Genital Herpes in Women: Causes, Treatments, and More

If you’re reading this, chances are you or a loved one has been diagnosed with genital herpes.

And you know what? You’re not alone. Especially if you’re a woman. 

Approximately one in 6 women in the U.S. between the ages 14 and 49 has genital herpes (compared to one in 12 men), making it one of the most common sexually transmitted diseases (STD) in the country.

But while genital herpes in women may be common, there is still a lot of stigma surrounding it.

A diagnosis can be both physically and emotionally painful—especially once you come to grips with the fact that there is no cure for it. 

Luckily, genital herpes is an extremely manageable condition, and it does not have to define you.

With the proper support and knowledge, you can live a happy, normal life despite your herpes status.

In this article, we go over all you need to know about dealing with genital herpes as a woman—including what symptoms you can expect, what causes it and how it spreads, how it’s different from HPV, how you can prevent it, the best ways to treat it, and so much more. 

Note: Not every woman has a vagina, and not every person with a vagina is a woman.

However, for the purposes of this article, when we refer to “a woman” or “women,” we are referring to people with vaginas. 

Genital Herpes Symptoms in Women

Not every woman with genital herpes will experience symptoms. (Experiencing symptoms is typically referred to as having an “outbreak.”)

Many people’s symptoms will be non-existent or very mild, and this is why many women do not actually realize that they have genital herpes. 

Women who do experience symptoms related to genital herpes, however, tend to find that their symptoms are most intense during their first-ever outbreak and are less severe with recurrent outbreaks (any outbreak after the first; typically shorter in duration than a first outbreak).

Symptoms of genital herpes in women include:

• Burning, tingling, or itching around the vaginal and/or anal area

• Small red bumps or white blisters on or around the vagina, vulva, cervix, or anus

• Ulcers in the vaginal and/or anal area when blisters pop, followed by scabbing when they heal

• Pain or trouble while peeing

There are also a number of additional symptoms that you may experience before or during your first outbreak, but typically not with recurrent outbreaks.

These generally begin 2-12 days after your exposure to the virus.

These symptoms include:

• Fever
• Chills
• Headache
• Fatigue
• Swollen glands
• Other flu-like symptoms

Genital Herpes (HSV) vs HPV

Herpes simplex virus (HSV) and human papillomavirus (HPV) are the two most common STDs in the U.S.

Both are incurable, can spread through sex, and can cause unsightly and painful skin imperfections.

However, they are not related to each other and have many key differences.

There are two forms of HSV—HSV-1 and HSV-2—which can cause oral and genital herpes.

People infected with either form of HSV may show no symptoms or have sores around the mouth or genitals. 

On the other hand, there are over 200 types of HPV, which can spread through skin-to-skin contact in addition to sexual contact.

HPV strains are typically divided into two groups: low-risk HPVs and high-risk HPVs.

People infected with low-risk HPVs may show no symptoms at all, while others may develop warts.

People infected with high-risk HPVs may develop different forms of cancer (most commonly cervical, penile, and anal cancer).

These strains of HPV can cause abnormal cell changes, which can cause cancer. 

Because certain strains of HPV can cause cancer, HPV is considered the more dangerous STD when comparing HSV and HPV.

Luckily, there is a vaccine which can reduce the risk of cancer due to HPV, as well as genital warts, called Gardasil 9.

This vaccine is suggested for both girls and boys around the ages of 11 or 12. 

Causes of Genital Herpes in Women

As previously discussed, genital herpes is an STD caused by HSV.

There are two forms of the virus, both of which can cause genital herpes: type 1 (HSV-1) and type 2 (HSV-2).

HSV-2 is the virus type that most often causes genital herpes in both men and women.

HSV-1 is the virus type that most often causes oral herpes (cold sores or fever blisters around the mouth) in both men and women.

How it Spreads

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

This is true no matter the gender of the sexual partner.

Women can become infected with genital herpes if they come in contact with one or more of the following:

• A herpes sore of an infected partner (no matter the location of the sore)

• The genital fluids of a partner who has with genital herpes

• The saliva of a partner who has oral herpes

• Skin in the mouth area of a partner who has oral herpes

• Skin in the genital area of a partner who has genital herpes

As previously mentioned, HSV-2 is the virus type that most often causes genital herpes, and it is extremely contagious, spreading through both sexual contact and skin-to-skin contact.

HSV-1, on the other hand, can still cause genital herpes by spreading to the virus from the mouth area to the genital area through oral sex.

One of the reasons why genital herpes is so common is because the virus can still spread even if it is not visible.

The virus can still shed from the skin or in body fluids and spread to a partner even if there are no sores present.

Further, many people who have genital herpes have never experienced symptoms, so they are not even aware that they have it.

This is because the virus can lay dormant for many years before actually presenting itself through an outbreak.

