Genital Herpes Symptoms and Diagnosis

Genital herpes is a sexually transmitted infection (STI) caused by the herpes simplex virus (HSV).

Most people infected with the virus that causes genital herpes don’t know they have it; their symptoms may be so mild they go unnoticed. But those who are symptomatic may notice blisters that break and turn into painful, itchy sores, and they may have other symptoms, such as difficulty urinating.

• Inner thighs and buttocks
• External areas of the female genitals
• Penis and scrotum
• Anus

Herpes sores can also erupt inside your body, where you cannot see them. Women can have sores in the vagina and on the cervix. Both sexes can have sores in the rectum, the part of the large intestine closest to the anus.

• Small red bumps or tiny white blisters may crop up first, within a few days or a few weeks of the first infection, or in a later outbreak.
• Ulcers may form when blisters rupture and ooze or bleed.
• Scabs form when the ulcers crust over and start to heal.

Everyone experiences genital herpes somewhat differently. Besides sores, symptoms of genital herpes can include these kinds of uncomfortable or painful sensations:

• Burning when you urinate, or if any of your urine touches sores.
• Trouble urinating because sores and swelling are blocking the urethra, the tube through which urine passes. This problem can become extreme.
• Pain, itching, or tenderness in your genitals

Lots of people who have been infected with either HSV-1 or HSV-2 don't know it because they have never noticed any signs or symptoms.

People often mistake a herpes outbreak for another problem. You may think you have the flu, another STI, or that you have pimples or ingrown hairs, when in fact you have genital herpes symptoms.

Primary Herpes Outbreak

• Fever
• Achy muscles
• Headaches
• Swollen lymph nodes in the groin
• Malaise, a general feeling of discomfort

Later Outbreaks

“Most people do have a prodrome with a recurrent outbreak, with tingling and burning in their skin. Then they usually break out in sores in the same place over and over when they actually become symptomatic,” says I. Cori Baill, MD, an obstetrician-gynecologist and a professor at the University of Central Florida College of Medicine in Orlando.

In many cases, outbreaks become more widely spaced as years pass.

If you develop any of the symptoms mentioned above, you should see a doctor for an evaluation. Your doctor may be able to diagnose herpes just by looking at your blisters or sores, and there are also lab tests to diagnose herpes.

If you don’t have a primary care doctor or gynecologist, you can find expert advice at a Planned Parenthood clinic or a community health center.

The CDC recommends testing to find out which virus is involved and also advises that people diagnosed with genital herpes be tested for HIV infection. If you have herpes, it’s easier for you to develop an HIV infection because herpes sores give HIV an open path into your body.

Knowing you have genital herpes allows you to take steps to reduce outbreaks and to protect your sexual partner or partners.

Consistent use of condoms and dental dams during sex also lowers — but doesn’t eliminate — the risk of transmitting the virus.

When Is Genital Herpes Most Contagious?

During active outbreaks, your viral load is heavier, and at those times you are most likely to infect a sexual partner, says Dr. Baill. “Without an outbreak, the viral load is usually insufficient to infect a normal, healthy partner.”

Remember, some people with HSV infections never have signs or symptoms of genital herpes at all. Although you are most contagious during outbreaks when sores are visible, you can also be contagious at times when you are free of any visible sores.