"Now that we understand the virus and have good, safe, anti-viral drugs it is much easier to live with genital herpes."
In brief...
Both sexes can get genital herpes at any age, it is a very common infection. It is a viral infection which is usually caught during unprotected sex. Genital herpes is related to the cold sores that you might get around your mouth and can be caused by the same, herpes simplex, virus. During the first attack the virus can make you feel very unwell, it will be painful for you to pass water and you will feel very sore in the genital area. Genital herpes can come back in some people but these 'recurrent' attacks are usually mild. Most people don’t have too many problems after the first attack of herpes. It is usually easy for us to test for and treat genital herpes.
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What are the different types of herpes simplex virus?
There are two types of the herpes simplex virus, HSV, type 1 and type 2. Mouth cold sores are caused by type 1 HSV only, whereas genital herpes is caused by both type 1 and type 2 HSV. About half of all genital herpes infection are caused by each type of virus. We can tell which one only by using laboratory tests.
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How did I catch it?
Genital herpes can be caught by:
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Having sex with someone who has genital herpes at the time.
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Having sex with someone who is shedding the herpes virus in the genital area but is unaware of this.
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Contact between your genitals and someone with mouth cold sores during oral sex.
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Contact between your genitals and someone who is shedding herpes in their mouth but is unaware of this.
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Transferring the infection from your own cold sore to your genitals, or eyes.
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Using a wet towel that has been used immediately before by someone who has an active herpes virus infection. This is very uncommon.
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What are the symptoms the first time I am infected, initial genital herpes?
Many people who have one attack of genital herpes never have another attack. Like those of cold sores the symptoms of genital herpes vary. The first time you are infected you might not have any symptoms at all. You might experience flu-like symptoms, fever, tiredness, headaches, and aches and pains in the lower back and down the legs or groin. You might then get 'crops' of small blisters anywhere in the genital region. They burst to leave small, red, punched-out ulcers. These are sore to touch and can be painful even if you don't touch them. One crop might go and be replaced by another one in another place. They will heal on their own and don't scar. You might find it painful when you urinate, 'pee'. If you can't see the blisters, this might be the first thing you notice.
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How long does a first attack last for and what should I do?
If you don't seek treatment, this first 'attack of herpes' might last for 2 to 3 weeks.
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Until the sores have all healed you are infectious.
Don't have sex and be very careful about washing and sharing towels.
It is important that you do get seen and arrange some treatment as early as possible to prevent you getting some of the more serious complications including urinary retention, the inability to pee. Some other infections have similar symptoms to those of genital herpes but need different treatment.
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If I am having a first attack, what should I do before getting to shac?
The following advice can help ease the symptoms until you can get to a doctor:
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If the pain is bad, try taking paracetamol or any other painkiller that you usually take.
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Put something cold against the sores, some ice cubes wrapped in a clean cloth, or a packet of frozen peas or carrots.
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Keep the sores as dry as possible, don't overwash them, and leave them exposed to the air as much as possible, avoid tight clothes.
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Bathe the sore area with warm, salty, water 2–4 times a day. (One teaspoon of table salt per pint of water, well dissolved.)
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Add some table salt to your bathwater, about a handful.
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If peeing is very painful try to pee while you are in the bath. You might want to have another wash afterwards.
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How can I avoid giving herpes to others while I am infectious?
The herpes virus can 'shed', be infectious, even when you don't have an attack. This is most likely to happen in the week before and after an attack, especially in the first year after you catch herpes.
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Don't kiss anyone if you have cold sores.
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Don't have oral sex if you or your partner have cold sores or genital sores.
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Don't have sex even with a condom when you have sores, or have a genital itch, or soreness, in case it is herpes.
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Don't let your partner touch your genitals when you have sores.
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Wash your hands well with soap and water after touching the area that has sores.
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Don't share towels or flannels.
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Don't use saliva to wet contact lenses you might spread the sores to your eyes.
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When can I have sex again?
