Genital Herpes

Genital herpes is also referred to as Herpes simplex virus 2, HSV-2 or herpes pro-genitalis. It is a very common Sexually Transmitted Infection (STI) that is generally spread by skin-to-skin contact.

Answers to Questions about Genital Herpes

Is genital herpes common?

If you have genital herpes you are definitely not alone. Genital herpes is extremely common. In fact, it is so prevalent that in America one out of every five of the adolescent and adult population are infected.
The statistics are just as alarming in the UK and Australia. An estimated 1 in 4 people in the UK are diagnosed with genital herpes and one out of every six adults in Australia.
A recent US survey reported that genital herpes is one of the most common sexually transmitted diseases in the world, with a 32% rise in infections between 1978 – 1990.
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What is the connection between cold sores and genital herpes?

Cold sores and genital herpes are both caused by the Herpes simplex virus (HSV), however, they are usually caused by different strands of the virus.
Cold sores are typically caused by Herpes simplex virus type 1 (HSV-1).
Genital herpes on the other hand is usually caused by a different strand of the virus called Herpes simplex virus type 2 (HSV-2).
Even so, it is possible to transfer the different virus types to other areas of the body.
HSV-1 (or cold sores) can be transferred to the genitals through oral sex. In the same way, HSV-2 (or genital herpes) can be transferred to the mouth.
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How does a person get genital herpes?

Genital herpes is generally contracted from skin to skin contact with an infected area.
For example, if someone has a genital herpes infection they can pass on the virus to another person by touching or making contact with the area, such as through vaginal, anal or oral sex, or by rubbing against the infection.
Once infected with genital herpes, the virus remains inside the body in a latent (sleeping) state. Throughout a person’s life the virus can then become “activated” causing a genital herpes recurrence.
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What causes or “activates” a genital herpes recurrence?

There are many factors that can influence or “trigger” a genital herpes outbreak, however, it seems to be related to times when the immune system is lowered or run down.

Herpes outbreaks can be triggered by the following

  • Being run-down
  • Suffering from other genital infections (affecting the local skin area)
  • Menstruation Cycle and other hormonal changes
  • Pregnancy
  • Drinking a lot of alcohol
  • Exposure of the area to strong sunlight
  • Conditions that compromise a person’s immune system (where the body’s immune system is not functioning normally)
  • Prolonged periods of stress
  • Fatigue
  • Ultraviolet light
  • Friction or damage to the skin, caused by, for example, sexual intercourse, may also lead to a recurrence
  • Skin irritation (such as sunburn)
  • Surgical trauma
  • Diet and certain foods
  • Another illness (especially with fever)
  • Temperature extremes
  • Steroid medication (e.g., asthma medication)
  • Anything that lowers your immune system or causes local injury can trigger recurrences

Some psychological factors

  • Emotional upset and stress
  • Periods of prolonged stress can cause more frequent recurrences
  • It is also common to experience stress and anxiety as a result of having recurrences

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What are some of the symptoms of genital herpes?

Before a genital herpes infection appears the area will sometimes tingle, feel slightly raised and may appear red and inflamed.
During a primary genital herpes episode (the first outbreak) it is common to feel flu like symptoms, such as swollen glands, headache or fever. Aching or ‘tingling’ sensations in the groin, thigh and buttocks muscles may also occur.
Itching, pain and tingling sensations called the prodrome (or warning symptoms) typically occur 1 to 2 days before any sores appear.
A genital herpes infection will generally appear as a small, fluid-filled blister which goes through a cycle of phases. The blister will usually weep (ulcerate) and form a scab or ‘crusting’ before healing and disappearing completely.
Genital herpes symptoms can vary from person to person and can sometimes resemble blisters, bumps, cuts, sores, or a rash in or around the genital area.
The symptoms of a genital herpes infection may last as long as six weeks, but the typical duration of an outbreak is three to fourteen days.
Although a person has been infected with the herpes virus, they may not necessarily ever experience an outbreak. This is because some people’s immune systems have the ability to completely suppress the virus.
Stages of a typical herpes outbreak
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Is genital herpes contagious?

Yes, genital herpes is caused by the Herpes simplex virus and if the virus particles are transferred to another person they too can become infected.
Genital herpes is typically spread by direct skin-to-skin contact with the virus. Oral sex, intercourse and rubbing against the infected area are common examples of how the virus particles can be transferred.
It is important to use latex condoms or latex barrier protection in-between outbreaks for additional protection (please see your doctor for alternative barrier methods if you’re allergic to latex).
The herpes virus does not pass through latex condoms, and when properly used latex condoms are likely to reduce your risk of spreading or getting herpes, however even the best condoms do not guarantee total safety.

When herpes sores occur in places not covered by a condom the condom is of little help, if any. Condoms and foams should not be relied upon when herpes sores or symptoms are present.
Condoms do not guarantee 100% protection because a lesion may be found which the condom did not cover. Used consistently, however, condoms are one of the best available forms of prevention.
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How is the genital herpes virus spread?

