Genital Herpes Symptoms

Most people with genital herpes may not know they're infected.

In fact, in the United States, an estimated 87.4% of 14- to 49-year-olds infected with genital herpes have never received a clinical diagnosis.

Katherine McGowan, MD, a Mass General Brigham infectious diseases specialist, describes the types of genital herpes, risk factors, symptoms, and treatment options.

Dr. McGowan is the section chief of infectious disease at Brigham and Women’s Faulkner Hospital.

What is genital herpes?

Genital herpes is a sexually transmitted infection (STI). This means you can get genital herpes by having sex with someone who has genital herpes. The infection can spread very quickly in new sexual relationships. You also can get herpes if your skin touches an infected area on someone else’s skin.

There are two types of genital herpes infections:

1. Herpes simplex type two (HSV-2), which causes genital herpes infections.

2. Herpes simplex type one (HSV-1), which is usually associated with oral herpes infections or cold sores.

Genital herpes transmission risk

Your risk of catching genital herpes goes up with age. It also increases with the number of sexual partners you have.

The herpes virus is most likely to be spread during an outbreak — which is when sores and blisters appear. But genital herpes also can spread from people who may not know that they have herpes and have no symptoms.

"Seventy percent of transmission occurs during sexual contact with an asymptomatic individual. This is why testing and treatment are so important," says Dr. McGowan.

Fortunately, unlike some STIs in pregnancy, genital herpes infections usually aren’t passed from a mother to their baby during childbirth.

What are common signs and symptoms of genital herpes?

Genital herpes infection usually starts as a vesicle, which is a small bubble that fills with cloudy fluid. This vesicle eventually forms an ulcer or a sore that heals without scarring.

Herpes simplex sores are very painful. This sets it apart from other STIs like syphilis. Other symptoms of genital herpes include:

• Fevers

• Sweats

• Chill

• Headaches

• Enlarged lymph nodes

Once someone is infected with genital herpes, the virus stays in their body. Many people with herpes experience repeated outbreaks. Often, these outbreaks have triggers like stress, illness, and hormone changes.

The symptoms of a repeat outbreak include:

• Blisters and sores

• Splits in the skin

• Red patches of skin

If symptoms reoccur, it means the virus is being shed and can spread to others. But remember, not everyone has obvious symptoms so testing is essential.

Genital herpes treatment options

Genital herpes treatments are easy, simple, and effective. Although there is no cure for herpes, you can manage your symptoms with oral medication. In fact, daily oral medication can decrease the risk of spreading herpes to other individuals.

If you suspect you have genital herpes, seek diagnosis and treatment as soon as possible. This can help reduce your likelihood of spreading the virus. It also decreases the time it takes to heal and can help manage existing symptoms or pain.

"Oftentimes people feel guilt and shame with herpes infections, which can prevent prompt testing and treatment. But there's nothing to be ashamed about," says Dr. McGowan.

Genital herpes is very manageable. Speak with your health care provider about your concerns and explore treatment options. Condoms can help decrease the risk of transmission, but not completely. So don't forget to talk to your sexual partner(s) and make sure they know their genital herpes health risks.