When you have painful sores you probably won't want to have sex anyway and this is also when you are most infectious. Even when you have sores you can still enjoy your partner's body as long as you don't put each other at risk. YOu must wait until the sores have healed completely, then wait a further week to be safe, and then use a condom.
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What are the symptoms of a recurrence, a 'return attack'?
The virus that causes genital herpes hides in the nerves where your body's immune system can't get to it and can return to cause symptoms later on. Many people who have had one attack of genital herpes never get another. Recurrent attacks usually last for 3–5 days and are usually much milder than the first one. About 12–24 hours before the sores come back you might notice a tingling sensation, this is the virus travelling down the nerves to the genitals. You are unlikely to feel ill when you have a recurrent attack. You are more likely to just get some sores which crust over and heal without scarring. Most people need no treatment for recurrent attacks.
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What causes a recurrent attack?
The virus responds to changes in your body which trigger an attack, these can include:
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When you are feeling stressed or 'under the weather'.
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In girls and women, when you are having your period.
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After friction from sex.
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When sunlight hits the area, beware of nude sunbathing or using sunbeds.
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When you are wearing tight clothing or nylon underwear.
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What can I do to avoid a recurrent attack?
Try to improve your health in general. Eat a well-balanced diet, avoid smoking and drinking too much alcohol, avoid direct sunlight.
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What tests can you offer at shac?
It can be quite easy for us to tell if you have herpes by the appearance of the sores but we may need to test for other infections and conditions as a precaution, this is routine.
At shac we will have a careful look at where you have the sores and any other areas that are likely to be infected. If you are very sore we won't do much at all. We will gently take a small sample, using cotton wool, from any sores that we can see to test for virus and we will ask to do a blood test.
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When can I expect the results?
The samples are tested in our laboratory and we should have the results in 7–10 days.
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What treatment can you offer at shac?
If we think that you have herpes, you can take tablets to reduce the severity of the infection and the sooner you are treated, the better. A cream is also sometimes used to control the symptoms. You will usually find that the symptoms of recurrent infections are tolerable without treatment.
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What should I do after coming to shac?
Because you have an infection that has probably been caught during sex we will offer you testing for some other infections. Until you have been given the 'all clear' it would be best to avoid having unprotected sex.
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Do I need to tell my partner?
If you have already had sex with someone at a time when you might have been infectious it would be a good idea to tell them, they might have given it to you...
If you haven't yet had sex with a new partner, you can decide whether to tell them. The chances of you giving them genital herpes between your attacks are low but using a male or female condom would be a very good idea.
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What about genital herpes and pregnancy?
Your fertility will not be reduced by having genital herpes. Most pregnant women who have either an initial herpes infection or a recurrence experience have no extra problems with their pregnancy. If you catch genital herpes in the first three months of pregnancy there is a small extra risk of miscarriage. You should tell your doctor if you are pregnant and have ever had genital herpes because if you have active sores at the time of giving birth you might be advised to have an elective caesarean delivery to prevent your baby becoming infected.
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How can I learn to live with genital herpes?
In the 1980's, the media gave a lot of publicity to the problem and it was very tough to live with herpes. We now know much more about this condition, herpes is often caught during steady relationships and has little to do with how many sexual partners you have had. Most people do not have troublesome recurrences. There are good treatments for herpes and most people who have genital herpes now have long-term, stable, happy relationships. At shac you can speak to a counsellor about living with genital herpes if it is causing you problems.
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re there other types of herpes virus and infections?
Herpes simplex virus can also infect the anus or rectum, or the eyes. Chickenpox and shingles are 'distant cousins' to the herpes simplex virus.
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Support and information.
If you are finding it difficult to live with herpes and would like some advice, a number of organisations can help including:
The Herpes Viruses Association,
Website: www.herpes.org.uk, written in the UK for UK residents.
Telephone helpline: 0207 609 9061, answered by trained volunteers who have herpes simplex, this can be very helpful at relieving the sense of isolation.
Or write to them, enclosing a large, stamped addressed envelope:
The Herpes Viruses Association,
41 North Road,
London
N7 9DP
You can also check out www.herpesweb.net as well as the local clinics listed on our useful links page.
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