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Symptoms of Genital Herpes

Most people are unaware they have genital herpes because they do not have symptoms. Some people may have mild symptoms or mistake their symptoms for something else, such as jock itch or a yeast infection. Sexual contact with others can spread the infection even if symptoms are not present.

If recognizable symptoms do occur, they usually appear within 1 week of exposure. Some may notice an early period of symptoms just before the onset of the disease appears which may include:

  • Local or regional pain
  • Tingling
  • Itching
  • Burning
  • Discomfort during urination

Flu-like symptoms may also occur including:

  • Headache
  • Fever
  • Body aches
  • Swollen lymph glands

Primary Outbreak and Recurrence

Genital herpes is marked by periods of outbreaks, healing, and recurrence. Outbreaks may cause:

  • Sores that start to form where the virus was contracted and entered the body
  • Sores that begin as small red bumps
  • Sores or blisters that appear and occur in clusters or small groupings

Blisters may become painful open sores. Outbreaks usually appear on or inside the genital and/or anal areas. Examples include the penis, vulva, cervix (the entrance to the uterus), rectum, or urethra (the tube that carries urine from the body). Lesions can also appear on the buttocks or upper thighs.

Genital Herpes
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The lesions usually heal without scarring within 2-6 weeks. At the end of the outbreak, a crust forms over the outer layer of the sore and the crust eventually falls off. This indicates a period of inactivity. Even though you don't have visible signs of genital herpes during inactive periods, it is important to know you can still transmit the virus to others.

Outbreaks may occur a number of times throughout the year, or may only occur once or twice in a lifetime. The frequency of outbreaks varies from person to person. The first year of the virus is usually most severe and painful, with a second outbreak often happening only a few weeks later. As time goes on, recurrences tend to become milder and shorter in duration. Often, recurrences are signaled by symptoms where the virus first entered your body.

Infection with the HSV-2 virus is associated with more frequent recurrences than an infection with HSV-1 virus.

Complications

Untreated, genital herpes can cause complications such as:

  • Lesions that appear on other parts of the body.
  • Psychological problems—Genital herpes can cause distress, depression, and anxiety.
  • Neonatal herpes—Pregnant women can transmit genital herpes to their newborns during childbirth.
  • Urinary problems—The inside of the urethra may become affected, causing burning when passing urine. Lesions inside the urethra may cause difficulty with passing urine, or block urine flow completely.
  • Proctitis—Lesions can spread to the rectum or begin there from anal intercourse. Proctitis causes pain, anal discharge and bleeding, and lower abdominal cramping.
  • Rare complications include:
    • Aseptic meningitis—infection of the cerebrospinal fluid that surrounds and protects the brain and spinal cord
    • Encephalitis—inflammation of the brain
    • Blindness

Revision Information

  • Reviewer: David Horn, MD
  • Review Date: 05/2014 -
  • Update Date: 10/15/2014 -
  • Beauman JG. Genital herpes: A review. Am Fam Physician. 2005;72(8):1527-1534.

  • Genital herpes—CDC fact sheet. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/std/herpes/stdfact-herpes-detailed.htm. Updated February 13, 2013. Accessed October 15, 2014.

  • Herpes genitalis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 8, 2014. Accessed October 15, 2014.

  • Workowski KA, Berman S, et al. Sexually transmitted diseases treatment guidelines, 2010. MMWR. 2010;59(No. RR-12):1-110.