Hello all

I thought I might post on a slightly different (non-contraceptive) but very important topic - herpes. Maybe not directly related to contraception but I have lots of conversations about it in clinic. It is something that there is a lot of misinformation about.

The first thing to say is ‘most people have herpes’! Most of us will catch the cold sore virus when we are children or young people and many of us will have ‘cold sores’. Cold sores are commonly caused by herpes virus type 1 and genital herpes is commonly caused by herpes virus type 2, but the cold sore virus can cause genital herpes. So genital herpes is a cold sore in the genital area.

The second thing to say is that it is very difficult to tell where the herpes came from. Again, it is worth thinking about it like a cold sore. We get the cold sore virus as children and the virus may cause a cold sore immediately or it may lay dormant in our nerve endings. It can stay there for years and years. It may never cause a cold sore or it may cause one many years later. So that means that the time when you get your first cold sore is not necessarily the time when you caught the virus. It is the same with genital herpes - just because you get a first herpes outbreak at a particular time, that does not mean that you have recently caught the virus.

The third thing to say is that herpes is unlikely to cause you any long term problems. Most people will never get a herpes outbreak or get one occasionally. Some people get more regular (and annoying) painful outbreaks. The main exception to this is if a woman gets her first outbreak of herpes in the late stages of pregnancy. This is important and should be discussed with her midwife.

Finally, treatment is relatively easy but often not necessary. A course of medication if started within the first 2 days of the outbreak can reduce the length of the outbreak but for most people treatment is not required as your body’s immune system will fight the virus and outbreaks are often mild and usually get better within a few days. Some people get a more serious symptoms and can benefit from treatment - both anti-viral medication and treatment to reduce the symptoms - like local anaesthetic gel.

Hope this is useful. I am happy to answer any specific questions on this topic or to hear what others think.

Many thanks