Genital Herpes: Types, Prevention and Treatments Explained

Genital herpes is a sexually transmitted infection (STI). It’s hard to put a number on how many people are affected by it, because, it’s thought that at least eight in 10 people infected with the genital herpes virus don’t know they have it (i). That’s usually because they have no symptoms or their symptoms are so mild they hardly notice them.

If you do get noticeable symptoms, they may not appear for months or perhaps even years after you were first infected. Some people, on the other hand, experience symptoms after about four to seven days. The first time you get symptoms they can be quite severe, and may include the following:

• Flu-like symptoms, such as a high temperature, tiredness, headache, swollen glands, aches and pains.

• Small blisters around your genitals that cause stinging, tingling or itching. These blisters can also appear on your anus, thighs and buttocks, and usually burst within a day or two to leave painful, red, open sores.

• Unusual vaginal discharge in women.

• Pain during urination

This first outbreak of symptoms can last up to three or four weeks. But the sores eventually heal, usually without leaving any scarring. You may, however, experience recurrent infections, though the symptoms are often milder and don’t last as long as the first time. Eventually, outbreaks may become even less frequent and less severe, as your body produces more antibodies to help fight the infection.

Two types of virus

There are two viruses that can cause genital herpes, called herpes simplex virus 1 (HSV-1) and herpes simplex virus 2 (HSV-2). HSV-1 is the version of the herpes virus that causes cold sores around the mouth and nose. But the virus can spread from the mouth to the genitals through oral sex, which explains why some cases of herpes are caused by HSV-1.

Both forms of the virus are highly contagious and can enter your body through cracks in your skin or the virus may be absorbed through the mucous membranes of the mouth, vagina, anus or urethra and under the foreskin. Once infected, the virus remains in the root of a nearby nerve and can stay dormant for any length of time. Symptoms of herpes can sometimes be confused with other sexually transmitted infections such as chlamydia and scabies.

The virus can be reactivated, however, causing another outbreak. Nobody knows exactly why the virus is reactivated, but some of the triggers that may be responsible include the following:

• Ultraviolet light from the sun or sunbeds

• Friction in the genital area (for instance, during sexual activity or by wearing tight clothes)

• Being unwell

• Drinking too much alcohol

• Stress

• Having a weakened immune system

• Having a period if you’re a woman

• Having surgery on your genital area

If you’ve been infected with HSV-2 rather than HSV1, it’s thought you’re more likely to experience recurrent outbreaks.

Genital herpes and pregnancy

If you develop genital herpes for the first time while you’re pregnant, or if you have recurrent genital herpes and become pregnant, speak to your midwife or GP, as there is a chance you could pass the infection to your baby. This is called neonatal herpes, and it can be very serious – though most babies recover with treatment.

Meanwhile, genital herpes doesn’t affect your health in any other way. There’s no evidence that it causes cancer, and it also doesn’t affect your fertility.

How does genital herpes spread?

Genital herpes is passed from one person to another by contact with a herpes sore or contact with infected skin around the mouth, the genital area or the hands. You can also be infected with the virus through saliva or genital secretions. Another way you can pass on genital herpes is by sharing sex toys.

The virus is particularly contagious when an infected person is experiencing an outbreak and has blisters or sores, and passes easily from one mucous membrane to another. But it’s also possible to get the virus from an infected person when they’re not having an outbreak, including from those who have the virus but have never had any symptoms and don’t realise they’ve been infected.

On the other hand, you can’t be infected by touching towels, bedding, cutlery or cups that have been used by someone with the virus, or by using toilet seats or swimming pools.

How can you prevent it?

There are a few things you can do to reduce your risk of being infected by the genital herpes virus, or by passing the virus on to your partner if you already have it.

Use condoms

Condoms don’t protect against herpes completely, as they don’t cover the entire genital area where the virus could be present. But it’s a good idea to use condoms anyway, especially when having sex with new partners, as they may help prevent the virus from spreading. You may want to consider using condoms even if you’re not in a new relationship, as you or your partner could have been infected with the virus previously without knowing about it. Consider using condoms for any kind of sexual intercourse – including oral sex – and if you’ve had genital herpes, use them even after your blisters have healed.

Don’t have sex during an outbreak

If you or your partner has an active genital herpes infection, avoid having sex until the outbreak has cleared up completely.

Watch out for cold sores

Similarly, if you or your partner is having an outbreak of cold sores around your mouth, avoid any intimate contact, including kissing and oral sex.

Be honest with your partner

If you know you have genital herpes, don’t keep it from your partner. You may want to suggest that they get tested for the virus too, as they may already have it without being aware of it.

Avoid sharing sex toys

Sharing sex toys can pass on STIs, including genital herpes. If you do share them, wash them thoroughly before you use them and cover them with a new condom each time.

How is genital herpes treated?

If you think you may have genital herpes, the best place to go for advice and treatment is your local sexual health or genitourinary medicine (GUM) clinic. The virus can be diagnosed by taking a sample of fluid from a blister, which means you should see a GUM specialist when you’re having an outbreak. And because there’s a chance you may have other STIs too, you may also be advised to have more tests.

To find a clinic, visit NHS Choices. Many clinics offer a walk-in service, which means you don’t need an appointment. The test and treatment will be free, even if you usually pay for your prescriptions. The service at sexual health/GUM clinics is also confidential, which means your GP won’t be informed without your permission. You may, however, be advised to contact previous partners who may also be infected – if you don’t want to tell them yourself, the clinic can do it for you, and your name will never be mentioned.

If your test result comes back positive, you may be offered a treatment to help prevent or shorten your outbreaks.

Antivirals

During your first outbreak of genital herpes you may be prescribed antiviral medicines. These help stop the symptoms getting any worse by stopping the virus from multiplying. However, you must start taking them within five days of the symptoms starting.

