Genital Herpes Symptoms

On This Page: Symptoms | Transmission | Complications | Pregnancy

Genital herpes, caused mostly by HSV-2 but sometimes by HSV-1¹, is one of the most common sexually transmitted infections. Most people who have genital herpes don’t know they have it because they show no symptoms or have mild symptoms that may be easily mistaken for another skin problem, like ingrown hairs or pimples. Because the virus can lie dormant for years, it’s difficult to determine when or from whom HSV was transmitted.

Genital Herpes Symptoms

While most people never have any symptoms, genital herpes can cause outbreaks of blisters or sores that are painful or itchy.² Genital herpes symptoms will usually begin with an initial outbreak that starts about 2-10 days after coming into contact with the virus and lasts around 2-4 weeks.³

Genital herpes symptoms can include:

• No symptoms
• Pain, itching, or tingling in the genital area
• Small red bumps or white blisters:
  • In or on the vaginal area
  • On the penis or scrotum
  • On the urethra (the tube that allows urine to exit the bladder)
  • On the butt and thighs
  • Around the anal area
• Ulcers that form when blisters rupture and ooze
• Scabs that crust over as ulcers heal
• Abnormal discharge
• Pain when peeing
• Pain in the lower back, buttocks, thighs, or knees

During an initial outbreak, you may also experience flu-like symptoms such as:

• Fever
• Chills
• Swollen lymph nodes in the groin
• Muscle aches
• Headache

Outbreaks heal with or without treatment, usually without a scar. After an outbreak, a person shows no symptoms while the virus lies dormant in the body– but it’s still there and can activate again, causing future outbreaks that may recur on and off for years. The frequency and severity of outbreaks vary from person to person. Future outbreaks usually heal after a week or more.

Can You Spread Herpes If You Have No Symptoms?

Yes, it is possible to spread herpes without showing or feeling symptoms. Herpes is most contagious during an active outbreak, though it can still be transmitted from normal-appearing skin. Genital herpes transmission can occur through genital secretions, contact with sores, or skin-to-skin contact with the infected area. Using condoms helps lower, but not eliminate, the risk of transmission.

How To Know You Have Herpes If You Don’t Have Symptoms?

If you’re concerned you have herpes or if you are showing symptoms of herpes, getting tested can confirm your health status. An HSV-1 & HSV-2 IgG antibody blood test can detect the presence of a herpes infection, whether you have symptoms or not.

Genital Herpes Complications

Although outbreaks can be uncomfortable, genital herpes isn’t deadly, and it doesn’t cause any serious problems in healthy adults. Even though the virus stays in the body for life, it doesn’t mean you’ll constantly have small blisters or sores. While genital herpes is not curable, its symptoms are manageable with antiviral medications, which lessen the severity and frequency of outbreaks.

Recurrent Outbreaks

Generally, the first herpes outbreak a person has is the worst they ever experience. Some people with genital herpes only have one outbreak ever, while others have repeated outbreaks— especially if they have an HSV-2 infection. These episodes can occur occasionally, even several times a year. Over time, outbreaks tend to become milder, shorter, and less frequent.

In immunocompromised people, such as those living with HIV, herpes symptoms and complications can be more severe and frequent.

Other Sexually Transmitted Diseases

Having genital sores (genital ulcerative disease) increases the risk of getting or spreading other sexually transmitted diseases like HIV, if exposed. In general, it’s a good idea to avoid intimacy during an outbreak and to use protection when you do have sex.

Psychological Distress

One of the hardest parts of living with herpes is the stigma. Learning you have genital herpes can be shocking, but don’t let it make you feel bad about yourself, sex, or your romantic future. Genital herpes is easily manageable and very common—more than one out of every six people aged 14 to 49 have it.¹ If you’re feeling troubled, talking to a healthcare provider,a professional therapist, or a trained counselor for support and advice.

Having herpes doesn’t mean the end of your sex life. Not having sex during active outbreaks and consistently using condoms/dental dams during sex and sexual contact can help reduce the risk, though it doesn’t get rid of it completely.

Bladder Problems

In some cases, genital herpes sores can cause inflammation of the rectal area or the urethra, the tube that carries urine from your bladder. Painful urination can occur when the urine comes in contact with sores. If the swelling and pain prevent you from emptying your bladder, you may require the insertion of a catheter to drain your bladder.

Meningitis and Encephalitis

In rare cases, a herpes infection can lead to meningitis (inflammation of the covering of the brain and spinal cord) or encephalitis (inflammation of the brain).^4-5 HSV encephalitis is mainly caused by HSV-1, though it can also be caused by HSV-2.

Infection During Pregnancy or Childbirth

It’s possible for a mother with genital herpes to pass the infection to her child before birth or, more commonly, during delivery. Although neonatal herpes is rare, it can cause skin problems, brain damage, blindness, organ failure, or even death for a newborn.

The risk of genital herpes transmission is higher with a mother who has a new herpes infection late in pregnancy and very low in women who have had herpes for a while before getting pregnant. A woman with an older herpes infection has antibodies that her immune system has developed against the virus, which help protect the baby.⁶

How Do You Prevent Spreading Genital Herpes to Your Baby?

If you’re pregnant and have genital herpes:

It’s important to talk to your doctor. You may be recommended medication to prevent an outbreak of sores during labor. Before giving birth, women with genital herpes are usually examined to see if sores or signs of an upcoming outbreak are present. If signs are present, it may be recommended to deliver the baby by C-section because active lesions are a risk factor for infection.

If you’re pregnant and don’t have genital herpes:

It’s recommended to abstain from intercourse during the third trimester with partners known or suspected to have genital herpes. If your partner has oral herpes (which causes cold sores or fever blisters), be aware that receiving oral sex from them can give you genital herpes.

Takeaway

It can be hard to know if you have herpes without herpes testing, which usually isn’t part of routine sexual health checkups. If you test positive for genital herpes, it can be alarming, but having herpes doesn’t have to be a big deal. Treatment reduces outbreaks and lowers the risk of developing complications.

Medically Reviewed by Gill Sellick, MBChB on May 18, 2023