Signs and Symptoms of Genital Herpes

Genital herpes is a common sexually transmitted infection (STI) that affects 12% of people between the ages of 14 and 49. Two types of herpes viruses can cause genital herpes:

• Herpes simplex virus type 1 (HSV-1): Typically causes oral herpes (blisters around the mouth). HSV-1 typically spreads through non-sexual contact with saliva. You can also transmit HSV-1 from the mouth to the genitals through oral sex or by touching the genitals after touching a sore.
• Herpes simplex virus type 2 (HSV-2): HSV-2 is the most common cause of genital herpes. It spreads through oral, vaginal, or anal sex (with or without sores present). You can also transmit it by touching a sore and then the genitals or anus.

Once someone has HSV, the virus stays in their body for life. HSV can sometimes be asymptomatic (does not cause symptoms). However, if you do develop symptoms, the most common sign is clusters of blisters or sores around the genitals, anus, or mouth. Sores can develop rapidly or gradually, and most people say they can feel irritation in the area before their sores form. 

Blisters and Sores

The most common symptom of genital herpes is small clusters of blisters or sores on or around the: 

• Vagina
• Penis
• Anus
• Urethra

Blisters inside the vagina or the urethra (the tube that transports pee out of the body) may develop but are often hard to see. 

If you develop sores, you may notice they have the following characteristics and symptoms:

• Clusters of blisters
• Pus inside the sores that is clear or yellow
• Red or white-colored sores
• Round and small blisters that are typically 1 to 3 millimeters in size
• Blisters that are highly contagious
• Pain, itchiness, and burning sensation
• Difficulty walking, sitting, or engaging in sexual activity
  

Painful Urination

Pain during urination (peeing) is another symptom of genital herpes, especially when you first are exposed to HSV. This can happen when urine comes into contact with the herpes blisters in the genital area or urethra. This can be especially uncomfortable if there are open sores. The discomfort can last a few moments during urination but may continue for some time afterward.

If you experience discomfort during urination with genital herpes, you can take a few steps to alleviate symptoms. These include:

• Drinking plenty of fluids to dilute the urine and reduce irritation
• Using a squirt bottle with warm water to rinse the genital area while urinating 
• Taking an over-the-counter (OTC) urinary pain relief medication like AZO Standard or Pyridium (phenazopyridine), especially if pain persists

Flu-like Symptoms 

It's common to experience flu-like symptoms when you first contract the virus. These symptoms occur because your immune system is responding to the virus for the first time. Generally, if you have herpes flare-ups in the future, your flu symptoms will be less severe.

Flu-like symptoms can range from mild to severe and may include:

• Headache
• Fatigue
• Fever
• Muscle aches or weakness
• Swollen lymph nodes
• Loss of appetite

Symptoms in Children 

In most cases, children who have genital herpes contract HSV-1 through non-sexual, saliva contact. They usually experience cold sores around the mouth.

If they touch an HSV-1 sore and then the mucus membranes of their genitals or anus, they could transmit HSV-1 to their genitals. Unfortunately, genital herpes (HSV-2) can also occur in children who experience sexual assault or abuse. 

Symptoms in Men and Women

Symptoms of genital herpes tend to be similar in both men and women, but they may be more severe in women. Men develop outbreaks on the penis or scrotum. Women typically get sores in the vaginal area or around the anus.

Pregnant people can also pass genital herpes to their babies during pregnancy or childbirth. Herpes can be very dangerous, even fatal, for neonates (newborns). While the condition is not curable, some medications can help you prevent giving the virus to your newborn.

When to See a Healthcare Provider 

If you suspect you have herpes or are experiencing symptoms, it's important to get tested. While there are at-home herpes tests that you can use, it’s best to consult a healthcare provider immediately if you have been exposed to HSV. This is especially important for those who are pregnant or who have a weakened immune system.

While there is no cure for herpes, antiviral medications can lessen symptoms or prevent outbreaks from commonly occurring. They also reduce the risk of transmitting the virus to your sexual partners. 

A Quick Review 

Herpes can occur due to HSV-1 or HSV-2. It's more common to develop genital herpes through HSV-2, which you can contract through sexual contact. Genital herpes can cause contagious and painful blisters or sores on the genitals, urethra, or around the anus. As a result, you may experience additional symptoms such as painful urination and flu-like symptoms.

If you suspect that you may have genital herpes, it's important to seek medical attention to manage the symptoms and reduce the risk of transmission to others.