What Is Genital Herpes?

There’s no cure for genital herpes, but medications can help prevent transmitting the virus to your sexual partner and shorten outbreaks.

Symptoms of Genital Herpes

Many people with genital herpes have no symptoms, or they may mistake mild symptoms for a pimple or an ingrown hair. The first outbreak often happens within two days to two weeks of contracting the virus. It’s typically the most severe outbreak if symptoms do occur.

Some people may have only one herpes outbreak, while others can have recurring outbreaks that are usually shorter and less severe than the first one. Although the virus stays in the body for life, the number of outbreaks tends to decrease over time.

• Fever
• Reduced appetite
• Malaise
• Muscle aches in the lower back, buttocks, thighs, or knees
• Swollen lymph nodes in the groin
• Burning or pain when urinating
• Unusual vaginal discharge

Genital symptoms can show up as small, painful blisters on the genitals, around the anus, and on the buttocks or inner thighs. Before the blisters appear, there may be itching, burning, or tingling on the skin area. The sores sometimes cause severe pain and are more likely to do so in people with weakened immune systems.

Women tend to have worse symptoms of genital herpes, but the infection doesn’t cause serious health problems in most people.

Causes and Risk Factors of Genital Herpes

Two types of viruses cause genital herpes: herpes simplex type 1 (HSV-1) and herpes simplex type 2 (HSV-2).

HSV-1 typically causes oral herpes, which show up as cold sores, or fever blisters, around the mouth. Most people contract oral herpes in their childhood or young adulthood through nonsexual contact with the saliva of a person who has the infection. Oral herpes doesn’t mean someone has genital herpes, but HSV-1 can spread from the mouth to a partner’s genitals during oral sex.

HSV-2 causes most cases of genital herpes. Since genital herpes is transmitted mainly through sex, it rarely arises before adolescence. When a child develops genital herpes, healthcare providers must consider the possibility of sexual abuse.

Genital herpes spreads through vaginal, anal, or oral sex with someone who has HSV-1 or HSV-2. The virus can pass through contact with:

• A herpes sore
• Saliva or oral skin area of a partner with oral herpes
• Genital fluids or skin in the genital area of a partner with genital herpes

“The more partners you have and the more partners they have had, the more likely you are to contract genital herpes,” says I. Cori Baill, MD, an obstetrician-gynecologist and an associate professor at the University of Central Florida College of Medicine in Orlando. “You sleep with everybody your partners have ever slept with.”

You can contract genital herpes from a partner who has no visible sores, or from a partner who doesn’t know that they have the infection. Genital herpes is most infectious during outbreaks when a person has visible sores, especially during the first outbreak.

How Is Genital Herpes Diagnosed?

A doctor can often diagnose genital herpes just by looking at the sores. A fluid sample from a sore or a blood test can also help screen for genital herpes.

Testing can show whether someone has herpes, but it can’t show who passed on the infection or when it happened.

Treatment and Medication Options for Genital Herpes

Medication Options

Oral antiviral medication is the primary treatment for genital herpes. A doctor typically prescribes the pills for 7 to 10 days. Recurring outbreaks can be treated with a shorter course of medication.

The U.S. Food and Drug Administration (FDA) has approved four antivirals for herpes:

• valacyclovir (Valtrex)
• acyclovir (generic)
• famciclovir (generic)
• pritelivir (Hovilpri) for immunocompromised adults whose infection hasn’t responded to the three medications above

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Complementary and Integrative Therapies

Getting enough sleep and following a nutritious diet can support a healthy immune system and make stress easier to manage.

Disparities and Inequities in Genital Herpes

Black Americans and Genital Herpes

Lifestyle Changes and Prevention of Genital Herpes

Condoms can’t fully cover every area where the virus can spread, such as the thighs and buttocks. Still, using condoms and dental dams consistently, not just during outbreaks, can help lower the risk of contracting and transmitting the virus.

Other ways to lower the chance of passing herpes to another partner include:

• Learning to recognize the early signs of an outbreak and stop having sex as soon as you sense the onset
• Avoiding sex during active outbreaks
• Waiting for all sores to scab over and heal before having sex again
• Avoiding touching herpes sores, and washing your hands right away after any contact
• Avoiding kissing and oral sex while a cold sore is present
• Telling a prospective sex partner about the infection before you have sex with them

How Long Does Genital Herpes Last?

Genital herpes is a lifelong infection, but it doesn’t cause symptoms all the time.

The first outbreak of genital herpes usually begins within two days to two weeks of infection. It often starts with inflammation, followed by small, fluid-filled blisters. The blisters eventually break open into sores that crust over and heal in a week or two, sometimes longer.

Complications of Genital Herpes

• Other STIs Genital sores make it easier to contract or transmit other STIs, such as HIV.
• Newborn Infection Pregnant women who have an active herpes outbreak while giving birth may pass the virus to the baby, which can cause brain damage, blindness, or death. It’s important to inform your doctor if you’ve ever been diagnosed with genital herpes.

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• Bladder Issues Herpes sores can sometimes cause inflammation around the urethra, the tube that carries urine out of the body. The swelling can block the urethra for several days; if this occurs, a catheter may be needed to drain the bladder.
• Rectal Inflammation Herpes can cause inflammation of the lining of the rectum, a condition called proctitis, especially in people who have anal sex.
• Eye Infection The virus can spread to the eyes and cause herpes keratitis, which can cause eye pain, redness, blurred vision, tearing, and sensitivity to light. Without treatment, it can lead to permanent eye damage.

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A genital herpes diagnosis may bring feelings of embarrassment or shame. Talking openly with a healthcare provider can help you normalize your experience and move forward. If you’re in a committed relationship, going to an appointment together may be helpful for both people.

You may also worry about getting herpes from a sexual partner. Having an honest conversation with your sexual partners, and educating yourself about the causes and symptoms of herpes, can help ease those fears.