What should I know about genital herpes?

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Genital herpes is a sexually-transmitted infection for which there is no cure. However, it may be managed with medication and careful sexual practices.

Herpes symptoms (such as painful sores in the genital area) usually start with one initial outbreak. Symptoms eventually go away, but the virus is still present, causing recurrent outbreaks. This on-and-off pattern may continue for years, although outbreaks might become less frequent over time.

What causes genital herpes and how is it spread?

Genital herpes is caused by one of two types of herpes simplex virus (HSV):

HSV-1 is the same virus that causes cold sores and blisters around the mouth. It is spread through skin-to-skin contact. It can also be transmitted through oral sex if a person has a cold sore.
HSV-2 is spread through genital and skin-to-skin contact. Most cases of genital herpes are caused by HSV-2.

While HSV is most contagious during an active outbreak, it can be transmitted at any time.

What are the symptoms of genital herpes?

Herpes is marked by lesions, blisters, or sores on genital areas like the vagina, vulva, cervix, penis, and scrotum. They may also appear on the buttocks and thighs or around the anus or mouth. The areas can become painful or itchy.

The blisters may break and ooze, forming ulcers, which eventually scab over.

Often, symptoms last longer during the first outbreak and heal more quickly during recurrent outbreaks. Flu-like symptoms during the first outbreak are also possible.

In some cases, people can tell a recurrent outbreak is about to start. “Prodromal symptoms” like pain and tingling, may occur days before blisters and sores start to form.

Some people infected with HSV have no symptoms at all, which makes genital herpes difficult to diagnose.

How is genital herpes treated?

Antiviral medications, such as acyclovir, famciclovir and valacyclovir – are used to treat herpes outbreaks. Some people have fewer outbreaks if they take medications daily.

Can genital herpes be prevented?

A person with herpes can transmit HSV at any time, even when the virus isn’t active. It is critical for people with herpes to let their sexual partners know about it. Even if couples follow safe sex practices, it is still possible to spread the virus.

However, there are ways to reduce the risk of transmission:

Always use latex condoms during every type of sexual activity. Condoms should not be re-used. (For example, if a couple has oral sex after vaginal sex, a new condom should be used for each type of sex. See tips for correct condom use here.)
Do not have sex during active herpes outbreaks, when sores are present.
If one partner has a cold sore, he or she should not perform oral sex.
Do not touch sores during an outbreak.
Wash hands frequently.
Use a different towel for washing genitals.

Resources

Centers for Disease Control and Prevention

“Genital Herpes – CDC Fact Sheet (Detailed)”

(Page last reviewed: January 31, 2017)

https://www.cdc.gov/std/herpes/stdfact-herpes-detailed.htm

EverydayHealth.com

Migala, Jessica

“How to Have a Healthy Sex Life if You Have Herpes”

(June 22, 2016)

https://www.everydayhealth.com/sexual-health/how-have-healthy-sex-life-you-have-herpes/

Harvard Health Publishing – Harvard Medical School

“Genital herpes: Common but misunderstood”