Genital herpes: symptoms, treatment and prevention

Genital herpes is a viral infection caused by the herpes simplex virus (HSV). Herpes is common in Ireland and is mostly diagnosed in young women and people with vaginas.

There are two HSV types: type 1 and type 2. Type 2 most commonly causes a genital infection. Type 1 has also been found to cause genital infection but more commonly causes oral herpes also known as cold sores. The two viruses are very similar and both can cause blisters or ulcers.

How do you get genital herpes?

The herpes virus (HSV) is transmitted by

• skin-to-skin contact
• kissing
• vaginal and anal sex
• genital contact
• oral sex
• sharing sex toys
• from parent to baby during delivery

As the virus is passed from skin to skin contact, vaginal fluid or ejaculate is not needed for the virus to pass to a partner. This means that even having the tip of a penis in a vagina, anus, or mouth or in contact with the genital area can pass the virus on. It can also spread from the pressing or rubbing of two pelvic regions together.

Many people who have and pass on the virus do not know they have herpes. It is possible to carry the virus without having any symptoms. Because of this, it is important to go for regular STI check-ups if you are sexually active. Clinics do not routinely check for herpes unless someone has symptoms, so be sure to ask your doctor specifically about checking for herpes if you are concerned or notice potential symptoms.

Sometimes you can catch herpes when your sexual partner has no visible sores or symptoms. This is because the virus can become active on the skin without causing any visible blisters or sores.

What are the symptoms of genital herpes?

Many people with the herpes virus do not experience any symptoms when they are first infected and, as a result, do not know that they have it. If you do get symptoms, your first outbreak will usually be the most severe. It usually takes between two and 12 days after contact with the virus for the first symptoms of genital herpes to appear.

Symptoms are multiple spots or red bumps around the genital area. These can be very painful. In time, these swellings can break open and form sores or ulcers which gradually crust over, forming new skin as they heal. As well as having painful ulcers or blisters, you may have swollen glands in your groin, flu-like symptoms and a feeling of being unwell. You may also feel pain when passing urine.

How can I be tested for genital herpes?

You can get tested for genital herpes at an STI clinic. If you have visible blisters, the doctor or nurse will take a swab from the sore for testing and sometimes may also take a blood sample.

The blood test for herpes simplex is looking for the body’s reaction to a previous infection with herpes. Clinics don’t routinely do this blood test on people who have no symptoms. If you think you may have previously come in contact with herpes, but have no symptoms, you can speak to your nurse or doctor at the sexual health clinic about this. They will be able to advise you on the next best steps to take.

How is genital herpes treated?

There’s no cure for herpes, but the symptoms of the virus can be treated. If you have symptoms of genital herpes for the first time, the treatment usually involves antiviral tablets, to help speed up the healing process, and sometimes painkillers.

Your pain can usually be managed with simple painkillers and a local anaesthetic (numbing) cream. You will usually need to take the antiviral medicine for 3 or 5 days.

Can genital herpes come back?

After the initial infection, the virus can remain in the nerve cells in the affected area of your body. The virus can reactivate and cause sores to come back, but this will happen less frequently with time.

If genital herpes does come back, you will usually only experience minor symptoms and these will heal up quickly, even without treatment. However, a small number of people will find that recurring outbreaks can be painful. Genital herpes is more likely to come back in people who have been infected with the type 2 virus than the type 1 virus.

What if I get a lot of herpes outbreaks?

Some people may be put on antiviral medication for 6 months to a year if they get a lot of outbreaks. Other people who occasionally get outbreaks just take the antiviral medication when they get symptoms. At your STI check-up, your doctor or nurse will explain what may be the best option for you.

How can I avoid passing genital herpes to a partner?

Using condoms and taking antiviral medications can reduce the chances of passing on genital herpes. It is best to avoid sex during an outbreak.

In some cases, your partner will be offered a blood test. This is to see if their body has been exposed to the infection before. You can discuss this further with your doctor or nurse at your STI check-up.

It is always best to speak to a partner and let them know you have genital herpes before having any type of sex with them. Read our article on telling your partner you have an STI for advice on how to have that conversation.

What if my partner tells me they had genital herpes in the past?

If your partner tells you they have had genital herpes in the past, it is a good idea to visit your doctor or nurse to discuss this. You should avoid having sex with your partner if they have an outbreak. A blood test can show if you have been exposed to herpes in the past. You can discuss this further with your doctor or nurse at your STI check-up.

Is it ok to have sex again after an outbreak?

Yes. Talk with your doctor or nurse about what you can do to reduce the risk of passing genital herpes to someone else. It is important to avoid sexual contact with someone when you have an outbreak.

What happens if my genital herpes is left untreated?

Genital herpes will heal up even if you are not treated. However, this can take longer than if you start having treatment soon after developing sores.

If I had genital herpes and get pregnant, what should I do?

In most cases, there will be no problem with the pregnancy. If you are pregnant or planning a pregnancy, tell your doctor of your history of herpes. Sometimes antiviral medication will be recommended towards the end of the pregnancy. In most cases, a history of herpes has no impact on how your baby should be delivered. Your doctor or nurse will discuss this with you.

How to look after yourself if you have herpes

Having an outbreak can be uncomfortable and it is important to look after yourself during these times.

You can help to make yourself more comfortable by:

• Taking your medication as directed
• Avoid nylon and other synthetic tights and underwear. Instead, wear loose cotton underwear and thigh highs/knee-highs instead of regular tights
• Use disposable gloves to apply medication. This will help to prevent spreading the virus to other parts of your body
• Do not use cleansers, soaps, sprays or deodorants in the genital area
• A warm salty bath may help to relieve the itching, soreness and problems with peeing that can occur during an outbreak
• Take painkillers as directed by your doctor or pharmacist
• Use a cool washcloth on the genital area to help ease the pain

Looking after your mental health after an STI diagnosis

If you are diagnosed with an STI, you might feel a mixture of emotions. Unfortunately, there is still stigma in our society surrounding STIs that can cause some people to feel shame about having one. However, like any other healthcare diagnosis, you are not to blame for your STI and have not done anything “wrong”. Being diagnosed with an STI can have a negative impact on your mental health and wellbeing and if you don’t feel comfortable telling friends or family about it, you might feel isolated and alone. If you have found out you have an STI and you’re finding it difficult to cope, there are things you can do to support your mental health.

• Remember that STIs are common and lots of people have one at some point in their life, even though they aren’t talked about a lot
• Take time out to do something you enjoy and practice self-care
• Reach out for mental health support if you need it. If you don’t feel comfortable talking to a friend or family member, our 24/7 anonymous text service, 50808, can help
• Be patient with yourself and allow yourself to feel your emotions. It’s ok to be upset when you find out you need healthcare treatment. It’s important to take the time you need to adjust

Feeling overwhelmed and want to talk to someone?

• Get anonymous support 24/7 with our text message support service
• Connect with a trained volunteer who will listen to you, and help you to move forward feeling better
• Free-text SPUNOUT to 50808 to begin
• Find out more about our text message support service

If you are a customer of the 48 or An Post network or cannot get through using the ‘50808’ short code please text HELLO to 086 1800 280 (standard message rates may apply). Some smaller networks do not support short codes like ‘50808’.