Genital Herpes: Learn the Basicsby Robin Elise Weiss, Ph.D. Health Professional
Genital herpes is a sexually transmitted infection (STI). In the United States, more than one out of every six people aged 14 to 49 years have genital herpes, according to the Centers for Disease Control and Prevention (CDC).
What Causes Genital Herpes?
There are two viruses known to cause genital herpes. The most common is herpes simplex virus type 2 (HSV-2). The other, less common type is herpes simplex virus type 1 (HSV-1). Though there are an increasing number of cases of HSV-1 being found in the genital area, HSV-1 is most often associated with sores around the mouth, lips, and eyes. Oral symptoms of HSV-1 are often called cold sores.
What Are the Symptoms of Genital Herpes?
During your first outbreak of herpes, you may notice flu-like symptoms. This may include a fever, muscle aches, headache, and fatigue. You may also notice swelling in your genital region, followed by painful blisters in the area. It’s also not uncommon to feel a burning or pain when you urinate. These symptoms usually begin within 2 to 10 days of your first exposure to the virus. This first outbreak is often the longest you will ever have, lasting from 2 to 4 weeks.
Later outbreaks can occur, but they usually become less frequent after the first year that you have the virus. The good news is that these outbreaks tend to be less painful than the first, and the sores typically last only 5 to 7 days.
In recurrent outbreaks, you may also experience what is known as a prodrome. This is a time just before an outbreak where you have itching or tingling at the site where sores will break out or even along your lower back, buttocks, or spine.
It’s important to know that most people with herpes have no noticeable symptoms, or they have very mild symptoms, according to the CDC. It’s possible to be infected with the herpes virus and not know you have it.
Treatment of Genital Herpes
There is no cure for genital herpes or other types of herpes. Herpes is a virus that enters your body and stays there permanently. However, the virus lies dormant much of the time, meaning you won’t have always have symptoms. If you do have outbreaks, there are things you can do to manage and even suppress them.
Medications known as antivirals can be given to help decrease the length or severity of an outbreak, according to the American College of Obstetricians and Gynecologists (ACOG). Some people may also take antivirals all the time to help prevent outbreaks from occurring in the first place; this is called suppressive therapy. Taking these medications can also help reduce the chance of passing the virus to a sexual partner.
Testing for Genital Herpes
If you are not sure if you have herpes, you can ask your doctor to test you. If you have small, fluid-filled sores at the time you see your doctor, they can be tested to see if it is herpes. A blood test can also tell if you have the virus in your body, even when you don't have an active outbreak. Typically, doctors do not recommend blood testing if you have never had symptoms. For people whose partners are known to have genital herpes, a blood test is sometimes considered after discussion with your doctor.
Because genital herpes is contagious, you will need to inform your sexual partners that you have it. They will want to get tested as well.
How to Prevent the Transmission of Genital Herpes
It is possible to transmit genital herpes to other people, even if you do not have active sores or notice symptoms. However, transmission is much less likely when you don't have an active outbreak. Any skin-to-skin contact with the area of the body that is infected can transmit the virus. This includes anal sex, vaginal sex, and oral sex. While researchers are at work on a vaccine to prevent getting the virus, there is no way to guarantee the prevention of herpes other than avoiding that skin-to-skin contact.
If you or your partner have genital herpes, you should have a conversation about how to prevent the transmission of the virus or reduce the risk to the non-infected partner. For example, avoiding sexual contact from the time you experience prodromal symptoms to the time the herpes sores have healed can help reduce the risk of transmission. Additionally, using latex condoms can also reduce your risk. If you or your partner have a latex allergy, you may also use polyurethane condoms. However, affected areas of skin that are not covered by the condom still potentially put you at risk of transmission. Suppressive therapy can help you reduce the risks of potentially transmitting the virus it to your partner.
It is also important to know that if you have genital herpes, you have an increased risk of contracting human immunodeficiency virus (HIV) if you are exposed to it. Taking medication to suppress outbreaks does not reduce this risk.
The Bottom Line
If you notice genital sores, lesions, or other symptoms of genital herpes, it is worth getting tested. If you do test positive, you can still have an active and healthy sex life, albeit with some modifications to protect your partner. There are also medications available to help treat and prevent outbreaks. While there is no cure, the condition is highly manageable.