Genital Herpes (Herpes Simplex Virus – HSV)

WHAT IS IT?

Genital herpes is a common STI that can cause blisters and open sores on the genital area. Genital herpes is caused by the herpes simplex virus (HSV).

There are two types of HSV. HSV-1 typically causes oral infection such as cold sores, while the HSV-2 mainly causes genital infection. About 20% of adults are infected with HSV-2.

 

HOW WOULD I GET IT?

The herpes virus is most often transmitted between partners during unprotected oral, anal, or vaginal sex with an infected partner.

  • Herpes is spread through direct contact with the infected area.
  • HSV-1 is most commonly transmitted by oral or genital sex, while HSV-2 is transmitted by unprotected anal or vaginal intercourse.
  • If someone receives oral sex from a partner with a history of cold sores, it is possible they could get HSV-1 (oral herpes) on their genitals.
  • An infected person can pass it on to a baby during vaginal childbirth. If you are pregnant, talk to your doctor to discuss ways to reduce transmission risk.
  • There is no risk of becoming infected after exposure to environmental surfaces such as door knobs, toilet seats, utensils, and bed sheets.

When a person is infected with HSV, the virus is not contagious 100% of the time. The risk of spreading the infection is much greater when a person has signs or symptoms of active infection. But it is still possible to spread the HSV infection even when no symptoms or visible sores are present. This is called “asymptomatic shedding.”

 

HOW WOULD I KNOW I HAD IT?

Many people may not know they are infected with HSV, or have genital herpes, as they may not have any symptoms. People with no symptoms can still pass on the virus.

Many infected individuals will have recurrent episodes of genital herpes sores for several years. The symptoms of genital herpes can vary widely, depending upon whether you are having your first outbreak or a recurrent outbreak.


Primary Outbreak:

In most cases the first herpes outbreak is the most severe. Symptoms tend to be more severe in people with vaginas than people with penises. The first outbreak usually occurs within a few weeks after infection with the virus. Symptoms typically appear within two to twenty days of infection.

Symptoms may start with a tingling or burning sensation where the virus first entered the skin and typically includes blisters that become painful ulcers. With HSV-2, the primary outbreak may cause multiple blisters or sores in the genital area.

The most common areas of infection and sores include the vagina, vulva, penis, scrotum, buttocks, anus, and thighs.

Blisters on the penis or outer labia may crust over and heal. New lesions may develop for up to a week after the first group appears.
In addition to genital ulcers (external or internal), other primary outbreak symptoms (that tend to resolve after approximately 15 to 23 days) of genital herpes include:

  • Flu-like symptoms (fever, headache, sore muscles, and joint pain)
  • Tender and/or swollen lymph nodes in the groin
  • Pain while urinating
  • Genital pain

A small percentage of people can develop headache, nausea and vomiting, or difficulty urinating when the herpes infection affects the nervous system. Inflammation in the nervous system (aseptic meningitis) can occur in up to 25% of cases.

Recurrent Infections:

It is possible to have a recurrence a few years after the initial HSV infection was acquired. Recurrent infections tend to be slightly less severe than initial infection.

Ulcers may develop in the same area as those of the first outbreak, or in new areas. It is also possible to develop lesions in areas where there was no direct initial contact. Other symptoms include:

  • A slight tingling, itching, or burning may be a sign that an active outbreak is coming
  • Outbreaks can be triggered by stressors (such as illness, surgery, emotional stress, lack of sleep), the menstrual cycle, sex, surgery, and some medications (i.e. alcohol)
  • Infection from oral sex can cause sores inside the mouth or on the lips
  • Symptoms resolve after approximately 9 to 11 days

 

HOW DO I PROTECT MYSELF AND MY PARTNER?

Using condoms can reduce your risk of transmission BUT the virus can still be spread through contact with an area that is not covered by the condom (buttocks, inner thighs). The following measures can also reduce risk of herpes spread:

  • Tell you sex partner if you have herpes.
  • Use condoms and dental dams to prevent transmission during oral sex.
  • Avoid sexual intercourse if your partner is having early symptoms or active sores.
  • Do not share personal products like razors and sex toys.
  • Decrease the risk of spreading herpes by taking an antiviral medicine every day.
  • Sex partners of infected persons should be aware that they may become infected even with the use of condoms or antiviral medications.

 

WHEN AND HOW DO I GET TESTED?

You should see a doctor or nurse to be tested for HSV the first time you have symptoms, or if your symptoms are severe. In Nova Scotia, there are no tests available that allow to you find out if you are carrying either of these viruses unless you have active lesions.

  • Herpes is tested by swabbing an active lesion for cells and/or fluid. Tests are most effective when the swab is collected as soon as possible after the sore appears.
  • Sexual partners from the 60 days prior to early symptom onset should be informed if you had an outbreak of herpes.

 

HOW IT IS TREATED?

There is no cure for genital herpes so treatment is not required, but is recommended, especially if you are sexually active and/or having symptoms. The infection can be managed with antiviral medication and self-care measures to decrease the duration and severity of outbreaks, while also reducing the risk of spread to sexual partners. It is best to start antiviral medications as soon as possible after initial outbreak begins.

Self-care steps to help reduce discomfort and manage outbreaks include:

  • “Sitz bath” or bathtubs where you can sit in warm water for about 20 minutes. Avoid bubble baths.
  • Keep the genital area clean and dry, and avoid tight clothes.
  • Practice good hand-washing and do not contact other areas of your body after touching an infected sore.
  • Take over-the-counter pain medicine such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin). Avoid aspirin (acetylsalicylic acid, ASA).
  • Over-the-counter creams and ointments are generally not recommended.

You should also let your doctor or nurse know if you are worried or upset about your herpes. We may be able to help you locate supportive services.

 

IF IT ISN’T TREATED, CAN IT LEAD TO MORE SERIOUS PROBLEMS?

By themselves HSV-1 and HSV-2 are generally not considered a serious health risk. Some less common long-term consequences include:

  • Life-threatening infections of the central nervous system can occur in babies who acquire herpes from their parent during childbirth.
  • Very rarely, HSV can cause meningitis or encephalitis (inflammation of the brain).
  • Herpes infection of the eye can cause scarring of the cornea and even blindness.
  • Herpes increases the risk of transmission of HIV. People with HIV can have particularly severe outbreaks of HSV, which can be a sign they have progressed to have AIDS.

 

 

HOW TO BOOK AND PREPARE YOURSELF FOR AN APPOINTMENT

An appointment to test for HSV is urgent. Please explain this to the person the phone while booking so that you may be fit in within the 48 hour testing window.

Booking an appointment with us is easy! Give us a call at 902.455.9656 ext. 0. You will be speaking with either a volunteer or a medical administrator. We cannot book appointments by email or Facebook. You cannot book an appointment for someone else, even if they are your partner or child. We will need to speak with them directly. To book, we will need your full name, birth date, phone number, and a very brief reason for your visit. That’s it! The person on the phone will outline anything you need to know to prepare for your appointment. For most general appointments, we run very short waitlists! While this is not a guarantee, we can often book you in within 1-2 weeks from the day you call.

Make sure you bring your valid provincial health card with you to your appointment. Clients without health cards are subject to doctors and lab fees.

Are you a youth? You do not need parental consent for any of our appointments.

Don’t have access to or lost your health card? You are entitled to your health card information! Call MSI toll-free at 1-800-563-8880 (in Nova Scotia) or at 902-496-7008 from Monday-Friday 8am-5pm. We require the number and the expiry date. Another tip: take a picture of your card! You will never lose it again!

APPOINTMENT PREP

Oral, vaginal, and anal STI tests have no preparation. In Nova Scotia, you must be displaying active lesions to test for genital herpes.