Herpes is not spread through vaginal fluids, blood, semen or saliva. It is also not spread through the air like a flu virus. It is spread by direct contact with the Herpes simplex virus particles.
It is important to take precautions during an active genital herpes outbreak to prevent the virus from spreading.Herpes treatments can help to shorten the duration of the outbreak.
Genital herpes can be transmitted through direct contact with an infected blister or sore, usually through sexual contact. It can also be transmitted when there are no symptoms present.
HSV-2 infection is usually passed on during vaginal or anal sex. HSV-1 is usually transmitted to the genital area by oral sex (mouth to genital contact).
It is possible for a person to carry the virus without knowing that they have it, since up to 80% of people who are infected with HSV-2 show no signs of the infection.
So it is very easy for a person to unwittingly transmit the infection to their partner. The symptoms of the infection vary greatly between individuals. It might be totally unnoticeable in one person, but cause severe blistering in their partner.

Since the genital herpes virus can be transmitted through oral sex as well as vaginal sex, it is also possible to contract the virus from a cold sore on a partner’s mouth or face. It is possible to pass the virus on even if they did not have a cold sore present at the time of contact.

Alternatively, a person can contract the virus from a previous sexual partner, perhaps even several years ago. The virus can remain inactive in the body for long periods, so this may be the first time it has caused symptoms. Or, previous symptoms may have been so slight that the herpes condition went unnoticed or was dismissed (e.g… a mild rash, itching or tingling).
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When is genital herpes most contagious?

Herpes is considered to be most contagious when the blisters have burst open and have begun to weep fluid. This is because the liquid held in these blisters contains literally millions of herpes simplex virus particles.
During an outbreak, the population of virus particles becomes less and less as the herpes sore runs its course. There is a much smaller amount of virus particles present when the sore is healing and when the scab has formed.
However, as there are still virus particles present throughout every phase of the herpes outbreak the infected area is still considered contagious until the skin has completely healed.
If you know that you have come into contact with the virus in the past few minutes or so (e.g. if you or your partner have just touched an infected area) the simple action of washing your hands and the infected area with soap and warm water can help to sweep away the virus from your hands and other areas. By doing this you can help avoid the virus from spreading further.
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Can the virus be transferred to other areas of the body?

One kind of complication involves spreading the virus particles from the location of an outbreak to other places on the body by touching the infection. The fingers, eyes, and other body areas can accidentally become infected in this way.
Preventing self-infection is simple. Do not touch the area during an outbreak. If you do, wash your hands as soon as possible with soap and warm water. This will help prevent the virus from spreading further.
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Where do genital herpes sores usually appear?

Typically, if there is a recurrence a herpes sore will occur in the same location as it did previously, or closely nearby.
Nerves can have many axons which is why the herpes virus can take a number of pathways to your skin. This is why outbreaks can sometimes appear in different areas nearby to one another.
Each nerve has a particular area of skin that it serves, called a dermatome, so the herpes lesions are limited to the dermatome it initially infected, unless you autoinnoculate (self-infect) yourself somewhere else.
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How do I know if what I have is genital herpes?

Genital herpes can be mistaken for many different conditions and should always be diagnosed professionally.
If you suspect that you have herpes, but have not had your condition diagnosed, it is important that you visit your health care provider for a professional analysis.

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Are there conditions that can be mistaken for genital herpes?

Yes. People often presume that they have a particular condition without getting a professional diagnosis. This is very risky as not only can herpes symptoms appear differently in each person, but herpes can also be confused with many other infections.
If you have possible symptoms of an STI (Sexually Transmitted Infection) it is important that you visit a health care provide for their professional opinion. They will be able to give you proper guidance in managing the condition.
Also, a serious condition could get overlooked or you may be worrying yourself over a harmless irritation, but without a diagnosis you will never know for sure.
Conditions Confused with Herpes
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What is the difference between Genital Herpes and Genital Warts?

Genital warts is an STI (Sexually Transmitted Infection) caused by the Human Papilloma Virus (HPV). Genital herpes is a completely different condition, caused by the Herpes Simplex Virus (HSV).

Human Papilloma Virus (HPV) is a viral infection of the skin and is sometimes also called ano-genital warts, condylomata acuminata, genital or venereal warts.

There are approximately 30 types of HPV that are spread through sexual contact and can infect the genital area. This virus can cause growths of skin-colored, cauliflower-like masses of various sizes and shapes.

The symptoms of genital warts may occur several weeks to months after being exposed to the virus and include itching or burning around the genitals and painless growths (usually on damp or moist surfaces of the body) beginning as tiny and soft pink or red spots.

The spots usually develop into small white, yellow or gray ‘bumpy’ warts on the genitals or anus. These warts can grow quickly into irregularly shaped cauliflower-like masses.

More information about Genital Warts.

In comparison, the herpes virus generally develops into a fluid filled blister which ulcerates, begins to form a dry scab and then heals. Before the lesion appears the area can become inflamed, itchy and sometimes red. Burning and tingling sensations are commonly felt with an outbreak.

Once a person has contracted herpes the virus will remain in the body. Most of the time when Herpes sores are not present on the skin the virus remains in a latent (sleeping) state in the central nervous system, where it does no damage.
When the virus reactivates (wakes up), it travels nerve paths to the surface of the skin, sometimes causing a breakout of symptoms on the skin’s surface, otherwise known as an outbreak.
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What does a diagnosis for genital herpes involve?

