Genital herpes is a sexually transmitted infection (STI) most commonly caused by the herpes simplex virus type 2 (HSV-2). However, herpes simplex virus type 1 (HSV-1), which is more commonly associated with cold sores, can also cause genital herpes.
Both types can be transmitted from one area of the body to another, especially through oral sex. For this reason, it is not uncommon for HSV-1 to cause genital herpes and for HSV-2, less frequently, to appear in the oral area.
What should we know about herpes?
Let’s debunk some myths and share key information to help you understand how genital herpes works:
- Herpes is transmitted through skin-to-skin contact, not only through bodily fluids. Mucous membranes (mouth, genitals, anus) are more vulnerable, but the virus can also enter through thicker or keratinised skin.
- Condoms help, but they do not offer 100% protection. They only protect the area they cover, which means that even when using a condom, the virus can be transmitted if the lesions are in uncovered areas.
- Herpes appears in outbreaks. The first time the virus enters the body, it usually causes a more intense outbreak. It then remains dormant in the nerve ganglia and reactivates from time to time in the same area or nearby.
- Outbreaks can be triggered by various factors such as a weakened immune system (for example, due to flu), stress, or medications that affect the immune system.
- Outside of outbreaks, the risk of transmission is very low (around 1%), although it does not disappear completely. Some people may have asymptomatic outbreaks, meaning there are no visible symptoms, but they can still transmit the virus. This is not common and should be assessed on an individual basis.
- Routine herpes screening is not recommended unless there are symptoms or another clinical reason. This is because the diagnosis does not significantly change how the virus is managed, and in many people the infection is mild or goes unnoticed.
- Blood tests are not very reliable. Serological tests for herpes have low sensitivity (percentage of cases detected) and a high rate of false positives (positive results in people who do not have the infection). The only robust test for herpes is PCR testing using a swab taken from a suspected lesion.
The most important thing:
Genital herpes is not usually a serious infection and does not compromise your overall health. It can be uncomfortable, yes, and it affects an area that may cause embarrassment or distress, but it is not life-threatening.
That said, as with any STI, having one increases the likelihood of acquiring another. For this reason, it is important to look after your sexual health, use protection, and consult healthcare professionals if you have any concerns.
For diagnosis, when symptoms are compatible, it is best to have a medical consultation with an STI specialist before undergoing tests. If the clinician has any doubts during the consultation, a PCR test of the lesion can be carried out to confirm or rule out the diagnosis.
At Open House, we have specialist doctors who can advise you and diagnose herpes, in many cases even without carrying out tests. If testing is necessary in your case, we offer PCR testing, which is the most reliable option available. If you have symptoms of herpes or need guidance from a specialist doctor, book an appointment at one of our clinics or arrange a remote medical consultation.
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Dra. Julieta Domingorena Córdoba
