The Facts About Genital Herpes

Genital herpes is a common sexually transmitted disease (STD) caused by the herpes simplex virus (HSV). In the United States, approximately 11.9 percent of people ages 14 to 49 live with genital herpes, according to the Centers for Disease Control and Prevention (CDC).

Primarily transmitted through sexual contact, the virus that causes genital herpes can lie dormant in the body after the initial infection and reactivate several times a year. The condition may cause itching, pain and sores in the genital area. However, some people do not experience any signs or symptoms of genital herpes. If infected, you can be contagious even if you have no visible sores.

Two types of HSV infections cause genital herpes. HSV-2 commonly causes genital herpes and is spread through sexual and skin-to-skin contact. This type is highly contagious and very common, regardless of whether you have an open sore.

HSV-1 is the type that typically creates cold sores around the mouth and is generally spread through skin-to-skin contact, though it can be spread to your genital area during oral sex. While HSV-1 is the most common strain of the virus, it is much rarer for it to develop into genital herpes.

Despite the myths, the virus dies very quickly outside of the body. It is nearly impossible to contract genital herpes through contact with toilets, towels or other objects used by an infected person.

Many people who get infected with HSV-2 do not know they have it because they do not have any signs or their symptoms are too mild to notice.

Symptoms can begin two to 12 days after exposure to the virus. The symptoms include pain or itching in the genital area, small red bumps or tiny white blisters, ulcers and scabs. These signs are known as having an "outbreak." When blisters break, they leave painful sores that may take more than a week to heal.

During an initial outbreak, you may have flu-like symptoms such as swollen lymph nodes in your groin, headache, muscle aches and fever. Sores appear where the infection enters the body and these can be spread by touching a sore and rubbing another area of your body, such as your eyes. Mild symptoms can be mistaken for another condition, like ingrown hairs, so many people do not know they have the infection.

All sexes develop sores in mostly the same places, including the buttocks, thighs, anus, mouth and urethra. In people with vaginas, sores may also develop in or on the vaginal area, external genitals and cervix. In people with penises, sores can develop on the penis and scrotum.

Although outbreaks of genital herpes can reoccur over time, especially for people with HSV-2, repeat outbreaks are often shorter and less severe than the initial one. Genital herpes is a lifelong infection, but the number of outbreaks can decrease over time.

Getting diagnosed may be delayed by a lack of signs and symptoms. Regular testing may also be tough due to the large false-positive rate of HSV tests. Most of the time, testing is done if there is a genital outbreak.

Visit your healthcare provider if you notice any symptoms or your partner has an STI or symptoms of an STI. A medical professional may diagnose you by looking at any sores in the genital area or they might take a sample from the sores and test it. If there are no sores present, a blood test can be taken to check for HSV antibodies.

Even though a blood test can confirm a herpes infection, it cannot tell you who initially passed on the infection or when you contracted it.

The terms genital warts and genital herpes are sometimes used interchangeably, but there are distinct differences. Primarily, their underlying causes are different.

Herpes is the commonly used term for an HSV infection, whereas genital warts is a common term for an infection of the human papillomavirus (HPV). There are similarities, however, as both conditions can be asymptomatic and there is no cure for either condition.

Once genital herpes is contracted, it stays in your body for life. It is not possible to cure it with medication. However, the condition can be managed by avoiding triggers that cause symptoms.

Outbreak triggers may include ultraviolet light, friction in the genital area, alcohol and smoking. However, some triggers are unavoidable such as stress, illness, the menstrual cycle, surgery on the genital area and a weakened immune system.

Genital herpes cannot organically spread in your body to cause blisters elsewhere because it stays in a nearby nerve and triggers the development of blisters in the same area.

Alongside sores and associated pain, genital herpes can come with other health complications.

Sometimes sores cause inflammation around the urethra, and the resulting swelling can close the passage completely, requiring a catheter to drain the bladder. Genital herpes may also lead to inflammation in the lining of the rectum, known as proctitis, especially among men who have sex with other men.

HSV infection can also cause meningitis, which inflames the cerebrospinal fluid and membranes surrounding the brain and spinal cord. This outcome occurs only in rare instances.

Genital sores increase your chances of transmitting or contracting other STIs, such as HIV/AIDs.

The sores and skin breaks caused by the herpes infection create a pathway for HIV to enter the body, increasing your chances of contracting it during an outbreak. Herpes also increases the number of immune cells in the lining of the genitals, meaning you have a high risk of contracting it even without visible sores because HIV targets immune cells for entry into the body.

