We’re revisiting one of our most-watched episodes, a conversation with Marian Nicholson, of the Herpes Viruses Association and Shingles Support Society. Genital herpes is common, usually mild, and still one of the few conditions people talk about in terms of shame rather than health.
Top 5 highlights from the conversation
1. It’s the word people fear, not the condition
Nobody says they don’t mind having cancer, only that they don’t want to pass it on, yet that’s exactly how people talk about herpes. The distress, she says, comes from decades of stigma attached to the name, not from the virus itself, which is mild for the vast majority of people. Facial cold sores, caused by the same family of virus, carry none of the same weight, simply because everyone already understands they’re common.
2. Most people who have it don’t know they have it
Only around one in three people who catch the virus ever develop symptoms clear enough to prompt a diagnosis. Transmission overwhelmingly comes from people who don’t realise they’re carrying it, and GP-level misdiagnosis as thrush is common without access to lab testing. For an accurate diagnosis, go to a sexual health clinic rather than a GP surgery.
3. Warning signs exist, and noticing them changes the outcome
Many people feel a tingling, itching or “volcano” sensation up to 24 hours before a visible outbreak appears. Avoiding sexual contact from that first sign, rather than waiting for a sore to show, meaningfully reduces the chance of passing the virus on. Trust that signal when it’s specific to the affected area, rather than second-guessing every unrelated sensation.
4. The condom numbers people rarely hear
Where a man has genital herpes, condoms reduce the risk of passing it to a partner by 96%; where a woman has it, the figure is 65%, because outbreak sites in women can extend beyond what a condom covers. There’s also a useful diagnostic clue for anyone unsure what they’re dealing with: a genuine recurrence appears on one side of the body only, so symptoms on both sides at once point to something else, and a GP can help rule out what that might be.
5. Pregnancy carries far less risk than most people assume
Where someone already has the virus before conception, normal delivery is expected even with a recurrence at term, since babies acquire protective antibodies from their mother late in pregnancy. The real risk is different: a first infection late in pregnancy, before those antibodies have built up, which is why condom use is recommended from around month seven if there’s any chance the pregnant partner hasn’t already had the virus.
About the expert
Marian Nicholson has been the director of the Herpes Viruses Association since 1995. She answers helpline calls, writes the monthly updates and the website. She hosts the monthly in-person sessions in London, as well as meet-ups around the country on an ad hoc basis. She is often the host of the monthly free Zoom sessions. Regularly, sexual health clinics request her talk for their staff entitled “Helping You to Help Your Patients with Herpes”
Charity: Herpes Viruses Association established 1985
Helpline 0345 123 2305 (weekdays 9 am-8 pm, local rate)
Medical disclaimer
This content is for general information only and is not a substitute for professional medical advice. Always consult your GP or a qualified healthcare professional if you have any concerns about your health.