Genital herpes living in adults

Overview

Genital herpes is a common sexually transmitted infection caused by the herpes simplex virus (HSV). It causes outbreaks of painful blisters or sores in the genital area, but many people have no symptoms. The virus stays in your body and can cause recurrent outbreaks, but these usually become less frequent and less severe over time.

Yes, genital herpes is one of the most common sexually transmitted infections worldwide. In the UK, around 1 in 5 adults has HSV-2, and many more have HSV-1 (which can also cause genital herpes).

It affects sexually active adults of all ages, genders, and backgrounds. People with weakened immune systems or multiple sexual partners have a higher chance of getting it.

Symptoms

Common symptoms

• Small, painful blisters or sores on the genitals, buttocks, or thighs
• Itching or tingling in the area before blisters appear
• Pain when urinating (from urine touching sores)
• Flu-like symptoms during the first outbreak: fever, body aches, swollen glands in the groin

Symptoms in children

• Genital herpes in children is rare and often occurs through non-sexual transmission (e.g., from an infected mother during birth).
• Symptoms are similar to adults: blisters, sores, and pain in the genital area.

Symptoms in older adults

• Older adults may have more severe or longer-lasting outbreaks, especially if their immune system is weaker.
• Some may not have typical symptoms and may mistake sores for other skin conditions.

Causes

Main causes

• Genital herpes is caused by the herpes simplex virus (HSV). Most cases are due to HSV type 2, but HSV type 1 (commonly causing cold sores) can also cause genital herpes through oral sex.
• The virus enters the body through small breaks in the skin or mucous membranes during sexual contact.

Risk factors

• Having unprotected vaginal, anal, or oral sex
• Having multiple sexual partners
• Having a weakened immune system (e.g., from HIV, chemotherapy, or long-term steroid use)
• Being a woman – women are more easily infected than men

When to see a doctor

See a doctor urgently if:

• If you have your first outbreak of genital sores and are in significant pain
• If you are pregnant and suspect you have been exposed to genital herpes
• If you have severe symptoms like difficulty urinating or signs of a more widespread infection

Book a routine appointment if:

• If you have recurrent outbreaks that are bothersome or frequent
• If you have been told by a partner that they have genital herpes and you want to get tested
• If you want to discuss ways to reduce the risk of passing the virus to a partner

Diagnosis

A healthcare provider can usually diagnose genital herpes by looking at the sores. To confirm, they may take a swab from a blister or sore and send it to a lab for testing. A blood test can also detect antibodies to the virus, which shows you have been infected at some point.

Tests that may be done

• Swab test from a fresh blister or sore (most accurate when sores are present)
• Blood test for herpes antibodies (can tell if you've had the virus in the past, even without symptoms)

What to expect at your appointment

A swab test is quick but may be slightly uncomfortable. Results usually come back in a few days. Your healthcare provider will explain what the results mean and what treatment options are available. If you are diagnosed, they will also talk to you about telling partners and preventing spread.

Treatment

There is no cure for genital herpes, but treatment can reduce the severity and frequency of outbreaks. Antiviral medication can be taken during an outbreak to speed healing, or taken daily to suppress outbreaks and lower the risk of passing the virus to a partner. Your healthcare provider will discuss the best approach for you.

Self-care at home

• Keep the affected area clean and dry to help sores heal faster
• Wear loose, cotton underwear to reduce irritation
• Take over-the-counter pain relief (e.g., paracetamol or ibuprofen) for pain – ask your pharmacist
• Apply a cool compress or use a salt bath (a handful of salt in warm bathwater) to soothe sores
• Avoid sexual contact until all sores have healed completely

Medical treatments

Antiviral medication is the main medical treatment. It can be prescribed for each outbreak (usually taken for 5–10 days) or taken every day as suppressive therapy to reduce outbreaks and transmission risk. Always take medication exactly as prescribed by your doctor.

When is surgery considered?

Surgery is not used to treat genital herpes.

Living with this condition

Living with genital herpes means managing outbreaks when they happen and taking steps to protect your partner(s). Outbreaks tend to become less frequent and less severe over time. Many people with herpes have long periods with no symptoms. You can have a full and active sex life by using condoms and taking medication if prescribed.

Lifestyle tips

• Reduce stress – it can trigger outbreaks – try relaxation techniques like deep breathing or yoga
• Get enough sleep to keep your immune system strong
• Avoid excessive alcohol and smoking, which can weaken your immune system

Diet and exercise

A balanced diet rich in fruits, vegetables, whole grains, and lean protein can support your immune system. Regular exercise (like walking, swimming, or cycling) helps reduce stress and improve overall health. There is no specific 'herpes diet' but good nutrition helps your body fight the virus.

Mental health and emotional wellbeing

Being diagnosed with genital herpes can be upsetting. You may feel shame, anxiety, or worry about relationships. These feelings are common and normal. Over time, most people adjust and realize it does not define them. If feelings of depression or anxiety persist, speak to a healthcare provider or counsellor.

Prevention

Genital herpes cannot always be prevented, but you can reduce the risk. Using condoms every time you have sex lowers the chance of transmission, but condoms do not cover all skin where the virus may be shed. If you have herpes, taking daily suppressive antiviral medication can significantly reduce the risk of passing it to a partner. Avoid sex during an outbreak.

Vaccines

There is currently no vaccine to prevent genital herpes.

Screening programmes

Routine screening for genital herpes is not recommended for the general public. Testing is usually only done if you have symptoms or have been in contact with someone who has herpes.

Complications

If left untreated

• Recurrent outbreaks can be painful and disruptive
• People with weakened immune systems may have more severe and long-lasting outbreaks
• If a pregnant woman has an outbreak at the time of delivery, the virus can be passed to the baby (neonatal herpes), which is serious but rare
• In very rare cases, the virus can spread to the brain or spinal cord causing meningitis or encephalitis

Long-term outlook

With good management, genital herpes is not dangerous for most people. Outbreaks usually become less frequent and less severe over several years. Many people with the virus live normal, healthy lives, have fulfilling relationships, and have children without passing on the infection. Treatment helps keep symptoms under control.

Find support

Local organisations

• Your local sexual health clinic or genitourinary medicine (GUM) clinic · UK

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