Home
Search
About AVERT
Donate here
Help & advice
Contact us
Links

Avert.org has more information about other STDs including statistics and our STD booklet.

The majority of the information on this page can be applied universally, and is not country specific. However, certain sections, such as 'Where to go for help', 'Treatment' and 'Testing' may be specific to the UK.

Genital herpes is caused by the herpes simplex virus. The virus can affect the mouth, the genital area, the skin around the anus and the fingers. Once the first outbreak of herpes is over, the virus hides away in the nerve fibres, where it remains totally undetected and causes no symptoms.

However, in some people, genital herpes may come back (recur) on the skin surface, at or near the place where it was caught. This may be when the person is ill or run down. Some people never get another outbreak.

Types of the virus

There are two types of the genital herpes virus. Either type is infectious, but:

• Type I infects the mouth or nose. It is more likely to recur than if Type II infects this area
• Type II infects the genital and anal area, it is more likely to recur than if Type I infects this area.

Genital and anal infections used to always be caused by Type II, but Type I is becoming more common in these areas, because more people are having oral sex.

Signs and symptoms

Symptoms of the first infection usually appear one to 26 days after exposure and last two to three weeks. Both men and women may have one or more symptoms, including:

• an itching or tingling sensation in the genital or anal area
• small fluid-filled blisters. These burst and leave small sores which can be very painful. In time they dry out, scab over and heal. With the first infection they can take between 2 and 4 weeks to heal properly
• pain when passing urine, if it passes over any of the open sores
• a flu-like illness, backache, headache, swollen glands or fever.

At this time the virus is highly infectious.

Recurrent infections are usually milder. The sores are fewer, smaller, less painful and heal more quickly, and there are no flu-like symptoms.

How genital herpes is passed on

Genital herpes is passed on through skin contact with an infected person. The virus affects the areas where it enters the body. This can be by:

• kissing (mouth to mouth)
• penetrative sex (when the penis enters the vagina, mouth or anus)
• oral sex (from the mouth to the genitals).

At this time the virus is highly infectious.

Where to go for help

• Your local sexual health (GUM) clinic.

  You can find details of your nearest NHS sexual health clinic in the phone book under genito-urinary medicine (GUM), sexually transmitted diseases (STD) or venereal diseases (VD). Or phone your local hospital and ask for the 'special' or GUM clinic. If you look in our Links section, you will find websites that list where to find your nearest clinic.

  You will get free, confidential advice and treatment. You can go to any clinic anywhere in the country - you don't have to go to a local one - and you don't have to be referred by your GP. (Non-NHS sexual health clinics may not always offer the full range of services which are available at NHS sexual health clinics.)

• Your own GP.
• The Herpes Viruses Association - for information and support for people who have herpes - tel. 020 7609 9061.
• The American National Herpes Hotline, tel : (919) 361-8488.
• If you are in the UK, go to www.playingsafely.co.uk to find details of STD clinics.
• If you are in the USA, go to http://herpes-coldsores.com/support/std_clinic_us.htm, from this site you can also find details of STD clinics in Australia, New Zealand, Puerto Rico and India.

The tests for genital herpes

• A clinical examination of your genital area is carried out by a doctor or a nurse.
• A sample is taken, using a cotton-wool or spongy swab, from any visible sores.
• Women may be given an internal pelvic examination.
• A sample of urine is taken.

As with any suspected sexually transmitted infection, it is possible to have more than one infection at the same time, so it is advisable to have a full check-up.

NHS sexual health (GUM) clinics routinely test for a number of sexually transmitted infections. You can have a test as soon as you have signs or symptoms for the doctor or nurse to look at. Laboratory tests will confirm their opinion.

Diagnosis and treatment

Samples taken during your examination are sent to a laboratory for testing, and the result is available usually within 2 weeks.

Treatment is not essential, as genital herpes will clear up by itself. Tablets are available which reduce the severity of genital herpes infection. These are only effective when taken within 72 hours of the start of the symptoms. Recurrent infections often do not require treatment.

If you have been told you have genital herpes you may be asked to see a health adviser who will explain about the infection and answer your questions. The health adviser will also ask you about your sexual partner(s).

NHS sexual health (GUM) clinics routinely test for a number of sexually transmitted infections.

Help during an outbreak

When you are suffering from genital herpes, there are several things you can do to help you feel better.

• Take pain-killers (aspirin/paracetamol) if you have any pain.
• Gently bathing the sore areas with a salt solution (half a teaspoon of salt to half a pint of warm water) twice a day may help: it is soothing and helps the sores to dry out.
• Wear loose clothing so that the air can get to the sore areas.
• Place an ice-pack wrapped in a clean cloth or towel on the affected area.
• If passing urine is painful, try urinating in a bath of water. Or try pouring water over yourself as you pass water.
• Drink plenty of fluids, such as mineral water and soft drinks, to help neutralise the urine. It is important not to hold back from passing urine as this can cause further problems.
• Avoid sunbathing and using sunbeds.
• Get plenty of rest.

