Commonly asked questions about genital herpes

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Genital Herpes Commonly Asked Questions

People often find a diagnosis of genital herpes to be distressing and shameful. It needn’t be so.

Accurate information about herpes, and how it can be treated, reduces that distress.

The following questions are just some of commonly asked questions – and answers – about genital herpes.

Just imagine that you are talking to Dr Doug Ross (aka George Clooney) from ER. He features in all of my talks, so why not one of my Blogs?!

How do I tell a new partner that I have genital herpes?

There is a small risk of passing on the infection between symptomatic episodes by asymptomatic viral shedding, so informing a new partner about having herpes is a difficulty to face up to. Some people find it easier to wait until a relationship has developed and strengthened before disclosing this sensitive information while at the same time being careful to practice safer sex.

Will I give genital herpes to a new partner?

The sexual transmission rate between discordant couples is about 10-15% a year. The risk of transmission is reduced by avoiding sex when active lesions are present, but asymptomatic shedding may occur with the subsequent risk of transmission.

How have I caught genital herpes if my partner did not have symptoms?

It is possible to be infected without knowing.

2 out of 3 people catch the virus from someone who is symptomatic.

Viral particles can be shed through the skin when lesions are not present.

Commonly acquired from the lips through oral sex.

How often will I get an episode of genital herpes?

Some people have no further episodes after their primary episode.

A few get frequent recurrences

(6 or > episodes per year).

HSV 2: 90% have a recurrence within the first year with the frequency of attacks related to the severity of the initial infection.

Frequency of episodes (and viral shedding) decreases in second and subsequent years.

HSV 1: 60% will have a recurrence within the first year, with recurrences beyond the first year unusual.

What brings on an episode?

A recurrence occurs when latent virus is reactivated, causing a peripheral lesion to appear. It is not clear why, but precipitating factors such as local nerve stimulation (local trauma, UV light), immunosuppression (HIV, malignancy) and persistent stress have been implicated. The association with menstruation is unclear.

Will all episodes be this painful?

The first symptomatic attack of herpes is usually the worst. Subsequent attacks tend to be shorter and less painful. Patients are advised to use painkillers e.g. codeine, paracetamol and ibuprofen and/or salt baths. Urinating in the shower may be more comfortable, particularly for women with painful sores around the urethral orifice.

Do I need to treat each episode?

Usually only the initial episode of genital herpes is treated with an antiviral preparation, as treatment of subsequent attacks has little influence on the symptoms and their duration. Therefore, generally only symptomatic treatment is advised for recurrent attacks. If someone is experiencing symptomatic attacks >6 times a year they can consider suppressive treatment.

 

If you have more questions about genital herpes, make an appointment to see Dr Tonia Mezzini today. 

Dr Tonia Mezzini is known for offering the best possible advice and treatment options for a person’s sexual health care needs. In particular, she cares for patients with: