Genital herpes (GH) is a common sexually transmitted infection caused by herpes simplex virus (HSV).

There are two main types of HSV called type 1 and type 2. Oral cold sores are caused by type 1 HSV and genital herpes can be caused by either type. As many as one in five people are infected with type 2 HSV. Many have no symptoms and are not aware of their infection.

After getting GH, most people will have repeated outbreaks (episodes) of the infection.This is more likely during the first year or two of infection and in people who have type 2 HSV. Over time, recurrences become less frequent and may stop altogether.

Initial infection

For many people, the first episode is often painful. Typically, blisters develop on the genitals (penis or labia) which then scab and heal over two to three weeks.

You may also develop swollen glands in the groin. Rarely, some patients suffer a fever, headache and joint aches.

Latent (quiet) stage

HSV travels to nerves near the spine where it stays dormant (inactive). This may have occurred even without symptoms of the initial infection. There are no symptoms during this stage but small amounts of virus may be present on the skin from time to time (called viral shedding).

Recurrent episodes

This occurs when HSV ‘wakes up’ and travels along the nerve bundles to the skin and causes an outbreak of blisters. This is often in the same place as the initial infection, but may be elsewhere in the genital area; around the anus or buttocks and, rarely, the backs of the thighs. You may experience a ‘tingling’ or ‘stinging’ sensation before the blisters occur. Some people also feel feverish and lethargic at this stage, which is called the ‘prodrome’ of infection. Illness, severe prolonged stress (not every day worries), strong sunlight and sex can trigger recurrences. For women, recurrences can occur around the time of their period.

GH outbreaks are most common during the first months of infection, and recurrences may occur up to five or six times during the first year. As time passes, recurrences become less frequent. If you experience six or more in a year, you may benefit from preventative treatment.