How did I get herpes? Did my partner cheat? Or did I have it before the relationship? How long can herpes stay dormant?
These are some of the questions that people newly diagnosed with genital herpes ask. Here's what we know about how this infection occurs.
The first outbreak usually occurs within 2-10 days of exposure to the virus. This outbreak may be a sore or lesion in or around the vagina or on the cervix in women or on the penis and scrotum of men. Men or women can get lesions within the urinary tract, around or inside the anus, on the buttocks, thighs or other parts of the body.
Usually the lesions start as reddened bumps which evolve over hours or days into blisters/open sores which crust over, dry up and heal. Sometimes a second crop of lesions occur.
The initial infection may be severe and have more generalized symptoms such as fever, headache and muscle aches.
However, these lesions are not the only symptom of an initial outbreak. Symptoms of genital herpes can vary in appearance and intensity. In many cases the outbreak is mild, perhaps just a bit of itchy or tender skin, or perhaps it's mistaken for jock itch. Some people just have painful or difficulty urinating during a primary infection. Others have vaginal discharge that they mistake as a symptom for another vaginal infection. Still others have no symptoms at all.
After initial infection, the virus travels up the nerve that supplies the skin in the area of the outbreak and settles in at the base of the spine. This is called dormancy.
When the virus travels back down the nerve, and causes an outbreak, this is called recurrence.
Recurrent outbreaks can occur days, weeks, months or years after the initial outbreak. Or, recurrence may never occur.
What's tricky about genital herpes is that you don't have to have an outbreak to infect another person. The virus can be present on the skin, usually at the place of first infection, without causing symptoms. That's called asymptomatic shedding. The virus can also shed into rectal tissue or in the fluids from the penis or vagina.
This is why herpes is called a silent epidemic. The disease can easily be transmitted from person to person with complete unawareness of disease presence.
You can torture yourself forever trying to figure out who infected whom and when or if your partner was unfaithful, but what's much more productive is to work as a team to keep the infection at bay.