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Further STD Patient Information Sheets: resource list ... see also herpes type 2

GENITAL HERPES

Genital herpes is a common condition that is easily spread through sexual contact

• Genital herpes is difficult to treat and can cause serious problems for women.
• Genital herpes can be prevented by using condoms during sex.

What Causes Herpes?

Genital herpes is a common disease transmitted sexually. It is caused by infection with one of two kinds of microscopic organisms called herpes simplex virus, types 1 and 2 (HSV-1 and HSV-2). These viruses also cause cold sores on the mouth.

Herpes causes particular problems for pregnant women, since babies can be infected during their passage through the birth canal if HSV is present. This rare occurrence can usually be prevented with careful management.

How You Know You Have Genital Herpes

HSV infection sometimes causes no symptoms at all; the body's immune system keeps the virus under control. Usually, infection causes an outbreak of sores in the genital or anal area. Sores may appear in the following places:

• In women, on the vulva or the walls of the vagina, and occasionally in the cervix or around the anus.
• In men, usually on the head or the shaft of the penis, but also around the anus.

Before the appearance of sores there can sometimes be other symptoms. These may include:

• General aches and pains and fever (these can occasionally be quite severe, particularly in the first episode.
• Depression or moodiness.
• Pain, tingling or itching and redness on the affected site.

Herpes sores appear, usually two to twenty days after the initial infection, as a cluster of small blisters. After a day or two these break down into small red ulcers, which scab over and heal after a few days. Some people experience only one outbreak, but about half will have recurring episodes.

The extent, severity and length of herpes outbreaks varies from person to person. The usual pattern is for later attacks to be less severe than the initial one, and for attacks to become less frequent over time.

Many people with herpes find that outbreaks are linked to events in their lives. These may include:

• Stress or depression.
• Other infections.
• Menstruation.
• Heavy alcohol use.
• Sunburn.
• Friction to the skin, such as sexual intercourse or masturbation, which can also trigger outbreaks.

How Herpes Is Spread

HSV infection may be spread by vaginal, anal or oral sex. Infection comes through direct contact with blisters or ulcers, not necessarily during penetration. Thus, HSV can be spread by any kind of sex. Non-sexual touching of affected areas can also spread infection in some circumstances. Very rarely, herpes can be spread to the eyes, or to cuts or abrasions in the skin.

Because HSV infection can have serious consequences for women, heterosexual men have a particular responsibility not to pass the infection to their female sexual partners. Sexually active men should have regular check-ups for herpes and HSV infection.