This is why it’s important to always practice safe sex if you are not in a mutually monogamous relationship.   

It’s also important to note that, despite some old wives’ tales, it is nearly impossible for herpes to spread through non-sexual behaviors.

That means you don’t need to worry about sharing toilet seats, towels, silverware, swimming pools, etc. with an infected person.

This is because, despite being highly contagious, the herpes virus dies very quickly outside of the body.

Treatments and Management for Women

Unfortunately, there is no cure for genital herpes, and there are no commercially available vaccines to prevent it at this time.

It is, therefore, a lifelong disease.

But with the proper support and guidance from your doctor, it is manageable.

A medical professional (typically a primary care doctor or gynecologist), will help women manage their genital herpes in three main ways (and may suggest a combination of all three): 

Supportive therapy: This is when a doctor does or suggests things that make managing a genital herpes diagnosis—and any related symptoms—a bit easier. This includes suggesting the use of certain analgesics and saline bathing on the affected areas, and counselling the patient about sexual behavior and how to best approach their partners with their herpes status.

Episodic antiviral therapy: This is when a doctor prescribes an anti-herpes medication to be taken in the leadup to or beginning of a genital herpes outbreak in order to reduce the severity and duration of the outbreak.

Suppressive antiviral therapy: This is when a doctor prescribes an anti-herpes medication to be taken daily as a preventative measure against future genital herpes outbreaks. 

There are also a number of ways that women can practice self-care to help ease genital herpes symptoms.

These include:

• Applying a cool compress to the sores to relieve pain and itching

• Taking acetaminophen, ibuprofen, or aspirin for pain management

• Wearing loose-fitting, cotton underwear

• Gently washing herpes sores with soap and water, then patting dry

• Urinating in a tub of water (helpful if urination is painful due to sores)

• Avoiding tight pants and underwear or pantyhose made of synthetic materials

• Avoiding picking at herpes sores

• Avoiding putting bandages on herpes sores (air helps the sores heal quicker)

• Avoiding putting ointments or lotions on herpes sores, unless suggested by a doctor

Prevention and Precautions for Women

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 confirmed that they do not have herpes.

However, if you are sexually active and have more than one partner, there are a number of precautions you can take to protect yourself and your partners against infection.

Some examples include:

Using protection during sex: Using a condom or dental dam during all forms of sex can help prevent transmission of a herpes virus. However, the virus can shed from areas that condoms and dental dams do not cover (like the scrotum, upper thighs, and buttocks), so transmission is still possible. 

Abstaining from sex during outbreaks: Refrain from having vaginal, anal, or oral sex if you or your partner have visible sores anywhere on the body, as active sores spread more easily. 

Discussing herpes with your partner: Before having any form of sex, check in with your partner. It is essential to tell them if you have genital or oral herpes, and they should share with you if they have any form of herpes (or any other STD, for that matter). 

If you have already been diagnosed with genital herpes, taking a daily anti-herpes medication can help reduce the risk of spread to a partner.

It can also be helpful to ask your partner to be tested for herpes, even if they don’t think they have it. 

Women who are or are trying to become pregnant should be extremely precautious about contracting genital herpes, as it can impact their child.

We will discuss this more in the next section. 

Genital Herpes and Pregnancy

It is very important for women to share their herpes status with their doctors as soon as they find out they are pregnant.

This is because the virus can be passed from mother to child during pregnancy or childbirth if the virus is present in the birth canal, infecting the child with a condition called neonatal herpes, which can cause damage to their central nervous system, intellectual disability, or even death. 

Children are most at risk for developing neonatal herpes if their mother contracts genital herpes during their pregnancy, as opposed to having been diagnosed before becoming pregnant.

Further, If the virus is contracted later in the pregnancy, it’s more likely that it will be passed on to the child.

There are two reasons for this:

One, because the mother will not have developed antibodies to fight against the infection (these antibodies can be passed to the child through the placenta if developed early enough); and two, because a new infection is more likely to be active, so there’s a greater chance that it will be present in the birth canal during delivery.

It is therefore important for a woman to try to avoid contracting genital herpes while pregnant. 

If herpes symptoms are present at the time of delivery, a doctor will typically recommend a cesarean delivery to avoid spreading the virus to the child. 

There are different options available, including suppressive therapy, depending on if you experience your first infection or a recurrent infection during pregnancy.

When to See a Medical Provider

If you believe you may have been infected with genital herpes, be sure to schedule an appointment with your primary care doctor or gynecologist as soon as possible.

Your medical professional of choice will be able to confirm your diagnosis through a physical exam as well as laboratory tests, and will provide you with treatment options from there.

While there is no cure for genital herpes, there are plenty of ways to manage it.

Your doctor is the best person to guide you, so don’t delay making an appointment. 

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