Genital herpes is a sexually transmitted infection caused by HSV (herpes simplex virus). This virus affects the genitals, the cervix, as well as the skin in other parts of the body. There are two types of herpes simplex viruses: a) HSV-1, or Herpes Type 1, and b) HSV-2, or Herpes Type 2.
Herpes is a chronic condition. Chronic, in medicine, means long-term. However, many people never have symptoms even though they are carrying the virus. Many people with HSV have recurring genital herpes. When a person is initially infected the recurrences, if they do occur, tend to happen more frequently. Over time the remission periods get longer and longer. Each occurrence tends to become less severe with time.
Herpes simplex virus is highly contagious
The herpes simplex virus (HSV) is easily human transmissible. It is passed from one person to another by close, direct contact. The most common mode of transmission is through vaginal, anal or oral sex. When somebody becomes infected with HSV, it will generally remain dormant.
Most people who are infected with HSV do not know it because their symptoms are so slight - many people have no discernible symptoms.
Cases of genital herpes are typically caused by HSV-2, which is primarily transmitted through sexual contact. HSV-1, which most commonly causes oral herpes, can cause genital herpes through oral-genital contact.1
Fast facts about herpes
- People who have genital herpes can have sex. They should avoid sexual contact if they have symptoms. Wearing condoms helps prevent passing it on.
- More than 50% of the population of the US have HSV-12
- Around 15.5% of people in the US aged 14-49 have HSV-23
- Around 1 in 6 people in the US aged 14-49 have genital herpes2
- Receiving oral sex from somebody who has cold sores around their mouth significantly raises the risk of becoming infected.
- You cannot get genital herpes from a toilet seat.
- Genital herpes can spread from one part of your body to another.
- If you never have symptoms, this does not mean you do not have genital herpes.
- Stress can trigger a recurrence of symptoms.
- People who have genital herpes are more susceptible to HIV.
- Genital herpes cannot make you sterile.
Symptoms of genital herpes
A cold sore
For those who do experience symptoms, they are generally present as blisters on the genitals, and sores around the mouth.
Most people do not have apparent symptoms for many months, or even years after becoming infected. Those who do have symptoms during the initial period will usually notice them about 4 to 7 days after being infected.
Primary infection symptoms
Primary infection is a term used for an outbreak of genital herpes that is evident when a person is first infected. Primary infection symptoms, if they are experienced, are usually more severe than subsequent recurrences. Symptoms can last up to 20 days and may include:
- Blisters and ulceration on the cervix
- Vaginal discharge
- Pain when urinating
- A temperature (fever)
- Malaise (feeling unwell)
- Cold sores around the mouth
- Red blisters - these are generally painful and they soon burst and leave ulcers on the external genital area, thighs, buttocks and rectum
In most cases the ulcers will heal and the patient will not have any lasting scars.
Recurrent infection symptoms
These symptoms tend to be less severe and do not last as long, because the patient's body has built up some immunity to the virus. In most cases symptoms will not last for more than 10 days.
- Burning/tingling around genitals before blisters appear
- Women may have blisters and ulceration on the cervix
- Cold sores around the mouth
- Red blisters - these are generally painful and the soon burst and leave ulcers on the external genital area, thighs, buttocks and rectum.
Eventually recurrences happen less often and are much less severe. Patients with HSV-1 will have fewer recurrences and less severe symptoms than people infected with HSV-2.
What causes genital herpes?
When HSV is present on the surface of the skin of an infected person it can easily pass on to another person through the moist skin which lines the mouth, anus and genitals. The virus may also pass onto another person through other areas of human skin, as well as the eyes.
A human cannot become infected by touching an object, such as a working surface, washbasin, or a towel which has been touched by an infected person.
The following can be ways of becoming infected:
- Having unprotected vaginal or anal sex
- Having oral sex with a person who gets cold sores
- Sharing sex toys
- Having genital contact with an infected person.
HSV leaves the skin just before a blister appears. The virus is most likely to be passed on just before the blister appears, when it is visible, and until the blister is completely healed. HSV can still pass onto another person when there are no signs of an outbreak (but it is less likely).
If a mother with genital herpes has sores while giving birth it is possible that the infection is passed on to the baby (see section on pregnancy below).
On the next page we look at how herpes is diagnosed as well as treatments and prevention for herpes.