If you get recurrent outbreaks and your symptoms are severe, taking antiviral medicines could shorten the time you’re affected by up to two days if you take them as soon as the symptoms start. Meanwhile, if you get six or more severe outbreaks in a year, you may be offered long-term antiviral medicines, which you may have to take every day for up to a year.

Pain relief

You may also be given cream to help with pain.

However, some people decide not to have any treatment, as the virus clears up by itself. But if you do get treatment right at the start of an outbreak, it can reduce the risk of you passing the virus to someone else, as well as reduce the time the outbreak lasts.

How to help yourself

If you’ve been diagnosed with genital herpes and you’re having an outbreak, there are some things you can do to ease your symptoms:

Help blisters heal

Keep the affected area clean by using plain or salt water and cotton wool, as it may make your blisters heal more quickly as well as prevent them from becoming infected. Avoid using products such as scented soaps or bubble baths, as they may irritate your skin. After washing, carefully pat the area dry or use a hairdryer on its lowest setting instead of using a towel.

Use ice packs

If your sores or blisters are painful, applying an ice pack to the affected area may help make you feel more comfortable. Place some ice in a clean towel or flannel and place it next to the affected area, or apply some cold, wet tea bags to the sores. Never apply ice directly to your skin. Taking a cool shower may also feel soothing.

Drink up

If you feel pain when you urinate, drink lots of fluids, as it will dilute your urine and make passing it less painful. You could also try pouring water over your genitals while urinating, as this can also be helpful.

Apply ointment

Use a local anaesthetic ointment such as lidocaine on the affected area if you need more help with pain relief. Petroleum jelly can also be soothing. If necessary, you could also take an over-the-counter pain relief medicine, such as paracetamol.

Stay loose

Try to avoid wearing tight clothes during an outbreak, as they may irritate the skin in your genital area. Instead try wearing loose-fitting clothes made from natural fibres.

Also, remember never to touch your sores or blisters unless you’re applying cream. Always wash your hands thoroughly before you apply cream, then wash them again afterwards.

You may also be able to help prevent further outbreaks if you know what triggers them. Some triggers can’t be helped – having your period, for instance, or having a weakened immune system. But others can to some extent be avoided, such as being tired or stressed, or spending extended periods of time in the sun or using sunbeds.
 

Natural support for genital herpes

As genital herpes is caused by a virus, having a strong immune system could help make the symptoms milder and less frequent. You can support your immune system by eating healthily, taking regular exercise, reducing the amount you drink and giving up smoking. There are also several supplements that may help support your immune system, including the following:

Vitamins B and C

Both of these vitamins support the normal functioning of the immune system. But despite the fact that they’re found in a wide range of everyday foods, many of us may be running short. To make sure you’re getting the level of the B and C vitamins your immune system needs, you may want to consider taking a high-quality B complex supplement as well as a high-quality vitamin C supplement. You can also get both nutrients in good levels in a quality multivitamin and mineral formulation.

Live bacteria

Experts believe live bacteria – also called ‘friendly’ bacteria – may help regulate and support the immune system (ii). These live bacteria are thought to help restore the natural balance of bacteria in your gut.

High-strength multivitamin and mineral

As well as having a healthy diet, taking a high-strength multivitamin and mineral supplement may help make sure your immune system is getting all the nutrients it needs to stay as strong and as effective as possible, especially when dealing with infections. For the best results, a multivitamin and mineral supplement should include good levels of zinc, which is thought to be important for immune function (iii) as well as vitamin D (iv).

Elderberry juice

Another supplement that may be useful for immune health is elderberry extract as it contains powerful antioxidants called anthocyanins. There is also evidence to suggest black elderberry extract increases the body’s production of chemical messengers within the immune system called cytokines, suggesting it has an immune-supporting function (v).

Managing an STI can be difficult, but with this guide, we hope to make it a little easier. To discover more information on a number of other common health conditions,  visit our health library for some helpful advice.
 

References:

1. Available online: https://patient.info/sexual-health/sexually-transmitted-infections-leaflet/genital-herpes

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   Chiang, B.L., Sheih, Y.H., Wang, L.H., et al. Enhancing immunity by dietary consumption of a probiotic lactic acid bacterium (Bifidobacterium lactis HN019): optimization and definition of cellular immune responses. Eur J Clin Nutr. (2000). ;54:849-8551. Available online: https://www.ncbi.nlm.nih.gov/pubmed/11114680
   
   Aziz. N., Bonavida B., Activation of Natural Killer Cells by Probiotics. For Immunopathol Dis Therap. 2016;7(102):41-55. Available online: http://www.dl.begellhouse.com/journals/1a654bf03faf67ac,2451af3842dace87,4072614f2000aab7.html

3. Chandra, R.K. Trace element regulation of immunity and infection. J Am Coll Nutr. (1985). ;4:5-16. Available online: https://link.springer.com/chapter/10.1007/978-4-431-68120-5_23
   
   Fraker, P.J., Gershwin, M.E., Good, R.A., et al. Interrelationships between zinc and immune function. Fed Proc. (1986). ;45:1474-1479. Available online: https://pubmed.ncbi.nlm.nih.gov/3485544/

4. Aranow, C. Vitamin D and the Immune System. Investig Med. (2011 Aug). ;59(6):881-886. Available online: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3166406

5. Barak, V., Halerpin, T., Kalickman, I. The effect of Sambucol, a black elderberry-based, natural product, on the production of human cytokines: I. Inflammatory cytokines. Eur Cytokine Netw. (Apr-Jun). ;12(2):290-6. Available online: https://www.ncbi.nlm.nih.gov/pubmed/11399518

 

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