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Genital herpes is a sexually transmitted infection (STI) caused by the herpes simplex viruses type 1 (HSV-1) or type 2 (HSV-2). Most genital herpes is caused by HSV-2. HSV-1 can cause genital herpes. But it more commonly causes infections of the mouth and lips, called “fever blisters.”
Most people have no or few symptoms from herpes infection. When symptoms do occur, they usually appear as 1 or more blisters on or around the genitals or rectum. The blisters break, leaving tender sores that may take up to 4 weeks to heal. Another outbreak can appear weeks or months later. But it almost always is less severe and shorter than the first outbreak.
Although the infection can stay in the body forever, the outbreaks tend to become less severe and occur less often over time. You can pass genital herpes to someone else even when you have no symptoms.
Genital herpes is common. At least 45 million Americans age 12 and older have genital herpes. Genital HSV-2 infection is more common in women than men. About 1 in 4 women have HSV-2 infection compared to almost 1 in 8 men. This is due to the fact that women can get genital herpes and some other STIs more easily than men.
You can get genital herpes through genital-genital contact or genital-oral contact with someone who has herpes infection. The virus is most easily spread through contact with open sores. But you also can get the virus from skin that does not appear to have a sore. You can become infected with the herpes virus without having intercourse.
The symptoms of genital herpes vary from person to person. Most people with genital herpes are not aware they are infected. But, if symptoms do occur with the first outbreak, they can be severe. Genital herpes infection also can be severe and long-lasting in people whose immune systems don't work properly, such as people with HIV.
The first outbreak usually happens within 2 weeks of having sexual contact with an infected person, and symptoms can last from 2 to 3 weeks. Early symptoms of the first outbreak can include:
Within a few days, sores show up where the virus has entered the body, such as on the mouth, penis, or vagina. Sores can also show up on a woman's cervix or in the urinary passage in men. The sores are small red bumps that may turn into blisters or painful open sores. Over a period of days, the sores become crusted and then heal without scarring. Sometimes with the first outbreak, a second crop of sores appear and flu-like symptoms occur again.
Some people have no symptoms. Or they might mistaken mild sores for insect bites or something else. Yet even without symptoms, a person can still pass the herpes virus to others. So, if you have signs of herpes, see your doctor to find out if you are infected.
Yes. Herpes symptoms can come and go, but the virus stays inside your body even after all signs of the infection have gone away. In most people, the virus becomes “active” from time to time, creating an outbreak. Some people have herpes virus outbreaks only once or twice. People who have a first outbreak can expect to have 4 or 5 outbreaks within a year. Over time, the outbreaks tend to occur less often and be less severe. Experts don't know what causes the virus to become active. Some women say the virus comes back when they are sick, under stress, out in the sun, or during their period.
Doctors can diagnose genital herpes by looking at visible sores if the outbreak is typical and by taking a sample from the sore for testing in a lab. Some cases of herpes are harder to diagnose, especially between outbreaks. Blood tests that look for antibodies to HSV-1 or HSV-2 can help to detect herpes infection in people without symptoms or between outbreaks.
Genital herpes cannot be cured; the virus will always be in your body. But the antiviral drugs acyclovir, valacyclovir, and famciclovir can shorten outbreaks and make them less severe, or stop them from happening. Valacyclovir (brand name Valtrex) also can lower your risk of passing the infection to someone else.
Depending on your needs, your doctor can give you drugs to take right after getting outbreak symptoms or drugs to take on a regular basis to try to stop outbreaks from happening. Talk to your doctor about treatment options.
During outbreaks, these steps can speed healing and help keep the infection from spreading to other sites of the body or to other people:
No. Once you have the virus, it stays in your body and there is a chance that you will have outbreaks. Medicine can shorten and stop outbreaks from happening.
Research is underway to develop new ways to protect women from the herpes virus and prevent its spread. One large study is testing a herpes vaccine for women. Researchers are also working to make gels or creams that would kill the virus before it could infect someone.
Yes. If the mother is having her first outbreak near the time of delivery, she is much more likely to pass the virus to her baby. If the outbreak is not the first one, the baby's risk of getting the virus is very low. Babies born with herpes may be premature or may die, or they may have brain damage, severe rashes, or eye problems. Doctors may do a cesarean delivery if the mother has herpes sores near the birth canal to lower the risk of passing the virus. Fortunately, most women with genital herpes have healthy babies. Also, medicines can help babies born with herpes if they are treated right away.
It is not yet known if all genital herpes drugs are safe for pregnant women to take. Some doctors may recommend acyclovir be taken either as a pill or through an IV (a needle into a vein) during pregnancy. Let your doctor know if you have genital herpes, even if you are not having an outbreak. He or she will help you manage it safely during pregnancy.
If you have genital herpes, you can keep breastfeeding as long as the sores are covered. Herpes is spread through contact with sores and can be dangerous to a newborn. If you have sores on your nipple or areola, the darker skin around the nipple, you should stop breastfeeding on that breast. Pump or hand express your milk from that breast until the sore clears. Pumping will help keep up your milk supply and prevent your breast from getting overly full. You can store your milk to give to your baby in a bottle at another feeding. If the parts of your breast pump that contact the milk also touch the sore(s) while pumping, you should throw the milk away.
Genital herpes infection usually does not cause serious health problems in healthy adults. People whose immune systems don't work properly, such as people with HIV, can have severe outbreaks that are long-lasting. Sometimes, people with normal immune systems can get herpes infection in the eye. But this is less common with HSV-2 infection.
Herpes may play a role in the spread of HIV, the virus that causes AIDS. Herpes sores can make it easier for HIV to get into your body. Also, herpes can make people who are HIV-positive more infectious.
Living with herpes can be hard to cope with even if you have no symptoms. At first, you might feel embarrassed or ashamed. You might worry whether having herpes will affect your relationship with your sexual partner or keep you from having meaningful relationships in the future. Keep in mind that millions of people have herpes. And not unlike many other health issues, treatment can help you manage the infection. After a little time, most people with herpes are able to adjust to the diagnosis and move on. Let your doctor know if you're having a hard time adjusting. Talking to someone about your feelings may help.
There are things you can do to lower your risk of getting genital herpes:
For more information about genital herpes, call womenshealth.gov at 800-994-9662 (TDD: 888-220-5446) or contact the following organizations:
Content last updated: July 16, 2012.