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  1. Home
  2. Genital Herpes Treatment
  3. Consultation

Your Health

About You

1

Do you believe you have the capacity to make decisions about your own health; and that you do not require help to complete this consultation? *

2

Do you have any concerns about your relationship or sexual partner(s) that you wish to discuss privately with a healthcare professional? *

3

What is your height? *

4

What is your weight? *

5

Are you between 18-65 years of age? *

Your symptoms

6

Have you been diagnosed by your GP or sexual health clinic with genital herpes? *

7

What symptoms are you experiencing? *

8

Are you experiencing any unusual symptoms, such as: *

  • Chest pain
  • Digestive issues such as diarrhoea/constipation/vomiting/abdominal pain/swallowing problems/change in stool colour
  • Urinary retention - a condition in which you cannot empty all the urine from your bladder
  • Loss of appetite
  • Joint pain
  • Yellowing of the skin
  • Difficulty breathing
  • Rapid heartbeat
  • Memory loss or impaired mental ability
  • Lack of coordination
  • Changes to your vision
  • Seizures/muscle tremors
  • Slurred speech

9

Have your symptoms become less frequent and less severe since you were first diagnosed? *

If your symptoms have changed from when you were first diagnosed, please select 'other', and let us know what changes you have experienced

10

How long do your symptoms normally last? *

11

What triggers your outbreaks? *

12

Have your previously used aciclovir or valaciclovir for genital herpes? *

13

Do you understand that you are eligible for suppression treatment if you have had more than 6 outbreaks of genital herpes within the last year, or if genital herpes is affecting your social life or causing psychological distress? *

14

Please select the options that apply to you: *

Your health

15

Are you pregnant, breastfeeding, planning pregnancy or at risk of pregnancy whilst taking this medication? *

Pregnancy risk may be defined as late period or unprotected sexual intercourse which may have taken place since your last normal period

16

Do you have any other medical conditions? *

Please be sure to let us know if you have a history of:

  • Complications with your immune system or blood (thrombotic thrombocytopenic purpura/haemolytic uraemic syndrome)
  • Cardiovascular (heart) problems
  • Kidney or liver problems
  • Conditions affecting the nervous system
  • A condition or problem with your health that requires a transplant
  • HIV

Your Medication

17

Do you take any other medication? *

This includes over the counter medication, herbal remedies or recreational drugs

18

Do you have any allergies? *

A Bit More About You

19

Do you know of any conditions that run in your family? *

Agreement

20

Are you aware that self-care measures can help to ease symptoms and reduce transmission? *

You should:

  • Clean the affected area with plain or salt water to help prevent secondary infection and promote healing of lesions.
  • Apply Vaseline or a topical anaesthetic (for example lidocaine 5%) to lesions to help with painful blisters.
  • Increase fluid intake to produce dilute urine (which is less painful).
  • Urinate in a bath or with water flowing over the area to reduce stinging.
  • Avoid wearing tight clothing, which may irritate lesions.
  • Take adequate pain relief.
  • Avoid sharing towels and flannels with household members (although it is very unlikely that the virus would survive on an object long enough to be passed on, it is sensible to take steps to prevent this).
  • Avoid sexual contact involving the genitals until lesions have cleared

21

Do you understand that you should stop taking this medication and seek urgent medical advice if you experience: *

  • Signs of an allergic reaction such as a rash/itchy skin, swelling of your face/lips/tongue/other parts of your body, shortness of breath/wheezing/trouble breathing, collapse
  • Any other unusual side effects
    • Whilst you should seek urgent medical advice, you should also inform your GP and inform us if you experience any of the above. You should call 999 in the case of a medical emergency, or 111 for advice.

22

Are you aware that? *

  • If new lesions are still forming in 3-5 days’ time after using treatment for an outbreak, you must seek specialist advice from your GP or sexual health clinic immediately
  • If you are experiencing outbreaks when using suppression therapy, you must seek specialist advice from your GP or sexual health clinic immediately
  • Your partner(s) may already be infected with herpes simplex virus even though they may not have any symptoms. They should be assessed by a medical professional and treated if required
  • You should only request treatment if you are sure that you have the herpes virus
  • You should separate your doses leaving a few hours between each dose
  • You must drink plenty of water when using treatment
  • You should see your GP if symptoms do not improve after 7 days of treatment
  • You should see your GP if you experience any new symptoms
    • You should read the Patient Information Leaflet for common side effects, and report any side effects and changes in your health and body to your GP, and via the Yellow Card Scheme. Do not request treatment if you have used this medication, or any other antivirals and suffered side effects

23

Do you understand that? *

  • You should read this leaflet which explains the causes, signs and symptoms transmission, complications, treatments and the prognosis of genital herpes
  • Even with a negative swab result, you may have genital herpes and you should have symptoms checked by a specialist before starting any treatment
  • On average, people usually have 4-5 attacks within the first year after the first episode, however, symptoms improve and outbreaks usually reduce in frequency and severity with time, and can be well controlled
  • A first episode of genital herpes does not necessarily mean you have acquired the infection recently. You may have acquired the virus years ago, or the virus may have spread from another area of your body to your genitals
  • Transmission of genital herpes can occur at any time, but the risk is higher when symptoms are present. You should avoid sexual contact when symptoms are present (including foreplay and close skin contact).
  • Although male condoms cannot completely prevent transmission, they can reduce the risk of transmission.

24

Is there any additional information you would like to provide, or any questions you have? *

25

Do you agree that? *

  • You will read the Patient Information Leaflet supplied with your medication
  • You will contact us and inform your GP if you experience any side effects of treatment, if you start new medication or if your medical conditions change during treatment.
  • You are over 18 and the treatment is solely for your own use
  • You have answered all the above questions accurately and truthfully and that incorrect information can be hazardous to your health
  • You are aware the decision about your treatment are for both the prescriber and yourself to jointly consider during this consultation, but the final decision will always be the prescriber's
  • You will inform your GP that you have ordered this medication
  • By continuing, you agree to our Terms & Conditions, Cancellation Policy and Privacy Policy