Genital Herpes: Symptoms, Causes, Treatment, and More

If you or a loved one has been diagnosed with genital herpes, the first thing you need to know is that you are not alone.

Approximately one in six Americans has genital herpes.

Unfortunately, there is a great amount of stigma surrounding genital herpes, despite it being so common. This stigma leads many people to feel scared, embarrassed, and isolated after receiving their diagnosis.

But the more we talk about it, the more we can learn. And learning is the key to keeping ourselves and others safe.  

In the following article, we’ll go in depth on everything you need to know about genital herpes, from the basics, including symptoms and how it spreads, to more detailed information on potential complications and the best ways to manage an outbreak.

Whether genital herpes has been a part of your life for a while now, or you just found out that you or a loved one were exposed, this article will be a valuable resource as you navigate your way through this lifelong condition. 

Genital Herpes Symptoms 

Not everyone with genital herpes experiences symptoms. (Experiencing symptoms is referred to as having an outbreak.)

Many people don’t even know that they have genital herpes as most patients’ symptoms are nonexistent or very mild.

However, those infected who are symptomatic may experience a combination of the following:

• Small red bumps in the genital area

• Small white blisters in the genital area

• Pain or itching in the genital area

• Ulcers in the genital area when blisters pop

• Scabs in the genital area when ulcers begin to heal

Additional symptoms can also differ depending on whether it’s your first outbreak of genital herpes, or a recurrent outbreak (any outbreak after the first, and typically shorter in duration than a first outbreak).

For example, those experiencing their first outbreak may experience the following symptoms 2-12 days after their exposure to the virus:

• Headache

• Swollen lymph nodes

• Fever

• Body aches

On the other hand, those experiencing a recurrent outbreak may experience the following symptoms in the hours or days leading up the outbreak:

• Genital pain

• Tingling or shooting pain in the legs, buttocks, or hips

Genital Herpes Causes

Genital herpes is a sexually transmitted disease (STD) caused by two forms of the herpes simplex virus (HSV): the herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2). 

How Common is Genital Herpes?

Genital herpes is a common STD in the United States.

A CDC study published in 2021 found that there were 572,000 new genital herpes infections in the U.S. in 2018. 

A CDC report for 2015-2016 estimated that, in Americans aged 14-49, 47.8% were infected with HSV-1, and 11.9% were infected with HSV-2.

The same report notes that people with vaginas are more likely to become infected with both HSV-1 and HSV-2 than people with penises.

How Does it Spread?

Genital herpes spreads through vaginal, anal, and oral sex.

You can become infected if you come in contact with:

• A herpes sore of an infected partner

• The genital fluids of a partner infected with genital herpes

• The saliva of a partner infected with oral herpes

• Skin in the mouth area of a partner infected with oral herpes

• Skin in the genital area of a partner infected with genital herpes

HSV-2 is the herpes simplex virus type that most often causes genital herpes, spread through both sexual contact and skin-to-skin contact.

It is very contagious.

HSV-1, on the other hand, is the herpes simplex virus type that most often causes oral herpes (cold sores or fever blisters around the mouth).

HSV-1 can cause genital herpes, however, by spreading to the genital area through oral sex.

It is important to note that you can get genital herpes from a partner who does not have a herpes outbreak (does not have any visible sores) by asymptomatic viral shedding.

You can also become infected by a partner who is unaware of their infection, as the infection can lay dormant for many years before an outbreak. 

Despite the herpes simplex virus being very contagious, it dies very quickly outside of the body.

Because of this, it’s nearly impossible to contract the virus by sharing a toilet seat, swimming pool, silverware, bedding, towels, soap, or more with an infected person.  

Complications of Genital Herpes

While genital herpes is treatable, there are a number of complications that can make the diagnosis even more challenging to live with.

Some of these complications are explained below:

• People with suppressed immune systems may experience genital ulcers that are more intense and persistent 

• Though rare, HSV-1 and HSV-2 can both cause aseptic meningitis (inflammation of the linings of the brain) 

• Extragenital lesions may occur throughout the course of an infection

• The stigma surrounding genital herpes can lead to shame and embarrassment, and cause relationship problems

Genital herpes can also cause considerable issues for both those who may be exposed to human immunodeficiency virus (HIV), as well as those who are pregnant.

We outline the complications for these two communities below:  

• Impact on those exposed to HIV: People who have genital herpes are at an increased risk of becoming infected with HIV if they are genitally exposed to HIV. This is because ulcers or breaks in the skin or mucous membranes as a result of genital herpes make them more susceptible to infection, as the skin and mucous membranes typically act as protection against infection. 

• Impact on expectant mothers: Herpes can be passed from parent to child during pregnancy or childbirth, infecting the child with neonatal herpes simplex (neonatal HSV) Neonatal HSV can be fatal, so it is important for doctors to know the HSV status of an expecting parent. A child is more likely to develop neonatal HSV if the parent developed HSV close to the time of delivery, as opposed to a parent with recurrent HSV It is, therefore,  important for a person to avoid contracting herpes during pregnancy. If herpes symptoms are present at the time of delivery, a cesarean delivery is typically recommended to avoid spreading the virus to the child. 

Treatment and Management

Unfortunately, there is no cure for genital herpes.

There is also no commercially available vaccine to protect against infection.

However, it can still be a manageable condition.

Medical professionals help patients manage their diagnosis in three main ways:

Supportive therapy: These are things a medical professional does or suggests to help make your diagnosis—and symptoms—a little easier. This includes counselling about sexual behavior, and the use of saline baths and analgesia on affected areas.

Episodic antiviral therapy: These are anti-herpes medications taken in the prodrome phase, which may occur 2-24 hours and people can experience tingling, pain or burning before lesions appear),   or as soon as an outbreak begins.  This can help reduce the severity and duration of the outbreak.

Suppressive antiviral therapy: These are  medications that are taken daily as a preventative measure against future outbreaks and works by reducing viral shedding. 

Your doctor may suggest one or more of these options to help you treat and manage your genital herpes.

There are also a variety of things that you can do to make coping with genital herpes a little easier.

These include joining a support group, seeking additional counseling or therapy, educating yourself on the condition and treatment options, and striving for good communication with your partner(s). 

Prevention and Precautions

The only way to completely prevent genital herpes is to abstain from vaginal, anal, and oral sex, or to be in a long-term, mutually monogamous relationship with a partner who has been tested to confirm they do not have herpes. 

There are precautions you can take to make transmission less likely.

Using condoms properly during sex can help lower your risk, though they may not protect you entirely.

This is because herpes sores can present themselves in areas that condoms don’t cover, and the skin can shed the virus from areas where there are no visible herpes sores. 

If you are aware that you have herpes, you can prevent transmission by taking a daily anti-viral medication (as described in the Treatment and Management section) and refraining from all forms of sex when you are experiencing an outbreak.

It’s also essential to share your herpes status with your sexual partners, making them aware that there is a risk they become infected and that consistent condom usage can reduce that risk. 

When to See a Medical Provider

If you believe you may have genital herpes—or any other sexually transmitted disease/infection, please make an appointment with your primary care doctor or gynecologist as soon as possible.

Your doctor will give you a physical exam as well as laboratory tests to confirm your diagnosis, and will provide you with additional support about managing your diagnosis from there. 

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