Genital herpes is a sexually transmitted disease caused by the herpes simplex viruses (HSV) type 1 and type 2. Most genital herpes is caused by HSV type 2.
Most people have no or minimal symptoms from HSV-1 or HSV-2 infection. When symptoms do occur, they usually appear as one or more blisters on or around the genitals or rectum. The blisters break, leaving ulcers or tender sores that may take up to four weeks to heal. Typically, another outbreak can appear weeks or months later.
Although the infection can stay in the body forever, the number of outbreaks usually decreases over a period of years. You can pass genital herpes to someone else even when you experience no symptoms.
How common is genital herpes?
About 45 million Americans, age 12 and older have genital herpes. It’s estimated that up to one million people become infected each year. Genital Herpes (HSV-2) is more common in women than men.
How can I get genital herpes?
Herpes is a virus that can be passed through sexual contact. You can get genital herpes by having sex with someone who has open sores and when someone has no sores. However, herpes is most contagious when a person has open sores. People with herpes should not have sexual activity when sores or other symptoms of herpes are present. HSV-1 can cause genital herpes, but it more commonly causes infections of the mouth and lips or “fever blisters.” Condoms can lower the chances of getting herpes. Along with condoms, Valtrex ®, a drug used to treat herpes, can help lower the chances of passing the virus during vaginal sex.
The symptoms of genital herpes vary from person to person. Some people have severe symptoms, such as many painful sores, while others have mild symptoms. An initial outbreak of genital herpes usually brings about symptoms within two weeks of having sexual contact with an infected person and can last from two to three weeks. The early symptoms can include:
an itching or burning feeling in the genital or anal area
flu-like symptoms, including fever
pain in the legs, buttocks, or genital area
a feeling of pressure in the area below the stomach
Within a few days, sores (also called lesions) show up where the virus has entered the body, such as on the mouth, penis, or vagina. Sores can also show up on a woman’s cervix, which is the opening to the uterus or womb, or in the urinary passage in men. The sores are small red bumps that may turn into blisters or painful open sores. Over a period of days, the sores become crusted and then heal without scarring.
Other later symptoms of genital herpes may include:
small red bumps on the penis, vagina, or wherever the infection began. These bumps may become blisters or painful open sores that can take up to four weeks to heal.
itching or burning in the genital area
pain in the legs, buttocks, or genital area
feeling pressure or discomfort around your stomach
pain when urinating
swollen glands in the genital area
Some people may have no symptoms – but they can still spread herpes! Sometimes only very mild sores appear, but are mistaken for an insect bite or other skin problems. If you have HIV, a genital herpes infection can be worse.
Herpes symptoms can come and go, but the virus stays in the nerve cells of your body even after all signs of the infection have gone away. In most people, the virus becomes “active” from time to time, creating an outbreak. Some people have herpes virus outbreaks only once or twice. Other people have many outbreaks of herpes each year. Scientists don't know what causes the virus to become active, but the number of outbreaks a person has tends to go down over a period of years. Some women say the virus comes back when they are sick, under stress, out in the sun, or during their period.
Doctors can diagnose genital herpes by looking at visible sores if the outbreak is typical, and by taking a sample from the sore for testing in a lab. Herpes can be difficult to diagnose between outbreaks. Blood tests, which detect HSV-1 or HSV-2 antibodies, can help to detect herpes in people without symptoms or during the time between outbreaks.
There is no treatment that can cure genital herpes; the virus will always be in your body. Certain drugs such as acyclovir, valacyclovir, and famciclovir can shorten outbreaks and make them less severe, or stop them from happening. Depending on your needs, your doctor can give you drugs to take right after getting outbreak symptoms or drugs that you can take on a regular basis to try to stop outbreaks from happening. When used along with safe sex practices, Valacyclovir (brand name Valtrex ®) can also help prevent you from passing the infection to someone else. Talk to your doctor about which treatment plan is best for you.
During outbreaks, these steps can speed healing and prevent spreading of the infection to other sites of the body or to other people.
Keep the infected area clean and dry.
Try not to touch the sores.
Wash hands after contact.
Avoid sexual contact from the time the symptoms are first noticed until the sores have healed.
Once you have the virus, it stays in your body and there is a chance that you will have outbreaks. Medicine can shorten and stop outbreaks from happening.
Genital herpes and pregnancy
If the mother is having her first outbreak while she is pregnant, she is more likely to pass the virus to her baby. If the outbreak is not the first one, the baby's risk of getting the virus is very low. Babies born with herpes may be premature or may die, or they may have brain damage, severe rashes, or eye problems. Doctors may do a C-section to deliver a baby if the mother has herpes lesions near the birth canal to help prevent passing the virus. Also, acyclovir can help babies born with herpes if they are treated right away.
It is not yet known if all genital herpes drugs are safe for pregnant women to take. Some doctors may recommend acyclovir be taken either as a pill or through an IV (a needle into a vein) during pregnancy. Let your doctor know if you have genital herpes, even if you are not having an outbreak. He or she will help you manage it safely during pregnancy.
Breastfeeding and genital herpes
If you have genital herpes, you can keep breastfeeding as long as the sores are covered. Herpes is spread through contact with sores and can be dangerous to a newborn. If you have sores on your nipple or areola, the darker skin around the nipple, you should stop breastfeeding on that breast. Pump or hand express your milk from that breast until the sore clears. Pumping will help keep up your milk supply and prevent your breast from getting engorged or overly full. You can store your milk to give to your baby in a bottle at another feeding. If the parts of your breast pump that contact the milk also touch the sore(s) while pumping, you should throw the milk away.
There are things you can do to protect yourself from getting genital herpes:
Don’t have sex. The best way to prevent any STD is to practice abstinence, or not having vaginal, oral, or anal sex.
Be faithful. Have a sexual relationship with one partner who has been tested for herpes and is not infected is another way to reduce your chances of getting infected. Be faithful to each other, meaning that you only have sex with each other and no one else.
Use condoms. Protect yourself with a latex condom EVERY time you have vaginal, anal, or oral sex. Condoms should be used for any type of sex with every partner. For vaginal sex, use a latex male condom or a female polyurethane condom. For anal sex, use a latex male condom. For oral sex, use a dental dam. A dental dam is a rubbery material that can be placed over the anus or the vagina before sexual contact.
Know that some methods of birth control, like birth control pills, shots, implants, or diaphragms, will not protect you from STDs. If you use one of these methods, be sure to also use a latex condom or dental dam (used for oral sex) correctly every time you have sex.
Talk with your sex partner(s) about STDs and using latex condoms. It’s up to you to make sure you are protected.
Talk frankly with your doctor or nurse and your sex partner(s) about any STDs you or your partner have or had. Try not to be embarrassed.
Know the symptoms. Learn the common symptoms of genital herpes and other STDs. Seek medical help right away if you think you may have genital herpes or another STD.
What should I do if I have genital herpes?
See your doctor for testing and treatment right away.
Follow your doctor’s orders and finish all the medicine that you are given. Even if the symptoms go away, you still need to finish all of the medicine.
Avoid having any sexual activity while you are being treated for genital herpes and while you have any symptoms of an outbreak.
Be sure to tell your sexual partners, so they can be tested.
Remember that genital herpes is a life long disease. Even though you may have long periods with no symptoms, you can still pass the virus to another person. Talk with your doctor about what you can do to have fewer future outbreaks, and how to prevent passing the virus to another person.
National Women health Information Center