Genital Herpes Symptoms & Causes
Herpes Simplex Viruses (HSV) are a group of viruses which can cause infections that present as small often painful blisters on the skin of the mouth, lips, eyes or genitals.
They can be categorised as either Type 1 Herpes (Oral Herpes) or Type 2 Herpes (Genital Herpes). Type 1 Herpes can cause sores on the mouth or lips. Type 2 herpes can cause sores or blisters on the genitals or in the genital area. This is not concrete however, as Type 1 can sometimes cause genital herpes.
Of those with the Herpes virus, 67% of the global population under 50 have Type 1 Herpes.
This test looks for the previous exposure to Herpes type 1 & 2, with results in 20 minutes.
What are the symptoms of Genital Herpes?
Primary Genital Herpes Outbreak
During your first genital herpes outbreak, you may experience flu-like signs and symptoms. These may include:
- Sore throat
- Swollen lymph nodes in the neck and groin
- Muscle ache
Women may develop sores and ulcers on their:
- Vaginal wall
- Upper thighs
- Lips and surrounding area
- (and rarely the face)
Men may develop sores and ulcers on their:
- Penile shaft
- Glans penis
- Upper thighs
- Lips and surrounding area
- (and rarely the face)
Men and Women may experience at the site of sores and ulcers:
- Fluid-filled blisters
- Rawness of the affected area
- Pain, itching or tingling in the anal or genital area
- Small red bumps
- Ulcers and blisters which join together to form a larger area
- Scabs and scarring may form as a result of the ulcers and blisters healing
- Swelling and tenderness of lymph nodes in groin
Women may experience:
- Symptoms which mimic cystitis, a UTI or thrush
- Sudden increase in copious, thin vaginal discharge (generally due to the presence of ulcers in the cervix and vaginal wall along with ulcers on the external genitalia)
Men may experience:
- Extreme or severe painful urination (Dysuria) when sores and ulcers are at the tip of the penis
- Rarely there can be massive swelling of whole penile shaft
Can I get Genital Herpes again?
Genital herpes is different for each person. The signs and symptoms may recur, off and on, for years. Some people experience numerous episodes each year. For many people, however, the outbreaks are less frequent as time passes.
During a recurrence, shortly before sores appear, you may feel:
- Burning, tingling and itching where the infection first entered your body
- Pain in your lower back, buttocks and legs
However, recurrences are generally less painful than the original outbreak, and sores generally heal more quickly.
Can I have Genital Herpes without knowing it?
Genital Herpes (or cold sores) are caused by the Herpes Simplex Virus (HSV). It is common to speak of a herpes ‘outbreak’ when signs and symptoms present themselves.
Most people infected with Genital Herpes don’t know they have it. This is because the signs of symptoms of HSV are not easily noticeable.
The symptoms of genital herpes can be variable as well as latent.
Symptoms of genital herpes may be variable as some may experience signs and symptoms from 2 to 12 days after exposure, but others may only have an outbreak weeks or months (and even decades) after exposure to the virus.
The fact that many people don’t show signs or symptoms of the virus is because of a property known as latency. This is where the virus is sitting idly inside the body without causing any problems.
What if i’m pregnant and have Genital Herpes?
Please tell your clinician.
Your clinician may recommend that you start taking herpes antiviral medications late in pregnancy to try to prevent an outbreak around the time of delivery. If you’re experiencing an outbreak when you go into labour, your doctor will probably suggest a cesarean section to reduce the risk of passing the virus to your baby.
Herpes can be acquired during pregnancy because of an altered immune system.
The third trimester of pregnancy is the most important as the mother can pass on the herpes virus to the child if she has a vaginal birth.
We recommend this to be discussed with your midwife or obstetrician if HSV is suspected or confirmed during this trimester, as a caesarean section may be recommended to prevent passing on the virus to the child.
HIV & Genital Herpes
Genital herpes can be more serious with those living with HIV.
In the most extreme of cases, herpes can affect the eyes, brain and lungs. This requires specialist care.
How do I get Herpes Type 1?
HSV-1 is the type of herpes that usually produces cold sores or blisters around your mouth.
HSV-1 is most commonly gotten by anal, oral or vaginal sex. Also via intimate social contact.
HSV-1 is typically spread through skin-to-skin contact and can also be spread from the genital area during oral sex.
HSV-1 is less likely to be the cause of recurrence.
