Diagnosis of Genital Herpes
The diagnosis of genital herpes is based on a combination of clinical assessment, symptom history, and laboratory testing. Genital herpes is often diagnosed during or shortly after an outbreak, but it can also be identified through routine STI testing or investigation of unexplained genital symptoms.
Early and accurate diagnosis is crucial not only for symptom management but also for informing sexual partners and adopting protective measures.
Clinical Assessment
The first step in diagnosis is a detailed clinical examination, typically performed by a GP, gynaecologist, or sexual health specialist. The doctor will ask about:
Symptoms and duration, including the appearance of sores, pain, or tingling
Sexual history, including recent partners and use of protection
Previous STI diagnoses, if any
Other health conditions, such as HIV or autoimmune disorders
Visible sores, blisters, or ulcers may be examined for characteristics typical of herpes, including their location, appearance, and stage of healing.
While experienced clinicians can often make a visual diagnosis, lab tests are usually needed to confirm and identify the specific type of virus (HSV-1 or HSV-2).
Laboratory Tests
There are several diagnostic tests used to confirm genital herpes:
1. Viral Culture
A sample is taken from a fresh sore (preferably within 48 hours of appearance)
The sample is sent to a lab to check for HSV presence
This test can distinguish between HSV-1 and HSV-2, but may miss older or healing sores
2. Polymerase Chain Reaction (PCR) Test
A highly sensitive DNA test that detects HSV genetic material
Can be performed on a lesion swab, urine sample, or even spinal fluid in rare systemic cases
Preferred for its accuracy and ability to identify HSV type
3. Blood Tests (Serology)
Detect HSV antibodies to determine if a person has been previously exposed
Useful when no active sores are present or when evaluating a long-term unexplained condition
Cannot determine the exact location of infection (oral or genital), only that exposure has occurred
Blood tests are often used for asymptomatic individuals who have a partner with herpes or those planning a pregnancy.
Diagnosing Asymptomatic Cases
Some people learn they have genital herpes through routine testing or when a sexual partner is diagnosed. In these cases, if no sores are present, blood tests are the main diagnostic tool. However, because HSV is so widespread, a positive result may not indicate recent infection or predict future outbreaks.
A diagnosis of genital herpes does not mean a person is contagious all the time. Many people have antibodies without symptoms, and the risk of transmission can be greatly reduced with medication and condoms.
Importance of Type-Specific Testing
Identifying whether a person has HSV-1 or HSV-2 is important for prognosis and partner discussions. HSV-1 generally causes fewer recurrences and is less likely to be transmitted genitally during sex, while HSV-2 is more prone to ongoing shedding and repeated outbreaks.
Emotional Impact of Diagnosis
Receiving a diagnosis of genital herpes can be overwhelming. Common emotional responses include:
Shock, denial, or anger
Anxiety about future relationships
Concern about long-term health
It is essential to remember that genital herpes is a manageable condition. With time, education, and support, most people come to terms with their diagnosis and go on to lead healthy, confident lives.
When to See a Doctor
Seek medical advice if you:
Notice sores, ulcers, or blisters around the genital or anal area
Experience burning or itching with no obvious cause
Have a partner recently diagnosed with herpes
Are pregnant and have a history of herpes
Wish to be tested before starting a new relationship
Prompt diagnosis allows for quicker symptom relief, lower transmission risk, and better peace of mind.
Diagnosis of Genital Herpes
The diagnosis of genital herpes should be viewed not as a life-altering sentence, but as a step toward understanding your health, protecting your partners, and taking control of your wellbeing.
