What is genital herpes?
Genital herpes is an infection caused by the herpes simplex virus
or HSV. There are two types of HSV, and both can cause genital
herpes. HSV type 1 most commonly infects the lips, causing sores
known as fever blisters or cold sores, but it also can infect the
genital area and produce sores. HSV type 2 is the usual cause of
genital herpes, but it also can infect the mouth. A person who has
genital herpes infection can easily pass or transmit the virus to an
uninfected person during sex.
Both HSV 1 and 2 can produce sores (also called lesions) in and
around the vaginal area, on the penis, around the anal opening, and
on the buttocks or thighs. Occasionally, sores also appear on other
parts of the body where the virus has entered through broken skin.
HSV remains in certain nerve cells of the body for life, and can
produce symptoms off and on in some infected people.
According to the U.S. Centers for Disease Control and Prevention,
50 million people in the United States ages 12 and older, or 1 out of
5 of the total adolescent and adult population, are infected with
Nationwide, since the late 1970s, the number of people with
genital herpes infection has increased 30 percent. The largest
increase is occurring in young teens. HSV-2 infection is more common
in three of the youngest age groups which include people aged 12 to
How does someone get genital herpes?
Most people get genital herpes by having sex with someone who is
having a herpes "outbreak." This outbreak means that HSV is active.
When active, the virus usually causes visible lesions in the genital
area. The lesions shed (cast off) viruses that can infect another
person. Sometimes, however, a person can have an outbreak and have no
visible sores at all. People often get genital herpes by having
sexual contact with others who don't know they are infected or who
are having outbreaks of herpes without any sores.
A person with genital herpes also can infect a sexual partner
during oral sex. The virus is spread only rarely, if at all, by
touching objects such as a toilet seat or hot tub.
What are the symptoms?
Unfortunately, most people who have genital herpes don't know it
because they never have any symptoms, or they do not recognize any
symptoms they might have. When there are symptoms, they can be
different in each person. Most often, when a person becomes infected
with herpes for the first time, the symptoms will appear within 2 to
10 days. These first episodes of symptoms usually last 2 to 3 weeks.
Early symptoms of a genital herpes outbreak include
- Itching or burning feeling in the genital or anal area
- Pain in the legs, buttocks, or genital area
- Discharge of fluid from the vagina
- Feeling of pressure in the abdomen
Within a few days, sores appear near where the virus has entered
the body, such as on the mouth, penis, or vagina. They also can occur
inside the vagina and on the cervix in women, or in the urinary
passage of women and men. Small red bumps appear first, develop into
blisters, and then become painful open sores. Over several days, the
sores become crusty and then heal without leaving a scar.
Other symptoms that may go with the first episode of genital
herpes are fever, headache, muscle aches, painful or difficult
urination, vaginal discharge, and swollen glands in the groin area.
Can outbreaks recur?
If you have been infected by HSV 1 and/or 2, you will probably
have symptoms or outbreaks from time to time. After the virus has
finished being active, it then travels to the nerves at the end of
the spine where it stays for a while. Even after the lesions are
gone, the virus stays inside the nerve cells in a still and hidden
state, which means that it's inactive.
In most people, the virus can become active several times a year.
This is called a recurrence. But scientists do not yet know why this
happens. When it becomes active again, it travels along the nerves to
the skin, where it makes more viruses near the site of the very first
infection. That is where new sores usually will appear.
Sometimes, the virus can become active but not cause any sores
that can be seen. At these times, small amounts of the virus may be
shed at or near places of the first infection, in fluids from the
mouth, penis, or vagina, or from barely noticeable sores. You may not
notice this shedding because it often does not cause any pain or feel
uncomfortable. Even though you might not be aware of the shedding,
you still can infect a sex partner during this time.
After the first outbreak, any future outbreaks are usually mild
and last only about a week. An infected person may know that an
outbreak is about to happen by a tingling feeling or itching in the
genital area, or pain in the buttocks or down the leg. For some
people, these early symptoms can be the most painful and annoying
part of an episode. Sometimes, only the tingling and itching are
present and no visible sores develop. At other times, blisters appear
that may be very small and barely noticeable, or they may break into
open sores that crust over and then disappear.
The frequency and severity of recurrent episodes vary greatly.
While some people have only one or two outbreaks in a lifetime,
others may have several outbreaks a year. The number and pattern of
repeat outbreaks often change over time for a person. Scientists do
not know what causes the virus to become active again. Although some
people with herpes report that their outbreaks are brought on by
another illness, stress, or having a menstrual period, outbreaks
often are not predictable. In some cases, outbreaks may be connected
to exposure to sunlight.
How is genital herpes diagnosed?
Because the genital herpes sores may not be visible to the naked
eye, a doctor or other health care worker may have to do several
laboratory tests to try to prove that symptoms are caused by the
herpes virus. A person may still have genital herpes, however, even
if the laboratory tests do not show the virus in the body.
A blood test cannot show whether a person can infect another with
the herpes virus. A blood test, however, can show if a person has
been infected at any time with HSV. There are also newer blood tests
that can tell whether a person has been infected with HSV 1 and/or 2.
How is genital herpes treated?
Although there is no cure for genital herpes, your health care
worker might prescribe one of three medicines to treat it as well as
to help prevent future episodes.
Recently, the Food and Drug Administration approved Valtrex for
use in preventing transmission of genital herpes.
During an active herpes episode, whether the first episode or a
repeat one, you should follow a few simple steps to speed healing and
avoid spreading the infection to other places on the body or to other
- Keep the infected area clean and dry to prevent other infections
- Try to avoid touching the sores.
- Wash your hands after contact with the sores.
- Avoid sexual contact from the time you first feel any symptoms
until the sores are completely healed, that is, the scab has fallen
off and new skin has formed where the sore was.
Can genital herpes cause any other problems?
Usually, genital herpes infections do not cause major problems in
healthy adults. In some people whose immune systems do not work
properly, genital herpes episodes can last a long time and be
unusually severe. (The body's immune system fights off foreign
invaders such as viruses.)
If a woman has her first episode of genital herpes while she is
pregnant, she can pass the virus to her unborn child and may deliver
a premature baby. A baby born with herpes can
develop serious problems that may affect the brain, the skin, or the
eyes. If babies born with herpes are treated immediately with
acyclovir, their chances of being healthy are increased.
If a pregnant woman has an outbreak, which is not the first
episode, her baby's risk of being infected during delivery is very
low. In either case, if you are pregnant and infected with genital
herpes, you should stay in close touch with your doctor before,
during, and after your baby is born.
If a woman is having an outbreak during labor and delivery and
there are herpes lesions in or near the birth canal, the doctor will
do a cesarean section to protect the baby. Most women with genital
herpes, however, do not have signs of active infection with the virus
during this time, and can have a normal delivery.
Is genital herpes worse in a person with HIV infection or AIDS?
Genital herpes, like other genital diseases that produce lesions,
increases a person's risk of getting HIV, the virus that causes AIDS.
Also, prior to better treatments for AIDS, persons infected with HIV
had severe herpes outbreaks, which may have helped them pass both
genital herpes and HIV infection to others.
Note: All information is based upon materials published by the National
Institute of Allergy and Infectious Diseases (NIAD).and the
U.S. Centers for Disease Control.