How do I get Herpes Type 2?
This is the type of Herpes that causes genital herpes. Can be common and highly contagious, whether or not you have an open sore.
- Anal, oral and vaginal sex
- Intimate social contact
Can I get Genital Herpes even if I use a condom?
You can still get the virus even with condom use, because a condom only covers the penis, and if the virus is in another area you can acquire it without knowing.
Can I get Genital Herpes from sitting on a toilet seat?
Because the virus dies quickly outside of the body, it’s nearly impossible to get the infection through contact with toilets, towels or other objects used by an infected person.
Can I find out who gave me Genital Herpes?
Sometimes because symptoms might not appear for months to even years, it might be difficult to determine when you contracted the virus.
There is a greater likelihood of catching Genital Herpes if you:
- Are a women
- Have multiple sexual partners (like with other STIs)
How can I prevent getting Genital Herpes?
One of the key ways of protecting yourself against herpes is having protected anal, oral and vaginal sex. However, this cannot guarantee protection because condoms do not provide sufficient coverage of herpetic ulcers.
- Use, or have your partner use, a latex condom during every sexual contact
- Avoid intercourse if either partner has an outbreak of herpes in the genital area or anywhere else
How can I prevent getting Genital Herpes again?
There are two things that may help in preventing a recurrence of Genital Herpes:
- Avoid ultraviolet light
- Friction in your genital area
However, some other triggers which may cause a recurrence are unavoidable. These may include:
- Being unwell
- Having a period
- Surgery on your genital area
- A weakened immune system
Page reviewed by Dr. Manoj Malu (Clinical Director)
Last reviewed date: 3 March 2020
Next review due: 3 March 2023
Whilst this content is written and reviewed by sexual health specialists, it is for general guidance only. It is not intended to replace the advice of your clinician.
References & Further Reading
- Journal of Psychosomatic Research: Psychological factors in recurrent genital herpes infection: Stress, coping style, social support, emotional dysfunction, and symptom recurrence
- The Journal of Infectious Diseases: Transmission of Genital Herpes in Couples with One Symptomatic and One Asymptomatic Partner: A Prospective Study
- Sexually Transmitted Infections: Recurrent genital herpes among women: symptomatic v. asymptomatic viral shedding.
- The Lancet: Genital herpes
- Annals of Internal Medicine: Risk Factors for the Sexual Transmission of Genital Herpes
- The Journal of Infectious Diseases: Risk of Acquisition of Genital Herpes Simplex Virus Type 2 in Sex Partners of Persons with Genital Herpes: A Prospective Couple Study
- Patient.info: Herpes Simplex Genital. Genital Herpes Simplex Information
- MSD Manuals: Herpes Simplex Virus (HSV) Infections – Infections
- The New England Journal of Medicine: Virologic Characteristics of Subclinical and Symptomatic Genital Herpes Infections
- Sexually Transmitted Diseases: Human Immunodeficiency Virus Infection and Genital Ulcer Disease in South Africa: The Herpetic Connection
- British Association of Dermatologists: Herpes Simplex: Patient Information Leaflet
- Therapeutics and Clinical Risk Management: Single-day treatment for orolabial and genital herpes: a brief review of pathogenesis and pharmacology
- American Family Physician: Treatment of Common Cutaneous Herpes Simplex Virus Infections
- NICE: Herpesvirus infections | Treatment summary
- The Canadian journal of infectious diseases & medical microbiology: The laboratory diagnosis of herpes simplex virus infections
- Infectious Diseases: Diagnostics for herpes simplex virus: is PCR the new gold standard?
- Mayo Clinic: Genital herpes – Diagnosis and treatment
- Lab Tests Online: Herpes Testing
- BMJ: Polymerase chain reaction for diagnosis of genital herpes in a genitourinary medicine clinic
- The Journal of Infectious Diseases: Molecular Methods for the Diagnosis of Genital Ulcer Disease in a Sexually Transmitted Disease Clinic Population in Northern Thailand: Predominance of Herpes Simplex Virus Infection
- Microbiology Research: Specific IgG and IgM Antibody Responses in Herpes-Simplex-Virus Infections
- BMJ: Antibody to herpes simplex virus type 2 as serological marker of sexual lifestyle in populations
- Clinical Infectious Diseases: Serological Testing for Herpes Simplex Virus (HSV)–1 and HSV-2 Infection