Genital herpes living in older adults

Overview

Genital herpes is a common infection caused by a virus called herpes simplex. It causes sores or blisters on the genital area. Once you have the virus, it stays in your body and can cause outbreaks from time to time. For older adults, outbreaks may be less frequent but can be more uncomfortable if they occur.

Yes, genital herpes is very common worldwide. Many older adults have had the virus for years, and it may become less active as they age.

Anyone who has ever had sex can get genital herpes. It does not go away with age, but the immune system of older adults may handle the virus differently. Some people get their first outbreak later in life if they were exposed earlier and never had symptoms.

Symptoms

Common symptoms

• Small, painful blisters or sores on the genitals, buttocks, or inner thighs
• Itching or tingling in the area before blisters appear
• Flu-like symptoms such as fever, body aches, or swollen glands
• Pain when urinating if sores are near the opening

Symptoms in children

• Genital herpes in children is rare and usually results from non-sexual transmission (e.g., during birth).
• Symptoms may include blisters, fever, and irritability.

Symptoms in older adults

• Outbreaks may be less frequent but can cause more discomfort due to thinner skin or other health conditions.
• Sores may take longer to heal.
• Sometimes the first symptom is a painful rash that can be mistaken for shingles.

Causes

Main causes

• Infection with herpes simplex virus type 2 (most common) or type 1.
• The virus is passed through direct skin-to-skin contact, usually during vaginal, anal, or oral sex.
• You can get herpes even if the person with the virus has no visible sores.

Risk factors

• Having multiple sexual partners
• Not using condoms consistently
• Having a weakened immune system (e.g., due to age, medications, or illness)
• Having had another sexually transmitted infection (STI)

When to see a doctor

See a doctor urgently if:

• If you have severe pain from a first outbreak
• If you have trouble urinating or feel like your bladder is full but you cannot go
• If the sores look infected (increased redness, swelling, warmth, or pus)

Book a routine appointment if:

• If you have any sores or blisters in the genital area that do not go away within a week
• If you think you have been exposed to genital herpes and want to be checked
• If outbreaks happen more than 4–6 times a year and bother you

Diagnosis

A doctor or nurse can diagnose genital herpes by looking at the sores and sometimes by taking a sample from a blister to test in a lab.

Tests that may be done

• Swab test: A cotton swab is rubbed gently over a sore to collect fluid.
• Blood test: Checks for antibodies to the herpes virus, even if you have no sores.

What to expect at your appointment

The swab test may be slightly uncomfortable but is quick. Your doctor will explain the results and what they mean. If you have no sores, a blood test can tell if you have been exposed to the virus in the past.

Treatment

There is no cure for genital herpes, but treatment can help control outbreaks and lower the chance of passing the virus to a partner. Medicines can shorten outbreaks and make them less painful.

Self-care at home

• Keep the area clean and dry
• Wear loose, cotton underwear
• Use a cool compress or ice pack wrapped in a cloth to soothe pain
• Avoid touching the sores so the virus does not spread to other parts of your body
• Wash your hands after any contact with the sores
• Rest and stay hydrated

Medical treatments

Your doctor may recommend antiviral medications that you take by mouth during an outbreak. Some people take a small daily dose to reduce how often outbreaks happen. These medicines are safe for most older adults, but your doctor will check for interactions with other medicines you take.

When is surgery considered?

Surgery is not used to treat genital herpes. In very rare cases, if a person has severe complications like a blocked urinary tract, a doctor may insert a tube to drain the bladder, but this is not a surgery for herpes itself.

Living with this condition

Genital herpes does not have to stop you from enjoying life. Between outbreaks, most people feel completely normal. When an outbreak happens, plan extra rest and avoid sexual contact until the sores are fully healed.

Lifestyle tips

• Learn your triggers: stress, illness, lack of sleep, and certain foods can bring on outbreaks for some people.
• Use condoms and dental dams every time you have sex to reduce the risk of passing the virus.
• Tell your partner(s) if you have herpes so you can make informed decisions together.

Diet and exercise

A balanced diet and regular exercise can keep your immune system strong. Some people find that foods high in a substance called arginine (like nuts and chocolate) trigger outbreaks, but this varies from person to person. Staying active and managing stress are very important.

Mental health and emotional wellbeing

It is common to feel embarrassed, anxious, or sad after a herpes diagnosis, especially if you are older and have not had to worry about STIs for a long time. These feelings usually fade as you learn more about the condition. Talk to a trusted friend, partner, or counsellor if you need support.

Prevention

You can reduce your risk by using condoms correctly every time you have sex, limiting the number of sexual partners, and avoiding sex when you or your partner have any sores or symptoms.

Vaccines

There is no vaccine for genital herpes. Researchers are working on developing one, but it is not available yet.

Screening programmes

Routine screening for herpes is not recommended for everyone. Only get tested if you have symptoms or think you have been exposed.

Complications

If left untreated

• Recurring outbreaks that can be painful and disrupt daily life
• Higher risk of passing the virus to a sexual partner
• In rare cases, the virus can spread to other parts of the body (e.g., eyes or brain) if you have a weakened immune system
• Increased risk of getting other STIs, including HIV, because sores make it easier for infections to enter the body

Long-term outlook

Most people with genital herpes lead full, healthy lives. The number of outbreaks usually goes down over time. With the right care and support, you can manage the condition and have a normal sex life. You are not alone, and help is available.

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