Genital Herpes- from silent to symptomatic infection

Genital Herpes- from silent to symptomatic infection

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Genital Herpes

Genital Herpes is a common sexually transmitted infection (STI) caused by the herpes simplex virus (HSV). There are two forms– HSV1 and HSV2. HSV1 usually affects the mouth, as a cold sore, but it can also occur in the genital region. HSV2 usually infects the genital area.

Around 1 in 8 people carry the genital herpes virus (HSV2) – but 80% may be entirely unaware they have it. It can be difficult to tell when a person first became infected as the symptoms may not start for weeks, months or years- and many people never get symptoms at all!

Pregnant women with a history of genital herpes should tell their antenatal care provider, as HSV can be passed on to the baby during childbirth, leading to serious illness, though this is rare.

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How is it spread?

HSV is spread by skin-to-skin contact and can be passed on during vaginal, oral or anal sex. It can occur anywhere on the genitals or surrounding areas. A person who has had cold sores on their mouth can cause genital infection in a partner by having oral sex. It is important to realise that HSV can be spread when there are no blisters present- this is called viral shedding. The more often a person has flare-ups, the more virus they tend to shed in between the flare-ups.

How do I know I have genital herpes?

As mentioned above, many people do not realise they have been infected and are “silent carriers”. The first episode of herpes can cause a lot of pain, with small intensely painful blisters around the genital area (these break down and form shallow ulcers, which scab and heal over the following weeks). The pain can be very sharp (patients often say it feels like “sitting on glass”) and there may be redness and swelling in the genital area. Some people may have difficulty passing urine (if this happens it is important to seek medical attention).

Are later flare-ups of genital herpes as bad as the first episode?

Usually flare-ups are less painful and shorter than the first episode. Over time, episodes tend to become less frequent and in time, they may stop completely. If you get HSV1 in the genital area it is less likely to come back than HSV2.

What triggers flare-ups?

HSV can come back for no particular reason- but stress, illness, menstruation or sexual can also trigger it.

How is it diagnosed?

It is easiest to diagnose herpes when the rash is present. A doctor can take a swab from the area- results usually come back in a few days. Sometimes, a doctor may decide to do a blood test- this can show up past infection even if there is no rash.

genital herpes worried

What is the treatment?

Unfortunately, there is no medication that cures your body of the herpes virus, but there are treatments that ease symptoms and reduce flare-ups. Ice packs, cool salt water baths and painkillers may help during a flare-up. Local anaesthetic gel (such as Lignocaine gel) can be used to numb the area a little-this is available from your pharmacist. Antiviral medicines, such as Acyclovir, Famciclovir and Valaciclovir, can reduce the severity of an episode if taken early enough in the episode, and require a prescription from a doctor or an online doctor ( though for a first episode you should always see a doctor in person).

What prevents HSV infection?

Using condoms during sex reduces risk, and using a lubricant with a condom further reduces the risk (as it helps to lessen trauma to the genital skin during sex). Silicone-based lubricants are recommended but they may be less commonly available.
For people who have frequent episodes of genital herpes, a daily dose of antiviral medication can help to reduce the risk of passing it on to a sexual partner.

If you have been diagnosed with HSV2, have already had a full sexual health check-up with your doctor, and simply need a repeat prescription for your anti-viral medicine, it’s now possible to get a prescription with Qoctor.

For more information regarding genital herpes, sexual health and contact tracing, speak to a GP or log on to the Melbourne Sexual Health Centre at

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2017-09-30T17:46:05+00:00 By |Sexual Health, Genital Herpes|

About the Author:

Aifric Boylan
Originally from Ireland, Dr Boylan is an experienced GP based in Melbourne. She is also committed to innovation in the area of online medicine and health technology. Aifric is a keen distance runner, and plays the violin, but not at the same time…

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