Basic facts on the transmission, recognition, prevention and treatment of genital herpes.
On this page:
Basics about Genital Herpes
Comparison of Genital Herpes with other Sexually Transmitted Diseases
Signs and Symptoms
Recurrent Attacks of Genital Herpes
Signs for a Relapse of Genital Herpes
Causes of Recurrent Attacks
For More Information
Genital herpes is a sexually transmitted disease/infection (STD/STI) caused by a common virus called herpes simplex. The condition has been recognized for many centuries. Over 50 million Americans (1 in 5 adults) have been infected, although some do not develop any symptoms.
There are several types of herpes simplex virus. Type 2 most often causes genital sores, but type 1 (the type that most often appears as a cold sores on the mouth) can also cause infection in the genital area.
The genital sores contain the herpes virus that can be passed to another person during sexual contact. A person with genital herpes can also spread the infection to other parts of his or her body by direct contact (i.e., by touching the sores and then touching other parts of the body).
A person only can become infected with genital herpes through direct physical contact with someone who has herpes. It is almost impossible to catch genital herpes from toilet seats, restroom towels, or other inanimate objects.
Sexual contact (including oral-genital and oral-anal sex) is the most common way to spread the herpes virus. Avoiding sexual contact is the only sure way of not spreading the infection while herpes sores are present.
The risk of spreading genital herpes is greatest when genital sores are present, but an infected person may spread the virus even when there are no visible sores.
Genital herpes and genital warts are caused by viruses. Some other STDs/STIs, like gonorrhea and chlamydia, are caused by bacteria. Most bacterial infections can be readily cured with antibiotics, but viral infections cannot. Antibiotics (like penicillin or doxycycline) have no effect on genital herpes, but there are some medications (Acyclovir, Famcyclovir or Valaclovir) that can be used to reduce the severity or duration of genital herpes. Unfortunately, there is no cure and the genital herpes sores may recur periodically over time.
Genital herpes affects people in many different ways. Some people don’t notice any symptoms at all or have such mild signs that they don’t suspect they have an infection. This is one reason why genital herpes is so widespread.
In most cases, symptoms of genital herpes appear 2 to 20 days (the average is four to seven days) after contact with an infected person. Clusters of blister-like sores appear at the site where the virus first entered the body. These sores may itch, burn, or be extremely painful. A person also may experience other symptoms such as swollen glands, general muscle aches, fever, a burning sensation during urination, or a mild vaginal discharge. The sores usually last for 10 to 14 days and then heal completely, without scarring. The healing marks the end of the active phase of genital herpes.
The herpes virus remains in the body and becomes inactive after the sores have healed. While in the inactive stage, the herpes virus can remain in nerve tissue for long periods of time without causing any symptoms. This is true of both oral (cold sore) and genital forms of herpes.
There is a significant risk of infection in a newborn child born to a mother with active genital herpes infection (i.e., the presence of sores in the genital area). The risk is greatest during delivery for women who have their first episode of genital herpes sores. Infection in the newborn may cause brain damage or death. In most cases, the baby becomes infected while passing through the birth canal. However, in rare cases, the baby can become infected while still in the womb.
Recurrent episodes of genital herpes are common. For one-half to two-thirds of infected men and women, genital herpes symptoms do recur. One survey reported an average of four to seven recurrences during a person’s first year with the disease. Men have more frequent recurrences than women. In most people, these recurring bouts are less painful than the first bout of symptoms; sores tend to heal more quickly and shed less infectious virus. Some researchers believe that genital herpes “burns itself out” over the years as a person’s body slowly adapts to having the virus.
Many people experience warning signs or symptoms just before a flare-up of genital herpes sores. The symptoms, called a prodrome, indicate that the virus is reactivating beneath the skin. A prodrome may include itching, tingling, or a dull, throbbing pain in the area of the body where the sores are about to appear. Some people have shooting pains in the buttocks, legs, or lower back.
A prodrome may occur anywhere from a few hours to several days before sores appear, providing an indication that all sexual activity should stop.
Just as with cold sores, no one knows exactly what causes genital herpes to reactivate. A number of physical and emotional factors can trigger a relapse: stress, fatigue, the menstrual cycle, fever or sunburn, for example. Maintaining good health by proper nutrition, rest, and exercise can help to control recurrent genital herpes attacks. So can efforts to deal with and reduce emotional stress. Most people learn to manage their infections while leading a normal lifestyle.
The vast majority of genital herpes attacks simply consist of painful blisters that heal by themselves and cause no serious medical problems. Because herpes sores are breaks in the skin, they increase the possibility of other kinds of infections entering the body. To prevent this, extra care should be taken to keep the affected areas clean. Similarly, careful hand washing ought to be practiced to prevent the virus from spreading to other parts of the body, especially the eyes and mouth.
The most serious complication of genital herpes is infection of a baby during delivery. Although this is not common, infection in the newborn can be extremely serious and even fatal. A pregnant woman who has a history of genital herpes should tell her doctor. In certain cases a Caesarian section delivery may be recommended to prevent infection in the child.
If you think you have been exposed or show signs of herpes infection, see your health care provider. Prompt professional diagnosis may increase your chances of responding to a prescription medication like acyclovir that reduces the duration and severity of an initial bout of symptoms. A professional diagnosis can also help to avoid confusion with other diseases that have similar symptoms. Once you have a diagnosis, alert your sexual contacts, and seek the treatment and information you need to deal with genital herpes in your daily life.
Doctors can treat the symptoms of genital herpes, but as yet there is no drug that will actually eradicate the virus. However, there are a few antiviral medications that can be given to speed up healing and reduce the severity of the genital sores.
Antiviral medications are most effective when given during the first episode of genital sores. They have little, if any, effect during recurrent episodes. Use of antiviral medications during an initial episode of genital herpes will have no effect on the subsequent risk of recurrences.
Daily suppressive therapy with an antiviral drug like Acyclovir, Famcyclovir or Valaclovir may reduce the frequency of recurrences and is indicated for some patients.
You will be advised to not have vaginal, oral or anal sex while the sores are present, and to be extremely careful with personal hygiene. Loose-fitting clothing should be worn until the sores begin to heal, and the area around the sex organs should be kept clean and dry.
The only way to prevent genital herpes is to avoid being exposed to the virus. Both male and female condoms are likely to reduce the likelihood of transmission. However, since condoms may not cover all the areas where a herpes sore may appear, they may not provide full protection. Dental dams or similar latex barriers may help reduce transmission during oral sex. It is best to avoid sexual contact while symptoms are present in your genital or mouth areas or that of your sexual partner.
As with other STDs/STIs, your sexual habits and patterns determine the likelihood of being exposed and infected. The more frequently a person engages in sexual relations with different people, the greater the risk of acquiring genital herpes or another STD/STI. Limiting the number of sexual partners will greatly improve your chances of avoiding genital herpes.
Research is currently underway to develop a vaccine that protects against genital herpes.
For more information about genital herpes and other STDs/STIs, call the
Minnesota Family Planning and STD Hotline:
1-800-78 FACTS voice/TTY (Telecommunication devices for the deaf)
651-645-9360 (Metro area)
Attention: Non-MDH link
For more information about HIV/AIDS, call the
Minnesota AIDS Project AIDSLine:
(612) 373-AIDS, (612) 373-2465 TTY
1-800-248-AIDS, 1-888-820-2437 TTY
Attention: Non-MDH link
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