What is genital herpes?

Herpes is a common infection that often causes painful sores on the genitals of men and women. It's caused by a virus called herpes simplex virus type 2, or HSV-2. About 200 new cases are diagnosed each year in Ireland.

Unfortunately, once you're infected, the virus stays with you, and there's a good chance that you'll have recurrences from time to time. The good news is that there are many things you can do to relieve symptoms and stave off outbreaks.

How do you get it?

Most people get genital herpes by having sex with someone who has the virus. It's also possible to get a milder form of genital herpes by receiving oral sex from someone who has cold sores, which are caused by a closely related virus.

How can I avoid herpes?

You can reduce your risk of getting herpes with some simple precautions. For starters, avoid having sex with or sharing personal items with anyone who is having an outbreak, since the risk of infection is highest at that time. If you happen to touch a sore, don't touch anything else and wash the area immediately with soapy water, because that can kill the virus before it infects you.

Use a condom with spermicide at all other times, because some people with herpes can transmit the virus through their skin even when they don't have any sores. Spermicide helps to kill the herpes virus but isn't a guarantee against infection. Keep in mind, too, that a condom doesn't cover everything; you can still get herpes from uncovered areas.

Also, avoid multiple partners, since this increases the risk that you will come in contact with someone who has the virus. Don't assume you can tell whether your partner has herpes, since many people never have obvious symptoms.

What are the symptoms?

While many men have silent infections, with no symptoms for years, even decades, women tend to experience symptoms within two to 20 days of infection. During the first attack, you may have flu-like symptoms such as fever, headache, swollen lymph glands, and muscle aches.

You'll also likely notice pain, burning, or tingling around your genitals, thighs, or buttocks, where sores will eventually appear. Small red bumps usually follow, which turn into fluid-filled blisters and break open into shallow pinkish sores. These sores can be very tender and painful. In one to three weeks' time, the sores crust up and disappear.

Later flare-ups tend to be milder, sometimes so mild that you may not even notice them. You'll probably have fewer sores, too, and those you have will heal more quickly. Some people have frequent attacks; others have them only rarely. The average is four per year, and that number tends to go down as time goes by.

What should I do if I think I have herpes?

See your doctor immediately for a diagnosis. If you do have herpes, antiviral drugs can ease your symptoms and shorten attacks, especially when taken early. These drugs include aciclovir, along with newer ones such as famciclovir and valaciclovir, which are absorbed more easily and don't have to be taken as often as regular aciclovir.

Be sure to let your doctor know if you're pregnant or thinking about becoming pregnant, since it's possible to transmit the virus to your baby during delivery if you have an active infection at the time. Your doctor will want to talk to you about ways to protect your baby's health. You may want to consider having a caesarean delivery, for example.

Does having herpes mean I can't have a sex life anymore?

Having herpes doesn't mean you have to be celibate; it just means you have to be extra careful with sex and relationships. Make sure you tell your partner about your herpes, so you can discuss things openly. And always use condoms with spermicide, because they offer better protection against the virus than condoms alone.

What are other ways to get relief?

• Take warm baths and showers; the heat can inactivate the virus. Dry off with a hair dryer set on low; the warm air will be much more comfortable than an abrasive towel.

• Take a mild pain reliever, such as aspirin or paracetamol.

• Wear loose-fitting cotton underwear and clothes during outbreaks. Tight-fitting, synthetic garments can cause you to sweat and chafe, which can irritate sensitive sores.

• To dry up sores and speed healing, keep the area clean, cool, and dry. You may want to take a break from heavy exercise during an outbreak, since perspiration and chafing can aggravate symptoms.

• Apply a water-based zinc ointment, Sudocrem, for example. It helps dry out the sores so they can heal faster, and may also boost the immune system.

• Try lemon balm. Some people think that this fragrant herb helps heal sores faster and with less scabbing, especially if it's applied early in an outbreak. Make a tea of dried lemon balm leaves and apply it to sores with a cotton ball.

• Take echinacea. Some people believe that this popular herbal cold remedy doesn't just fight cold viruses but that it's also effective against herpes viruses, including strains that are resistant to aciclovir. Echinacea is available in capsule or tincture form and should be taken at the first sign of an outbreak, or dab on a topical formula. However, the benefits of echinacea are not backed up by research.

Is there anything I can do to prevent future outbreaks?

• The best thing you can do is keep your immune system as healthy as possible, since outbreaks are most likely to occur when you're run down. Eat a healthy diet, get enough sleep, exercise regularly, and manage your stress with meditation or other methods.

• If you have a weak immune system, talk to your doctor about antiviral drugs. The same ones used to lessen an attack can help prevent recurrences.

• Some people believe that to avoid herpes you should eat a diet high in the amino acid lysine, such as eggs, potatoes, and dairy products, and avoid foods high in another amino acid, arginine, such as peanuts, rice, and chocolate. They theorise that the herpes virus needs arginine to replicate, and lysine prevents arginine from getting into your bloodstream. Lysine is also sold as a supplement in health food stores. These theories are not backed up by research.

• Avoid vigorous sexual intercourse if you have genital herpes, since the friction can trigger outbreaks in some people.

• Talk to a close friend, support group, or counsellor. Herpes is for life, and it will probably change how you deal with sex and relationships. It's not uncommon to feel anxious, guilty, or lonely, especially when you've just been diagnosed. Talking to someone about it will help you feel better and reduce your stress, which will help you avoid recurrences.