I've genital herpes

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18 Dec 2014

Jenny from the ACT writes: I recently had a genital herpes outbreak — something that hasn’t happened for years (in fact I had almost forgotten I had it). Is it likely I’ll now have more outbreaks or is this just a one-off? I was a bit run down and under some stress at work. I don’t really feel like adding another pill to my regime but should I?

Dr Louise replies: Thanks, Jenny.

Herpes is a very common infection and antiviral herpes medications, like Valtrex, can help manage the symptoms. They are very effective and very safe, even when you take them for prolonged periods.

Mild and infrequent recurrences can be treated with short (e.g., two-day) courses. This is called ‘episodic’ therapy. But you should start treatment at the first sign of symptoms. If you catch it early enough — when you first notice itching or redness — it can sometimes prevent the full development of herpes lesions.

If you are experiencing more frequent outbreaks, you can take medication daily as ‘suppressive’ therapy. As well as reducing outbreaks, this will reduce the likelihood of transmitting it to your partners. Even when there are no symptoms, virus particles are shed from the skin and can be transmitted to others.

Genital herpes is caused by the Herpes Simplex Virus (HSV).

There are two strains of the virus and either can cause outbreaks in the genitals. But HSV 2 is more common. HSV 1 often causes the common cold sore, but can cause lesions in both areas. Accurate diagnosis is recommended and the best way to confirm you have the virus is from a swab taken from an ulcer or lesion.

Symptoms vary but usually include recurring sores or ulcers on the genitals, perineum, perianal region or buttocks.

Sometimes the first true outbreak can be quite severe and you get multiple ulcers, fevers, enlarged lymph nodes and muscle aches.

Initial herpes infections should be treated for up to 14 days to reduce the severity and duration of the initial episode. After that, outbreaks may be infrequent or come quite often.

Even though herpes is a common infection, many people don’t talk about it. If you have questions ask your healthcare professional or check out a rich source of professional, accurate and up-to-date information at the Australian HSV Management Forum.