Having both genital herpes and HIV/AIDs also increases your chances of spreading HIV to an HIV-negative partner during sexual contact.

Preventing the transmission of genital herpes requires the same precautions used to reduce the risk of catching any other STI.

Using barrier protection for all sexual activity, including oral sex, is a must. But even barrier protection and condoms do not keep you 100 percent safe from the virus.

People with genital herpes and those who are dating someone with it should avoid intercourse whenever an outbreak is present in the genital area or anywhere else. Even if there are no sores present, if a partner has a tingle or an itch, that can mean an outbreak is on its way, so abstain from sexual contact until it has passed. Avoiding sharing sex toys can also minimize the risk of transmission, as can suppressive therapy, an antiviral that is taken every day.

Genital herpes has no cure, and while symptoms generally clear up without medical intervention, the blisters may come back.

A general doctor or sexual health clinic can offer treatments to manage symptoms. They may prescribe creams to minimize the pain or antiviral medicine to prevent symptoms from worsening.

There are two forms of treatments: episodic and daily suppressive treatments.

Antiviral medicine, such as acyclovir or valacyclovir, is topical or oral and can help shorten the period of pain during the first primary outbreak. Outbreaks do generally settle by themselves, and recurrences are usually milder than the initial outbreak after infection, however, this doesn't mean someone should forgo treatment.

People who have more than six outbreaks per year may be prescribed antiviral medicine for six to 12 months to bring them under control. When managing sores and blisters at home, keep the genital area clean by using water to prevent infection, or try applying an ice pack wrapped in flannel—never apply ice directly—to soothe the pain.

During the first outbreak, every patient gets treated. After that, a patient can have an antiviral prescription on hand for the next time they have an outbreak. This is called episodic therapy and is usually a method used by people who have infrequent outbreaks.

Daily suppressive therapy is an antiviral that is taken daily and usually employed by people who have more frequent outbreaks or who are in a discordant sexual relationship (when one person has the virus and the other does not).

If you experience pain while urinating, pouring water over your genitals while peeing alleviates pain. It is advisable to avoid tight clothing during an outbreak because it can irritate blisters or sores.

Dating with a stigmatized medical condition along for the ride can be daunting, but it is possible to have a fulfilling love and sex life while living with genital herpes. The first step is honesty.

It is neither fair nor advisable to engage in sexual activity without informing people of your status. Not only does omitting your diagnosis disrupt any hope of building a trusting relationship, but you also deny sexual partners the right to make an informed decision before engaging in sexual contact with you. Be upfront and share your diagnosis along with reliable resources for them to consult.

The same approach applies if you are in a long-term relationship. Keep your partner informed about your symptoms and make sure you practice abstinence during outbreaks. It is possible to avoid transmitting genital herpes to your partners as long as you practice safer sex, suppressive therapy and avoiding sexual activity during an outbreak.

It is important to inform your doctor if you are pregnant and have previously been diagnosed with genital herpes or are experiencing symptoms. There is a chance that babies born via vaginal delivery to infected mothers during an outbreak can be exposed to the virus, which may cause brain damage, blindness or death for the newborn. But vaginal childbirth without an outbreak is possible.

A doctor may recommend that you take antiviral medications during the later stages of pregnancy to prevent an outbreak coinciding with delivery. If an outbreak is present when you are going into labor, the doctor may suggest undergoing a cesarean section to reduce the risk of passing the virus to your baby.

Herpes is common. Unfortunately, STIs remain heavily stigmatized, making it harder for people living with genital herpes to be open about their status. Handling the impact of the stigma sometimes takes just as much effort as managing the symptoms of genital herpes.

Opening up the discourse around genital herpes can help break down the influence of stigma, but tapping into your personal support network can be most empowering. Let your loved ones support you and trust that the rest of the world will catch up in time. Most importantly, remember that a herpes diagnosis does not change who you are as a person, nor does it have to define you.

What are the first signs of genital herpes?

The first signs of genital herpes are pain or itching in your genital area, small red bumps or tiny white blisters, ulcers or scabs.

Can you get rid of genital herpes?

Genital herpes has no cure, and while symptoms generally clear up without medical intervention, the blisters may come back. Taking control of your lifestyle by focusing on managing stress and limiting alcohol or drug intake can help you avoid certain triggers that may bring on an outbreak.

How are you tested for herpes?

Herpes is not included in a standard STI panel, which means when you visit your healthcare provider or clinic, you will need additional screening.

A medical professional may diagnose you by looking at any sores in the genital area during a physical exam or they might take a sample from the sores and test it. If there are no sores present, a blood test can be taken to check for HSV antibodies.