Fighting the stigma of genital herpes
Dr. Aysha Butt is the Medical Director of FROM MARS, and is a GP Partner at Woodcote NHS Medical Practice.
Finding out you have genital herpes can be difficult. Not least because it’s a disease that’s dogged by myth and misinformation, and because it carries a stigma it doesn’t deserve.
But we’re tackling it head-on. We’re going to dispel some of the more persistent genital herpes myths, and hopefully we’ll make a dent in that undeserved stigma too.
These are some of the most commonly held beliefs about genital herpes. Are they real or not?
Genital herpes is a sexually transmitted infection (STI)
Herpes viruses are usually transmitted through body contact, and genital herpes is most often caught through having sex, so it is counted as an STI. This is probably one of the reasons genital herpes has a stigma, because infections caught through sex tend to be viewed as more serious and damaging than non-sexual infections, even if that isn’t the case.
Genital herpes causes blisters to form on your genitals
One of the symptoms of genital herpes is the appearance of small blisters and sores on and around the genitals, around the anus, and across the buttocks. This is also probably the other reason genital herpes has a stigma, as the blisters can look a little unsightly. They aren’t permanent though, they usually clear up in a week or two, and then they only appear again when you have flare-ups (also called an outbreak).
Genital herpes is rare
Does the herpes virus live in everyone? No it doesn’t, but it isn’t rare either. The World Health Organisation (WHO) estimates that over half a billion people between the ages of 15 and 49 worldwide are infected by the two types of herpes virus which cause genital herpes, making it one of the most common STIs in the world. If you have genital herpes you aren’t different or unclean or unhealthy, you’re just like hundreds of millions of other people.
Only promiscuous people get genital herpes
As you might have guessed from the above answer, this one isn’t true either. Genital herpes infections are common and widespread, and the virus is highly contagious, meaning it’s very easy to transmit. You could catch genital herpes from a single sexual experience, even if you use protection. You can even catch it from non sexual contact by simply touching someone else’s infected skin and then touching yourself.
HSV-1 only causes cold sores, and HSV-2 only causes genital herpes
Genital herpes is caused by an infection of a virus from the herpes simplex family of viruses. Herpes simplex virus 2 (HSV-2) most often causes genital herpes, and herpes simplex virus 1 (HSV-1) most often infects the face and causes cold sores. But the reverse can happen too. HSV-2 can infect the face, and HSV-1 can cause genital herpes. This means you need to avoid oral sex with someone with a cold sore, as it can result in genital herpes.
Genital herpes is only contagious during an outbreak
Is genital herpes always contagious? What do you think? Truth is, you can pass a herpes infection on even when you don’t have an outbreak. You are generally at your most contagious when you do have an outbreak, as the virus can be found living on your skin, but it can also be found in your bodily fluids, like saliva and semen when you don’t have an outbreak, or particularly just before an outbreak happens. This means you don’t necessarily know when you’re contagious, so you should assume you are at all times, and you should use protection when having sex, like condoms and oral dams.
Genital herpes can’t be transmitted if you use a condom
Genital herpes is usually transmitted by skin-to-skin contact. If you have an outbreak, the live herpes virus can be present on your skin around the outbreak, and it’s very unlikely that a condom will cover all of that skin. You shouldn’t have sex at all when you have an outbreak.
If your partner suddenly gets a flare up, they must be cheating on you
Your partner could have cheated on you and caught genital herpes from someone else, but there are other, more likely, explanations. Firstly, you or your partner may have already had a herpes infection before you got together, but you might not have known about it, as sometimes it can take some time for the first symptoms to appear. And many people who have genital herpes never or rarely have symptoms, meaning you or your partner could have genital herpes for years without even knowing about it.
Regular STI checks test for genital herpes
There isn’t a regular genital herpes test. You can only be tested for it if you have a flare up. A doctor or nurse will examine your infected skin and will take a swab from the infected blister to be sent away for testing to see if it contains a herpes simplex virus. But if you don’t have an outbreak you can’t be tested, meaning you can’t be tested regularly for the virus.
Genital herpes means the end of your sex life
Is herpes something to worry about? A herpes infection isn’t the end of anything. You can have a sexual and romantic life that’s every bit as fulfilling as the one you had before your infection, you just have to make a few changes. There are four main things you need to do to still have sex with genital herpes:
Tell your partner you have genital herpes
We know this doesn’t sound like the easiest of conversations, and you may well dread having it. We’ve got you though, with a few tips on how to tell a partner you have genital herpes.
Don’t have sex when you have an outbreak
This is when genital herpes is most contagious. You shouldn’t have any form of sexual contact. Vaginal and anal sex is a really common way to spread genital herpes. Oral sex can spread the virus to your partner’s face, while you or your partner could spread the virus on your fingers to other parts of your bodies through foreplay. This might be frustrating, but over time outbreaks tend to happen less frequently and clear-up faster, so this should be manageable.
Take medication like Valtrex and valaciclovir
Valtrex and valaciclovir are medications used to treat herpes infections. They can help clear up outbreaks faster and minimise the symptoms. Sometimes they can even be taken to reduce the number of outbreaks you have. Research has shown these medications significantly reduce the risk of passing the virus on to a partner.
Use protection between outbreaks
When you don’t have an outbreak, which is most of the time, you can still pass the herpes virus on, as it can be found in your body fluids, like in your saliva or your semen. Because of this, you should use protection, like condoms and dental dams, when you don’t have an outbreak to further minimise your chances of infecting your partner.
You and your partner need to recognise that these measures aren’t perfect. Even if you avoid all sexual contact during outbreaks, use protection between them, and take medication, there’s still a chance you could pass the infection on to your partner. These measures minimise the chances, but there’s still a risk. This is something you need to make clear to your partner.
Genital herpes can’t be treated
Has anyone been cured of genital herpes? The truth is that genital herpes can’t be cured for good. Once you’ve been infected by a herpes simplex virus it’s with you for life, as the virus takes up residence in your nerve cells and stays there for good. But genital herpes can be treated. Medications like Valtrex and valaciclovir can reduce the severity of outbreaks, and even stop them from happening.
If you have genital herpes, your sex life isn’t over. Although it does still carry a stigma, you can fight it by arming yourself with the facts. With the right attitude, and by making some changes, you can have the sex and love life you want.