Common Signs & Symptoms of Genital Herpes

Herpes Symptoms

Genital herpes is asymptomatic in most carriers. When symptoms are present, they are mild and easily mistaken for other skin conditions. Experiencing symptoms of genital herpes is called having an outbreak and is most common in the first year of infection. The first outbreak is typically the worst and lasts the longest. It can also be accompanied by headaches, fever, body aches and swollen lymph nodes.

Symptoms of an HSV-2 outbreak vary for men and women, but the most common symptom in both is blisters in and around the genital area. Herpes blisters often break and leave painful open sores that will scab and heal over several weeks. Following the first outbreak, sores tend to heal more rapidly. Men may also notice swelling discomfort in the groin nodes. Women may notice discomfort similar to a yeast, bacterial or bladder infection and abnormal bleeding between periods.

What is genital herpes?

Genital herpes is a sexually transmitted infection caused by the herpes simplex virus types 1 and 2. HSV-1 (oral herpes) and HSV-2 (genital herpes) can infect both men and women, although they are statistically more common in women. Roughly 1 in 10 Americans aged 14-49 has a genital herpes infection.

Genital herpes is typically the result of an HSV-2 infection, but HSV-1 (known for causing cold sores around the mouth) can also be transmitted to the genitals during oral sex. Herpes can cause genital, anal and oral infections.

Who is at risk for genital herpes?

Every sexually active person is at risk of genital herpes, but according to the CDC it is most often found in women (15.9% vs 8.2% in men) and non-Hispanic blacks (34.6% vs. 8.1% in whites). Herpes may be more prevalent in women because it is easier for the virus to pass from a man to a woman than a woman to a man during sex.

How is genital herpes transmitted?

Genital herpes is transmitted through sexual or body to body contact with the open sores, mucosal surfaces or oral and genital secretions of an infected person. Herpes transmission occurs most often from persons who are shedding the virus but have no visible symptoms. After infection, the herpes virus replicates until there are no more resources in the infected cells to support more replication, and then it sheds. After shedding, the cycle begins again.

Herpes is contagious whenever the virus is shedding, with or without the presence of symptoms. A person currently experiencing an outbreak sheds herpes 20.1% of days while a person without symptoms sheds 10.2% of days. Herpes sores are typically found in whatever location the virus entered, but they can spread to other parts of the body while the virus is shedding. This takes place when you touch the infected area and then touch a mucosal surface that can be infected.

What is the incubation period of genital herpes?

The incubation period for genital herpes is two to 12 days from the time of infection.

Will I know before I have a herpes outbreak?

After the first outbreak, it is possible to know a herpes outbreak will occur before it happens. Many carriers report genital pain and tingling or shooting pain in the legs, hips and buttocks as an indicator that an outbreak may appear in the next few days.

What are the long-term consequences of untreated genital herpes?

In rare cases, genital herpes has been known to cause inflammation in the lining of the brain. More likely, herpes will cause severe and persistent open sores in persons with immune deficiencies, especially HIV.

The risk of HIV transmission increases significantly with herpes infection because is spread through direct contact with mucous membranes of an HIV-negative person and attacks white blood cells. Contact with HIV is more likely to happen if herpes blisters are present, especially because these blisters contain higher amounts of white blood cells than normal.

How does genital herpes impact pregnancy and expectant mothers?

Untreated herpes can cause miscarriage or early delivery. It can also be passed to the child during delivery, potentially resulting in neonatal herpes. This infection can be deadly if it is not diagnosed and treated immediately. It is much more likely for a child to contract herpes during delivery if the mother is having an outbreak or has just contracted herpes herself as the virus is sheds more frequently during this time.

Pregnant women should abstain from sex with partners known to have a herpes infection, especially during the third trimester. For the safety of the child, C-section is typically recommended if a woman is known to be shedding the herpes virus at the time of delivery.

How can I prevent genital herpes?

The only way to guarantee you will not contract herpes is to abstain from sex or to remain in a monogamous relationship with a partner who has tested negative for herpes. Condoms will lower the risk of herpes transmission but can only protect against transmission from areas covered by the condom.

If you know your partner has herpes, abstain from sex when your partner is having an outbreak and always use a condom. You may also want to consider antiviral therapy to decrease the risk of transmission.

Who should test for genital herpes?

Every sexually active person should test for genital herpes after every new partner and after known exposure. If you know you have been exposed, you may test positive within a few weeks. If you test negative, it is recommended that you test again after four months to be sure the result was accurate.

If you have participated in anal sex or oral sex you should also take an extragenital herpes test to check for infections in those areas.

How is a genital herpes test administered?

A genital herpes test uses a blood sample collected via finger prick to determine if the herpes antibody is present. If HSV-2 is found, it is safe to assume that a genital herpes infection is present. If HSV-1 is found, further testing is required to determine if the patient has an oral or genital infection.

Is genital herpes curable?

Neither HSV-1 nor HSV-2 can be cured and there are no vaccines available to prevent herpes infections.

How is genital herpes treated?

Genital herpes is treated with Zovirax, Famvir or Valtrex. These antiviral medications make outbreaks shorter and less frequent when they are taken regularly. Taking one of these medications daily can decrease the risk of transmission to a herpes-negative partner.

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