How can I treat genital herpes?

Legs of couple, genital herpes explanation and management

Genital Herpes Article. Author: Dr Peter England, Obstetrician and Gynaecologist

Genital Herpes is a viral infection that can occur in both men and women and is due to the herpes simplex virus. Genital Herpes is obtained through sexual contact with a partner who is affected and is spread through vaginal, oral or anal sex.

Legs of couple, genital herpes explanation and management

1 in 8 Australians who are sexually active have genital herpes. 

It’s important to note that not only is it common but highly variable in its effect on you. 

In this article, I discuss the general presentation and behaviour of genital herpes, and some strategies for treatment.  

What is genital herpes?  

Genital herpes is due to a virus herpes simplex type 1 and type 2.

Around 80% of genital herpes is Type 2, and 20% is type 1. The same viruses cause cold sore, with 80% of cold sores due to type 1, and 20% due to type 2. The herpes virus family is quite broad and includes varicella zoster which causes chickenpox, cytomegalovirus which causes CMV, a mild infection in adults but devastating in pregnant women, and epstein-barr virus which causes glandular fever, to name but a few.  It is important to understand that episodes can be so mild that either the affected male or female may be totally unaware they are exposing their partner to the condition.

What symptoms will I have if I think I have genital herpes? The first, or primary, attack tends to be the most severe. Usually, there are a few days of feeling slightly off generally, headache and even a fever followed by localised tingling then burning on the external genital or anal/perineal area. Inspection of the affected area will usually reveal localised redness, small blisters that can weep and leave a shallow ulcer.  

The attacks tend to last 5-10 days approximately, then the skin heals over and symptoms disappear. You may notice swollen tender glands in the groin area. On occasion, the primary attack in women is very severe causing significant pain and burning passing urine. Sometimes, admission to the hospital for pain relief and help with bladder emptying for a few days is required.  

How is genital herpes diagnosed?

Visual inspection of the affected area followed by a simple swab test sent to the laboratory will confirm the diagnosis. Your doctor may suggest a general STD screen at the time of your consultation.  

How is genital herpes treated?

The initial attack of genital herpes may require analgesics including panadol, nurofen and sometimes prescription-strength painkillers. Bathing in salt baths (one cup of salt in a warm bath), topical anaesthetic ointment and alkaline sachets every few hours orally to de-acidify the urine will all be beneficial. Anti-viral tablets help reduce the severity and duration of the attack.  

Does genital herpes keep coming back? 

The majority of patients do have symptomatic recurrences in the first year. There may be only one episode, or it can be as often as monthly. Some women notice recurrences timed to their menstrual cycle. The good news is that with the passing of time the attacks usually become milder and far less often. Men tend to have higher recurrence rates than women. 

Living with genital herpes.

Firstly, suppressive antiviral therapy taken daily is available to patients who are finding the attacks frequent and annoying. Feel free to discuss this with me at an appointment. Generally, trying to lead a healthy lifestyle with a good diet, sleep and minimal alcohol give your immune system a chance to work efficiently. Excessive stress can often trigger attacks. 

Telling your partner about genital herpes.

Unfortunately, human beings often become quite distressed by the diagnosis of genital herpes. You should not feel guilty about the diagnosis, and the condition is not due to poor hygiene. You cannot get herpes simplex from toilet seats, swimming pools, from hugging etc. Many attacks are mild and asymptomatic so do not leap to being angry with your partner. It is important to have an open adult conversation about the diagnosis. Your doctor can help with this. You should avoid sexual activity while you are aware of symptoms. You should practice safe sex, use condoms and consider dental dams for oral sex. While it may seem a little embarrassing, you need to tell any sexual partners about the condition, for their own health and to limit potential spread to others.  

There are suggestions here to help you discuss genital herpes with your partner.

Genital Herpes is also discussed more here at the Mayo Clinic

If you are needing more medical assistance to cope with a case of genital herpes, please call for an appointment and we can discuss how to improve things for you.

Author: Dr Peter England, Obstetrician and Gynaecologist.
Read more about Dr Peter England

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