Taking care of yourself and your partner

During an episode of genital herpes, the blisters and sores are highly infectious and the virus can be passed on to others by direct contact. To prevent this from happening you should avoid:

• kissing when you or your partner have cold sores around the mouth
• having oral sex when you or your partner have mouth or genital sores
• having any genital or anal contact, even with a condom or dental dam, when you or your partner have genital sores
• using saliva to wet contact lenses if you have sores around your mouth.

Remember - wash your hands with soap before and after touching the sores.

Between outbreaks of genital herpes rashes, the chance of passing on the infection is much reduced, although it may occasionally occur. However herpes does not mean the end of your sex life. Ask the advice of the clinic health adviser.

Remember, a condom will only protect against herpes infection if it covers all the blisters. Herpes can also be transmitted by non-penetrative sex.

Complications

Cervical cancer and genital herpes

There is no link between genital herpes and cancer of the cervix. However, it is still advisable for every woman to have regular smear tests.

Pregnancy and genital herpes

Having herpes does not affect a woman's ability to become pregnant.

If herpes first occurs in the first 3 months of your pregnancy there is a small risk of a miscarriage. Catching herpes towards the end of pregnancy may cause the baby to be born early. However, most women who have several episodes of genital herpes during pregnancy have a normal delivery.

Genital warts are small fleshy growths which may appear anywhere on a man or woman's genital area. They are caused by a virus called human papilloma virus (HPV).

There are more than 60 different types of HPV. Some types cause warts to grow on the genitals, others cause warts to grow on different parts of the body, such as the hands.

Signs and symptoms

After you have been infected with the genital wart virus it usually takes between 1 and 3 months for warts to appear on your genitals.

You or your partner may notice pinkish/white small lumps or larger cauliflower-shaped lumps on the genital area. Warts can appear around the vulva, the penis, the scrotum or the anus. They may occur singly or in groups. They may itch, but are usually painless. Often there are no other symptoms, and the warts may be difficult to see. In women genital warts can develop inside the vagina and on the cervix. If a woman has warts on her cervix, this may cause slight bleeding or, very rarely, an unusual coloured vaginal discharge.

Not everyone who comes into contact with the virus will develop warts.

How genital warts are passed on

Genital warts are spread through skin-to-skin contact. If you have sex or genital contact with someone who has genital warts you may develop them too.

They can be passed on during vaginal or anal sex.

(It is possible for warts to spread to the area around the anus without having anal sex.)

Where to go for help

• Your local NHS sexual health (GUM) clinic.

  You can find details of your nearest NHS sexual health clinic in the phone book under genito-urinary medicine (GUM), sexually transmitted diseases (STD) or venereal diseases (VD). Or phone your local hospital and ask for the 'special' or GUM clinic. If you look in our Links section, you will find websites that list where to find your nearest clinic.

  You will get free, confidential advice and treatment. You can go to any clinic anywhere in the country - you don't have to go to a local one - and you don't have to be referred by your GP. (Non-NHS sexual health clinics may not always offer the full range of services which are available at NHS sexual health clinics.)

• Your own GP.
• If you are in the UK, go to www.playingsafely.co.uk to find details of STD clinics.
• If you are in the USA, go to http://herpes-coldsores.com/support/std_clinic_us.htm, from this site you can also find details of STD clinics in Australia, New Zealand, Puerto Rico and India.

The tests for genital warts

A doctor or nurse can usually tell whether you have genital warts just by looking. If warts are suspected but not obvious, the doctor may apply a weak vinegar-like solution to the outside of the genital area. This turns any warts white.

To check for any hidden warts, the doctor may carry out an internal examination of the vagina or anus.

You can be checked as soon as you think you may have been in contact with the virus. Some people diagnosed with the virus won't develop visible warts straight away, and you may be asked to come back for another examination.

Diagnosis and Treatment

As genital warts are caused by a virus and not a bacteria, antibiotics will not get rid of them.

A common treatment is a brown liquid (podophyllin) which is painted on to the wart(s) and must be washed off 4 hours later (or sooner, if the area is irritated). The clinic may prescribe podophylotoxin for use at home. Another common treatment is freezing the warts or laser treatment. Often more than one kind of treatment is necessary before the warts are gone.

These treatments may be uncomfortable, but they should not be painful. If your treatment hurts, tell the doctor.

You should get individual advice about having sex during treatment from your doctor, nurse or health adviser.

Never try to treat genital warts by yourself. Always seek medical advice.

