Genital Herpes (SHV)
This webpage is for information purposes only and is not a substitute for professional medical advice.
Genital herpes is an STI that causes blisters and skin ulcers in the genital area. It is caused by the herpes simplex virus (HSV). There are two types: HSV-1 and HSV-2. HSV-1 generally causes sores on or near the mouth (cold sores), while HSV-2 usually causes sores on or near the genitals.
Genital herpes is spread from person to person through:
- Direct genital skin to skin contact.
- Vaginal sex (penis in vagina).
- Anal sex (penis in rectum).
- Oral sex (mouth to penis, vagina or anus).
- Mouth to mouth.
- Mother to child during a vaginal delivery.
While HSV is more likely to be transmitted when skin blisters or ulcers are visible, the virus can also spread when there are no symptoms.
Signs & Symptoms
Symptoms of genital herpes vary from person to person. It is estimated that 60% of people don’t know that they have herpes because they have very mild or no symptoms.
It can take up to 20 days after exposure for genital herpes symptoms to appear.
Symptoms in both men and women include:
- Fluid-filled blisters in the genital area (vaginal lips, vagina, cervix, head/shaft/foreskin of penis, scrotum, in or at the urethra, buttocks, anus or thighs)
- Pain in the genital or anal area.
- Pain when urinating.
- Flu-like feelings (fever and aches in the joints and/or muscles).
- Painful swelling in the lymph nodes of the groin.
- Genital itchiness - with or without sores.
Recurring Outbreaks
The first herpes outbreak is usually the worst. It may take 2 to 3 weeks for symptoms to go away. Genital herpes tends to be less severe when it is caused by HSV type 1.
After the symptoms are gone, the herpes virus remains in the body in nerve cells near the spine. Genital herpes symptoms can - and generally do - reoccur. The number of outbreaks varies from person to person, averaging 4 to 5 per year. Many people find that outbreaks tend to be less severe and happen less often over time.
Diagnosis & Treatment
Diagnosing Genital Herpes
Females
Your doctor will ask about your sexual history and/or any previous symptoms. Then he or she will perform a pelvic exam and take a swab of fluid from a herpes sore.
If you notice a blister or sore on or around your genitals you need to see a doctor within 48 hours - the sooner you go, the more accurate the test will be. Swabs are the most common method used to diagnose herpes. There is a blood test available but it is not covered by OHIP.
Males
Your doctor will ask about your sexual history and/or any previous symptoms. Then he or she will examine your penis and testicles and take a swab of fluid from a herpes sore.
This test should be done within 48 hours after sores appear. If the sore/lesion is very small, or if it is healing, there may not be enough of the virus to ensure an accurate test. The sample will be sent to a lab, where a test will show if herpes is present.
Herpes is NOT detected during routine STI tests. Your doctor must order a special blood test to accompany the swab for testing.
Treatment
Genital herpes is a life-long illness. There is no cure.
The sores herpes cause can be treated with anti-retroviral medications. The medications can help speed an ulcer or sore heal during an outbreak, reduce the number of outbreaks and reduce the chance of spreading the virus to others during and between outbreaks.
There are also alternative therapies available through naturopaths or homeopaths. Research is ongoing into new treatments and a possible vaccine.
Prevention
Reducing Your Risk
Genital herpes affects one in five adults. Once you’re infected you become a carrier for life.
While herpes is most easily passed when sores are present or just before an outbreak, it can be spread even when no symptoms are present. The virus can come to the skin surface without causing any symptoms. This is called “asymptomatic shedding”.
You can reduce the risk of contracting genital herpes by:
- Getting tested for STIs with each new sexual partner, before becoming sexually involved.
- Not having intercourse - including oral sex or skin to skin contact - when symptoms or sores are present or during the prodrome. Wait until the symptoms or sores are completely gone.
- Using a condom every time you have sex. (Remember, however, that condoms won’t give total protection because the virus can be on other genital parts and surrounding skin).
Reducing Your Outbreaks
The time before an outbreak is called the “prodrome”. During this period you might experience genital itching, irritation or tingling.
While no-one knows exactly what causes a herpes episode or outbreak, symptoms are most commonly brought on or linked to:
- A period of stress (either emotional or physical).
- Exposure to sunlight.
- Hormonal changes (e.g. menstruation).
- Poor nutrition.
- Sexual intercourse.
- Lack of sleep.
- A weak immune system (e.g. following surgery, injury or when you have a fever or other illness).
You can help boost your immune system and reduce the number of outbreaks by:
- Not smoking.
- Eating a healthy diet.
- Getting adequate rest.
- Getting adequate exercise.
- Trying a variety of ways to cope with stress.
Herpes & Pregnancy
While neonatal herpes (herpes infections in newborn babies) can cause serious health problems for a newborn, it is rare for a baby to become infected during delivery. An estimated 20-25% of pregnant women have genital herpes, while less than 0.1% of babies are infected during birth.
Genital herpes is more likely to seriously affect your baby if you become infected during your pregnancy.
If you have herpes and you’re pregnant, talk to your health care provider.
A caesarean section may be needed if there are herpes symptoms present at delivery.
If you’re a male with a history of genital herpes and your partner is pregnant:
- Don’t have sex when you have active outbreaks.
- Use a condom for intercourse between outbreaks.
- Try to abstain from intercourse during the last trimester of your partner’s pregnancy.
If you have oral herpes, avoid oral sex when you have an outbreak. (20% of neonatal herpes is caused by HSV1.)
