Genital Herpes Testing & Treatment

On This Page: Types of Testing | Diagnosis | Treatment 

Genital herpes can be caused by either the herpes simplex virus 1 or 2 (HSV-1 or HSV-2). The herpes simplex virus, regardless of what type, will most commonly cause no symptoms at all. However, herpes may occasionally cause sores or blisters (usually called “cold sores”), fever, aches, swollen lymph nodes, or discharge, all of which are indicators that usually cause people to get tested.¹

Types of Herpes Testing

There are a few different ways to test for herpes and doctors should determine what is needed on a case to case basis.

A physical exam

A doctor may begin with a physical exam to determine whether any symptoms are present. They will inspect your genital regions for signs of an outbreak which may be sores, lesions, or blisters. They may ask if you’ve experienced any flu-like symptoms or if you’ve seen any unusual discharge.

Viral culture

If a doctor finds obvious symptoms during the physical exam, they may opt to take a viral culture, which means they will scrape the affected area (around the sores) for a tissue sample. This sample will then be sent to the laboratory to be examined.

Polymerase chain reaction test (PCR) 

The PCR test copies your DNA from a sample of your blood or fluid from a sore. The DNA can be tested for the actual presence of HSV.

This is not the common form of testing, instead of inspecting actual DNA, it’s much easier to look for the antibodies to HSV in a blood test.

Blood test (antibody test)

If symptoms are not present, a doctor may choose to have you take a blood test. Due to how unreliable symptoms can be, STDcheck.com does not determine what test you should take based on symptoms.

Therefore, we only offer the blood test since HSV can be detected in the blood regardless if symptoms are present or not.  Plus, you don’t even have to take off your clothes! A small sample of blood will be taken and it will be examined by a lab. They will look for HSV-specific antibodies that your body builds to fight the virus infection. If there are antibodies found, this will tell us that the virus is present.

How Does STDcheck.com Test for Herpes?

STDcheck.com does not believe in determining your sexual status based on symptoms alone and we highly discourage this as many STDs are asymptomatic (causing no symptoms at all).

When you arrive at your chosen clinic, a phlebotomist will draw a small sample of your blood. This process takes just a few minutes and is typically painless. If you have selected any additional tests which require a urine sample, you will also be shown to a bathroom where you will be asked to provide your sample. There is no payment process at the lab because you have either already paid online or will be asked to pay when your results come in. Once you’ve supplied your samples, you are free to go home and wait for your results, which normally arrive in 1-2 business days. Yes, it’s that simple!

This test can differentiate between HSV-1 and HSV-2. If you are only taking the genital herpes test, you will only learn whether or not you have HSV-2. It is recommended that you test for both HSV-1 and HSV-2 antibodies, regardless of symptom location.

Who Should Get Tested for Herpes?

According to the CDC, herpes testing is not recommended for those who do not show symptoms. “There is no evidence that diagnosing genital herpes with a blood test in someone without symptoms would change their sexual behavior and stop the virus from spreading. In addition, without knowing the benefits of testing, the risk of shaming and stigmatizing people outweighs the potential benefits. For these reasons, testing everyone for herpes is not recommended at this time.”²

Though regular genital herpes testing is not recommended, STDcheck.com believes in giving everyone a choice and complete control over their sexual health. It could be beneficial for some to know if they are HSV-2 positive if any of the following apply:

• Pregnancy
• Genital symptoms related to genital herpes
• Have had sex with someone who is HSV-2 positive
• If it would bring peace of mind to know your complete sexual health status

It is recommended that pregnant women are tested for genital herpes because if symptoms are present at the time of childbirth, it can be incredibly harmful and potentially life-threatening to the baby. The baby will not usually incur an infection until coming into direct contact with the herpes lesions when passing through the birth canal. This is why it’s important to be aware of your status and make an informed decision about a potential C-section.

It is also recommended that those experiencing an outbreak get tested to confirm that they are infected. Testing to confirm suspicions can give you a better idea of what symptoms to expect in the future, and you can be prescribed medication to manage your outbreaks and minimize the risk of spreading the virus to others.

Diagnosis

What Should You Do if You Test Positive?

If you test positive for HSV but no symptoms are present, just monitor yourself for symptoms! You have the advantage of knowing what to expect, though some live their whole lives without experiencing any symptoms at all.

A positive HSV test will only tell you what type of herpes you have: HSV-1 or HSV-2. A herpes test will not tell when you developed the virus or who transmitted it to you. Some instinctually blame their partner for cheating or giving it to them, but remember to not place blame, because you may have acquired it long ago and even the CDC thinks that it’s not that big of a deal!

If you are experiencing symptoms, you may be eligible to be prescribed medication, so you could receive treatment though there is no cure.³ As time goes on, the frequency of outbreaks lessen and become less harsh to the point where you may even never experience outbreaks anymore.

How Is Herpes Treated?

There are three FDA-approved antiviral medications that can be used to treat genital herpes:

• Acyclovir
• Valacyclovir
• Famciclovir

Antiviral medicine is usually prescribed during the initial genital herpes outbreak, but medication may also be needed to manage future outbreaks.

There are two types of long-term HSV treatment: episodic and suppressive.

Episodic therapy

In episodic therapy, the goal is to cut down the outbreak time. The patient begins taking medication at the first signs of an oncoming outbreak and continues taking the medication for several days.

Suppressive therapy

In suppressive therapy, the goal is to entirely eliminate outbreaks through continuous daily medication. For patients with six or more outbreaks per year, studies have shown this method reduces outbreaks by 75 percent. For some, suppressive therapy can eliminate outbreaks entirely, as long as the medication is taken continuously.

Can You Get Re-Infected?

You are not able to get re-infected because HSV is a life-long disease. However, if you have tested positive for HSV-2, it is still possible for the symptoms of the virus to spread from your genitals to your mouth, and you are still able to additionally contract HSV-1.

When Can You Have Sex Again?

It’s best to wait to have sex until symptoms are no longer present.⁴ It’s important to speak with your partner(s) and be open and honest about your condition. Practicing safe sex and suppressive therapy can greatly lower your chances of spreading the virus. However, be aware of viral shedding, which are times when you may be contagious even when symptoms aren’t present. To learn more about how genital herpes is spread, visit our Genital Herpes Overview page.

Should You Retest After Treatment?

The HSV-2 virus will remain in your system for life, though symptoms will usually become less severe with time. In this case, it is not necessary to retest after treatment since there is no cure.

Medically Reviewed by William Terranova, MD on November 19, 2022