About Genital Herpes

Overview

What is genital herpes?

Genital herpes is an STI caused by two types of viruses – herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2).

Oral herpes

HSV-1 often causes oral herpes, which can result in cold sores or fever blisters on or around the mouth. However, most people with oral herpes do not have any symptoms. Most people with oral herpes get it during childhood or young adulthood from non-sexual contact with saliva.

Genital herpes is common in the United States (U.S.). In 2018, CDC estimates show there were 572,000 new genital herpes infections in the U.S. among people aged 14 to 49.¹

Signs and symptoms

How do I know I have genital herpes?

Genital herpes often has no symptoms, but it can cause serious health problems, even without symptoms.

Most people with genital herpes have no symptoms or have very mild symptoms. Mild symptoms may go unnoticed or be mistaken for other skin conditions like a pimple or ingrown hair. Because of this, most people do not know they have a herpes infection.

Herpes Outbreak

Herpes sores usually appear as one or more blisters on or around the genitals, rectum or mouth. This is known as having an "outbreak". The blisters break and leave painful sores that may take a week or more to heal. Flu-like symptoms (e.g., fever, body aches, or swollen glands) also may occur during the first outbreak.

People who experience an initial outbreak of herpes can have repeated outbreaks, especially if they have HSV-2. However, repeat outbreaks are usually shorter and less severe than the first outbreak. Although genital herpes is a lifelong infection, the number of outbreaks may decrease over time.

See your healthcare provider if you notice any of these symptoms. You should also see a provider if your partner has an STI or symptoms of one. Symptoms can include an unusual sore, a smelly genital discharge, burning when peeing, or bleeding between periods.

Risk factors

What is the link between genital herpes and HIV?

Herpes infection can cause sores or breaks in the skin or lining of the mouth, vagina, and rectum. This provides a way for HIV to enter the body. Even without visible sores, herpes increases the number of immune cells in the lining of the genitals. HIV targets immune cells for entry into the body. Having both HIV and genital herpes increases the chance of spreading HIV to a HIV-negative partner during oral, vagina, or anal sex.

How it spreads

How is genital herpes spread?

You can get genital herpes by having vaginal, anal, or oral sex with someone who has the infection. You can get herpes if you have contact with:

• A herpes sore
• Saliva from a partner with an oral herpes infection
• Genital fluids from a partner with a genital herpes infection
• Skin in the oral area of a partner with oral herpes
• Skin in the genital area of a partner with genital herpes

You also can get genital herpes from a sex partner who does not have a visible sore or is unaware of their infection. It is also possible to get genital herpes if you receive oral sex from a partner with oral herpes.

You will not get herpes from toilet seats, bedding, or swimming pools. You also will not get it from touching objects, such as silverware, soap, or towels.

If you have more questions about herpes, consider discussing your concerns with a healthcare provider.

Is there a link between genital herpes and oral herpes?

Yes. Oral herpes caused by HSV-1 can spread from the mouth to the genitals through oral sex. This is why some cases of genital herpes are due to HSV-1.

Prevention

How can I prevent genital herpes?

The only way to completely avoid STIs is to not have vaginal, anal, or oral sex.

If you are sexually active, you can do the following things to lower your chances of getting genital herpes:

• Being in a long-term mutually monogamous relationship with a partner who does not have herpes.
• Using condoms the right way every time you have sex.

Be aware that not all herpes sores occur in areas that a condom can cover. Also, the skin can release the virus (shed) from areas that do not have a visible herpes sore. For these reasons, condoms may not fully protect you from getting herpes.

If your sex partner(s) has/have genital herpes, you can lower your risk of getting it if:

• Your partner takes an anti-herpes medicine every day. This is something your partner should discuss with his or her healthcare provider.
• You avoid having vaginal, anal, or oral sex when your partner has herpes symptoms (i.e., during an "outbreak").

I'm pregnant. If I have genital herpes, how can I protect my baby from getting it?

If you are pregnant and have genital herpes, prenatal care visits are very important. Some research suggest that a genital herpes infection may lead to miscarriage or make it more likely to deliver your baby too early. You can pass herpes to your unborn child before birth, but it more commonly passes during delivery. This can lead to a deadly infection in your baby (called neonatal herpes). It is important that you avoid getting genital herpes during pregnancy. Tell your healthcare provider if you have ever had a genital herpes diagnosis or symptoms. Also tell them about any possible exposure to genital herpes.

If you have genital herpes, you may need to take anti-herpes medicine towards the end of your pregnancy. This medicine may reduce your risk of having signs or symptoms of genital herpes when you deliver. At the time of delivery, your healthcare provider should carefully examine you for herpes sores. If you have signs or symptoms of genital herpes at delivery, a 'C-section' is likely to occur.

Testing and diagnosis

How will my healthcare provider know if I have genital herpes?

Your healthcare provider may diagnose genital herpes by simply looking at any sores that are present. Providers can also take a sample from the sore(s) and test it. If sores are not present, a blood test may be used to look for HSV antibodies.

Have an honest and open talk with your healthcare provider about herpes testing and other STDs.

Please note: A herpes blood test can help determine if you have herpes infection. It cannot tell you who gave you the infection or when you got the infection.

Treatment and recovery

Is there a cure for genital herpes?

There is no cure for genital herpes. However, there are medicines that can prevent or shorten outbreaks. A daily anti-herpes medicine can make it less likely to pass the infection on to your sex partner(s).

Can I still have sex if I have herpes?

If you have herpes, you should talk to your sex partner(s) about their risk. Using condoms may help lower this risk but it will not get rid of the risk completely. Having sores or other symptoms of herpes can increase your risk of spreading the disease. Even if you do not have any symptoms, you can still infect your sex partners.

You may have concerns about how genital herpes will impact your health, sex life, and relationships. While herpes is not curable, it is important to know that it is manageable with medicine. Daily suppressive therapy (i.e., daily use of antiviral medication) can lower your risk of spreading the virus to others. Talk to a healthcare provider about your concerns and treatment options.

A genital herpes diagnosis may affect how you will feel about current or future sexual relationships. Knowing how to talk to sexual partners about STIs is important.

What happens if I don't get treated?

Genital herpes can cause painful genital sores and can be severe in people with suppressed immune systems.

If you touch your sores or fluids from the sores, you may transfer herpes to another body part like your eyes. Do not touch the sores or fluids to avoid spreading herpes to another part of your body. If you do touch the sores or fluids, quickly wash your hands thoroughly to help avoid spreading the infection.

If you are pregnant, there can be problems for you and your unborn fetus, or newborn baby. See "I'm pregnant. How could genital herpes affect my baby?" for information about this.