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What is genital herpes?
Genital herpes is a sexually-transmitted infection (STI) that is caused by the herpes simplex virus (HSV). It is one of the most common STIs in Australia, spread during unprotected vaginal, oral or anal sex. Some people with the virus will not experience any symptoms, while others will develop small blisters or ulcers on or around their genitals or anus. The best way to prevent getting genital herpes is avoid having unprotected sex.
Genital herpes is caused by an infection with HSV. There are two different forms of the virus that can cause herpes - HSV1 and HSV2. HSV1 is more usually associated with cold sores near the mouth (oral herpes), while HSV2 is more commonly associated with the genital herpes. However, it is possible to be infected with either strain at both sites.
Genital herpes is a STI, which means you can contract it by having unprotected sex. The virus that causes genital herpes is usually spread by direct contact with the herpes blisters during vaginal or anal sex, but people without any symptoms can still spread the virus. It can also be spread to the genitals through contact with cold sores around the mouth during oral sex. It is possible for HSV to be passed onto a baby during childbirth if the mother is infected, although this is not very common.
In people who experience repeated outbreaks of genital herpes, there are certain factors that may trigger an outbreak. These include:
The risk of passing on HSV during unprotected sex is increased by the presence of blisters or ulcers. However, it is also possible to spread the herpes virus without any symptoms. If you have herpes, your partner has a 5-20% chance of catching herpes within 12 months. 
Anyone who is sexually active can contract genital herpes. People who are at a higher risk of becoming infected include those who:
- Do not practise safe sex;
- Have multiple sexual partners;
- Are a young, sexually-active adult, or;
- Have a past history of contracting an STI.
Signs and symptoms
It is possible to be infected with HSV without developing any symptoms. This is called subclinical infection. In some people, the virus causes small blisters or ulcers on or around the genitals. The blisters can also occur around the anus, buttocks and upper thighs. If you have genital herpes you may also experience:
- Flu-like symptoms, such as headaches, fever and aches and pains;
- Pain or a burning sensation when urinating;
- Small cracks in the skin, and;
- A red rash or skin.
Once you contract the virus that causes genital herpes, you have it for life. After the signs and symptoms of an initial infection have cleared up, the residing virus can cause the symptoms to reappear. Generally, the herpes outbreaks occur less often over time and are less painful than the initial infection.
Methods for diagnosis
To diagnose genital herpes, a doctor will ask you questions about your medical history and identify any visible symptoms, such as blisters or ulcers. A swab from the blister or ulcer may be taken and tested for presence of HSV. The tests include:
Polymerase chain reaction
The polymerase chain reaction (PCR) is a commonly used test that can detect presence of the virus through its DNA. The test amplifies tiny amounts of viral DNA to amounts that can then be positively used to identify the type of HSV. A PCR test result is usually available within days of the sample being collected.
Diagnosis can be confirmed by culturing a sample of fluid taken from a blister. The culture is then tested with an antibody specific for the HSV strain. This test may take several weeks to confirm the diagnosis.
Although a blood test is available, it is not reliable. Individuals who have herpes can produce a negative blood result and those without herpes can produce a positive result. It is also possible for the results to change over time without any change in your herpes status. For these reasons, it is generally not recommended to have a blood test for herpes.
Types of treatment
There is no cure for genital herpes, but treatments are available that can help to relieve the symptoms and reduce the frequency of outbreaks.
To reduce the severity of the symptoms of a genital herpes outbreak your doctor may prescribe some oral antiviral medications, such as acyclovir, famciclovir or valaciclovir. If you experience repeated outbreaks, your doctor may prescribe an antiviral medication that may reduce the chances of developing symptoms. In addition, your doctor may recommend using over-the-counter medications, such as aspirin or paracetamol, to provide some relief from pain and discomfort associated with genital herpes.
Some simple things you can do at home to reduce the pain and itching associated with genital herpes include having a salt bath and applying icepacks to the affected area.
A mother with genital herpes can pass the infection on to her baby during childbirth. This is known as neonatal herpes and is one of the most serious complications of HSV. Infection of a baby with HSV can cause serious health issues and death. This condition is very rare.
Very rarely, the infection that causes genital herpes can lead to meningitis, which occurs when the thin membrane layers that surround the brain and spinal cord become inflamed.
Genital herpes can cause pain when urinating. This is known as dysuria and is a common complication for women with genital herpes. If the symptoms are very severe, the pain can make it difficult to urinate, which can potentially lead to urinary obstruction. Sometimes, passing urine in a bath of salty, warm water can help relieve the pain and relieve the need for further treatment.
If you are infected with genital herpes, the virus will remain in your body for the rest of your life. Some people with the infection will only develop one outbreak, while others may frequently develop symptoms. For people who have frequent outbreaks, there are antiviral medications available that can help reduce the symptoms and prevent future outbreaks.
The risk of contracting genital herpes can be reduced by practising safe sex, which means using a barrier such as a condom. Consistent use of condoms will reduce the risk of contracting herpes by 50%.  It is best to avoid any sexual contact if either partner has an outbreak of herpes.