If you have noticed symptoms that could be caused by the herpes virus you should visit your Doctor as soon as possible, while symptoms are still present. Your Doctor will examine your condition and should take a swab or sample of the infected tissue. This can be analyzed for herpes.
There are several tests that are used to diagnose herpes, some are more accurate then others. Methods of testing include diagnosis by:

  • Viral Culture
  • Serologic tests (Blood tests)
  • Antigen Tests

Some clinics will use diagnostic tools other than the recommended tests. Among these, two are generally not recommended; the Tzanck test and the Pap Smear, neither of which is a specific test for herpes.
If you have active symptoms and the sores have not yet healed you should ask your Doctor for a specific virus culture or assay for the herpes virus. Blood tests are generally used in cases where no symptoms are present.
For more information please visit our Herpes Diagnosis page.
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What is the most effective genital herpes treatment?

Herpes can be a difficult ailment to treat in some cases, and what works for one person may not necessarily work for the next. If you are having trouble with your outbreaks do not be disheartened, you just need to find the right treatment and combination of factors that will help you.
Herpes is directly related to your immune system, which is why outbreaks tend to happen most when the body is under pressure or not in its most vital state. Improving the health of the body is the most effective way to manage herpes, in addition there are many treatments, both conventional and alternative, that can assist your body in inhibiting the virus.
To manage herpes successfully there are 5 things that can be of great help

  • Improve your overall health and the strength of your immune system by eating lots of fresh fruit and vegetables and limiting processed and refined foods. Moderate exercise and avoiding toxins such as caffeine, cigarettes and alcohol will also be beneficial.
  • Certain herbs are antiviral and have been proven to help the body deal with the herpes virus, such as Andrographis with Echinacea, and Olive leaf. A blend of these herbs can be helpful if taken for 1 to 3 months consistently. Try to obtain herbs that are ‘standardized’ as this process guarantees the concentration of the herb for it to work.
  • Reduce or eliminate any outbreak triggers that could be aggravating the virus, such as a lack of sleep, intense stress or worry, poor diet or lifestyle habits. Taking some Panax Ginseng can be beneficial here to rejuvenate the body and counteract any stress or toxicity.
  • If the frequency of outbreaks is a problem, try cutting back on foods that are high in Arginine and increase Lysine rich foods. A supplement indicated for herpes may also be helpful, such as a Lysine tablet combined with vitamins and minerals.
  • Some treatments can help to ease the pain and make the symptoms go away much faster. These include prescription antivirals, ointments and supplements. You can research these options in our Treatment section.

AND Talk About It!

It sounds simple, but sharing your negative thoughts and feelings about the condition and letting out some of the bottled up emotions that you have can do you AND your body a world of good.
Pop into our Herpes Forum for support right now.
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What can I do to prevent genital herpes?

To minimize the risk of spreading herpes to a partner these simple steps will help

Tell your Partner

It is important for you and your partner to understand what herpes is, how it can be prevented and which precautions are best. By talking honestly and openly about the condition you will be able to work together to prevent infection.

Avoid Sexual Contact during an Outbreak

During an active outbreak the herpes virus is considered to be contagious from the very first sign of an outbreak (including the tingling, itching stage) until the area is completely healed again.

Herpes is most easily spread when a sore is present, but, the virus can also be spread at other times too. Some people notice itching, tingling or other sensations before they see anything on their skin.

These are called “Prodromal Symptoms” and they warn that the virus may be present on the skin. Herpes is most likely to be spread from the time these first symptoms are noticed until the area is completely healed and the skin looks normal again.
It is important to avoid any contact with the infected area during this high risk time. This includes oral sex, intercourse or rubbing against the area.

Limit the Number of Sexual Partners

By having sex with a non-infected partner who has sex only with you (mutual monogamy) you can greatly reduce the risk of spreading and contracting herpes.

Use Latex Condoms

Many couples have had sexual relations for years without transmitting herpes. Some simply avoid having sexual contact when signs or symptoms are present, while others also use condoms or other protection between outbreaks to help protect against asymptomatic shedding.
Condoms offer useful protection against herpes, protecting or covering the mucous membranes which are the most likely sites of infection. However, condoms do not provide 100 % protection because a lesion may be found which the condom did not cover. Used consistently, however, condoms are one of the best available forms of prevention.

Talk to your Doctor or Naturopath about medication

Discuss the option of taking a herpes suppressive medication, such as Valtrex or Acyclovir, with your Doctor. Certain supplements may also be helpful, such as Immune Support. Both of these contain ingredients which may help to reduce viral shedding, minimizing the risk of transmitting the virus when there are no symptoms.

Healthy Living

By taking better care of yourself you can help your body defend against the virus, reducing the possibility of an occurrence. Good rest, moderate exercise and fresh fruit and vegetable juices will assist in boosting the immune system (your body’s natural defense system against viruses, such as herpes).

Where to Now?

Ask questionsAsk questions and get support right now in the Herpes Support Forum