If you're pregnant, or trying to become pregnant, it is important that you tell your doctor, as podophyllin treatment could harm the developing baby and another treatment will be used.

Taking care of yourself and your partner

If you have genital warts:

• Keep your genitals clean and dry.
• Don't use scented soaps and bath oils or vaginal deodorants, as these may irritate the warts.
• Use condoms when having sex. Remember, condoms will only protect against the wart virus if they cover the affected areas.
• Make sure that your partner has a check-up too, as they may have warts which they haven't noticed.

Follow-up

It is important to return regularly for treatment until your genital warts have gone so that the doctor or nurse can check progress and make any necessary changes in your treatment. Sometimes treatment can take a long time.

The majority of people whose genital warts initially disappear will get a recurrence.

Warts and the cervix

Some types of the genital wart virus may be linked to changes in cervical cells which can lead to cancer. Although there is no direct link between genital warts and cancer of the cervix, it is important that all women over 20 years of age have a regular cervical smear test.

If a problem is suspected a colposcopy is done to look at cells on the cervix. A colposcope is a kind of small telescope with a light which is used to view the cervix. The scope magnifies the cells so the doctor can detect any changes. The doctor may take a small sample of cells (called a biopsy), which will be looked at in a laboratory.

The colposcopy may feel uncomfortable. If you have a biopsy taken you may have a dull ache like a mild period pain, with slight bleeding.

If you have genital warts on your cervix or vagina, they'll usually be removed by freezing or by laser treatment under local anaesthetic.

Remember, after treatment, using condoms can reduce your risk of getting or passing on sexually transmitted infections.

Non-specific urethritis (NSU) is an inflammation of a man's urethra. This inflammation can be caused by several different types of infection, the most common being chlamydia.

Signs and symptoms

NSU may be experienced months or even in some cases years into a relationship. The symptoms of NSU may include:

• pain or a burning sensation when passing urine
• a white/cloudy fluid from the tip of the penis. This may be more noticeable first thing in the morning
• feeling that you need to pass urine frequently

Often there may be no symptoms, but this does not mean that you cannot pass the infection on to your partner(s).

How NSU develops

NSU is almost always caused through sexual infection. Very rarely it can result from an allergic reaction, such as to bubble baths or washing powders or other chemicals.

Where to go for help

• Your local NHS sexual health (GUM) clinic.

  You can find details of your nearest NHS sexual health clinic in the phone book under genito-urinary medicine (GUM), sexually transmitted diseases (STD) or venereal diseases (VD). Or phone your local hospital and ask for the 'special' or GUM clinic. If you look in our Links section, you will find websites that list where to find your nearest clinic.

  You will get free, confidential advice and treatment. You can go to any clinic anywhere in the country - you don't have to go to a local one - and you don't have to be referred by your GP. (Non-NHS sexual health clinics may not always offer the full range of services which are available at NHS sexual health clinics.)

• Your own GP.
• If you are in the UK, go to www.playingsafely.co.uk to find details of STD clinics.
• If you are in the USA, go to http://herpes-coldsores.com/support/std_clinic_us.htm, from this site you can also find details of STD clinics in Australia, New Zealand, Puerto Rico and India.

Don't pass urine for at least 2 hours before attending the clinic or doctor's surgery.

The tests for NSU

• A physical examination of your genital area by a doctor or nurse.
• Samples are taken, using a cotton-wool or spongy swab, from the penis or urethra.
• A sample of urine is taken.

None of these tests should be painful, but they may be uncomfortable.

Diagnosis and treatment

Samples taken during the examination are looked at under a microscope to check for infection. In some clinics, the result is available immediately. A second sample is sent to a laboratory for confirmation of the infection. The result is usually available within one week.

Treatment for NSU is easy. You will be given antibiotic tablets. If you are allergic to any antibiotics, it is important that you tell your doctor.

It is important that you finish any course of treatment. If treatment is interrupted, it may be necessary to start again from the beginning.

Your partner should also attend the clinic for a check-up.

Follow-up

It is important to return for a check-up after you have completed the treatment to ensure that the infection has gone.

You should not have penetrative sex (when the penis enters the vagina, mouth or anus), not even with a condom, until you have returned to the clinic and been given the all-clear by the doctor.

Complications

NSU may recur. A recurrence may be triggered by excessive friction during sex or masturbation, or by excessive alcohol consumption. Serious complications are rare. If they do occur you may experience:

• inflammation of the testicles
• reduced fertility
• Reiters syndrome - which causes inflammation of the eyes, joints and urethra, and sometimes sores on the penis or soles of the feet.

Remember, after treatment for NSU, using condoms during sex can reduce your risk of getting or passing on sexually transmitted infections.

Last updated October 7, 2004