Genital herpes is a very contagious infection caused by the herpes simplex virus, or HSV. There are two types of HSV, type 1 and type 2. Type 1 usually causes mouth blisters or cold sores but can also infect the genital area. Type 2 causes most genital herpes cases.
Most people get genital herpes from having sex with someone who is infected. The virus settles in a nerve in the body and remains there permanently. Condoms are not a complete barrier because the virus and lesions can also be on thighs and buttocks.
Many people never have symptoms and don’t know that they have herpes until the first outbreak. Symptoms of a first outbreak may include pain and itching in the lip or genital area. Sometimes, during a first outbreak, there may be a feeling of pressure in the abdomen, discharge from the vagina, headache, fever, and difficulty urinating. The first outbreak is the longest and most painful. It may last several days.
HSV starts as small red bumps, which develop into blisters. These blisters become painful open sores. After several days, the sores crust and in time disappear completely. About 50% of people who have a first outbreak of herpes will have more blisters. These outbreaks are usually milder and shorter and usually end in 7 to 10 days. Symptoms vary, so some people may have only one or two outbreaks in a lifetime, but others may have several per year. The cause of repeated outbreaks is unclear. Emotional stress, fatigue, illness, and menstruation may trigger them. As time goes on, the number of outbreaks usually decreases.
The health care provider usually makes a diagnosis from a physical examination. The health care provider asks questions about symptoms and sexual activity.
Sometimes a sample may be taken from the blisters and sent to a laboratory to confirm that HSV is in the blister or to rule out other illnesses. A blood test can be done to check for antibodies to HSV, which indicate a current or past infection.
No cure exists at this time. Antiviral drugs including acyclovir, famciclovir, and valacyclovir can be prescribed to shorten and prevent outbreaks. The antiviral medicines may be taken at the beginning of symptoms or daily to help prevent frequent outbreaks.
Over-the-counter pain medicine, such as acetaminophen or topical preparations, can be used to relieve discomfort.
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