If you have frequent or severe outbreaks of genital herpes symptoms your doctor might suggest that you take antiviral drugs every day. This can cut down the number of times you get symptoms and also lower your chance of passing the virus to an uninfected partner.

Antiviral drugs don't usually cause problems. You might get headaches or feel sick, but these side effects are usually mild and don't stop people taking their treatment.

If you’re pregnant

Women with genital herpes can pass on the infection to their babies during a vaginal delivery, whether or not they have genital symptoms at the time.

The chance of this happening is very small, but herpes can make babies dangerously ill. For this reason doctors often recommend that women with genital herpes take antiviral drugs late in their pregnancy, usually from week 36 until delivery.

If you have an outbreak of genital herpes near your delivery date your doctor might recommend having your baby by caesarean section to reduce the chance of passing on the infection to your baby.

Picking up the infection for the first time in late pregnancy can be dangerous for your baby. If your partner has genital herpes and you aren't infected, you should get advice from a specialist about how to protect yourself and your baby.

What can I do to prevent passing on the infection?

• It's important that you tell your sexual partners that you have genital herpes.

• You should avoid having sex with an uninfected partner when you have symptoms of genital herpes, or if you feel symptoms coming on. You are most likely to pass on the infection during these times.

• Consistently using condoms during sex can lower the chance of spreading the infection.

• Taking an antiviral drug every day can reduce the chance of you passing genital herpes on to your uninfected partner. But you still need to use condoms during sex.

• None of these precautions or treatments can protect your partner completely.

What will happen to me?

Genital herpes is an infection that you can never get rid of. But most of the time the virus lives harmlessly inside your body.

Once you've had symptoms for the first time you are likely to have them again. But the second outbreak of symptoms will probably be milder than the first, and you'll get better faster. You'll get fewer outbreaks over time, even without any treatment.

Finding out you have genital herpes can be difficult. You might feel shocked, depressed, or embarrassed. Many people also feel angry. Talk to your doctor if you're having a hard time coping. He or she might be able to help, or refer you to a support group.

Meeting people who have genital herpes and learning how they cope can be helpful. Also, bear in mind that genital herpes is very common and anyone who is sexually active can get it.