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Symptoms
By Mayo Clinic staff
The majority of people who've been infected with HSV never know they have the disease because they have no signs or symptoms. The signs and symptoms of HSV can be so mild they go unnoticed. The first outbreak is generally the worst, and some people never experience a second outbreak. Other people, however, can experience outbreaks as long as 40 years after the initial outbreak.
When present, genital herpes symptoms may include:
- Small red bumps, blisters (vesicles) or open sores (ulcers) in the genital, anal or nearby areas
- Pain or itching around your genital area, buttocks or inner thighs
The initial symptom of genital herpes usually is pain or itching, beginning within a few weeks after exposure to an infected sexual partner. After several days, small red bumps may appear. They then rupture, becoming ulcers that ooze or bleed. Eventually, scabs form and the ulcers heal.
In women, sores can erupt in the vaginal area, external genitals, buttocks, anus or cervix. In men, sores can appear on the penis, scrotum, buttocks, anus or thighs or inside the urethra, the channel inside the penis leading to the bladder.
While you have ulcers, it may be painful to urinate. You may also experience pain and tenderness in your genital area until the infection clears. During an initial outbreak, you may have flu-like signs and symptoms, such as headache, muscle aches and fever, as well as swollen lymph nodes in your groin.
Recurrences
Genital herpes is different for each person. The signs and symptoms may recur for years. Some people experience numerous episodes each year. For many people, however, the outbreaks are less frequent as time passes. Various factors may trigger outbreaks, including:
- Stress
- Menstruation
- Immune system suppression, from medications such as steroids or chemotherapy, or due to infections, such as HIV/AIDS
- Illness
- Surgery
- Friction, such as that caused by vigorous sexual intercourse
- Fatigue
In some cases, the infection can be active and contagious even when lesions aren't present.
When to see a doctor
If you suspect you have genital herpes — or any other sexually transmitted disease — see your doctor.
- Goade D. Genital herpes. In: Cohen J, et al. Infectious Diseases. 2nd ed. New York, N.Y.: Mosby; 2004. http://www.mdconsult.com/das/book/body/130330290-4/0/1209/247.html?tocnode=49353813&fromURL=247.html#4-u1.0-B0-323-02407-6..50078-7_2618. Accessed April 7, 2009.
- Gupta R, et al. Genital herpes. Lancet. 2007;370:2127.
- Albrecht MA. Epidemiology, clinical manifestations, and diagnosis of genital herpes simplex virus infection. http://www.uptodate.com/home/index.html. Accessed April 7, 2009.
- Centers for Disease Control and Prevention, et al. Sexually transmitted diseases treatment guidelines, 2006. MMWR Recommendations and Reports. 2006;55:1. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5511a1.htm. Accessed April 8, 2009.
- Xu F, et al. Trends in herpes simplex virus type 1 and type 2 seroprevalence in the United States. Journal of the American Medical Association. 2006;296:964.
- Wald A. Prevention of genital herpes virus infections. http://www.uptodate.com/home/index.html. Accessed April 7, 2009.
- Genital herpes. American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp054.cfm. Accessed April 6, 2009.
