What are the symptoms of genital herpes?
Symptoms vary and depend on if it’s your first outbreak or a recurrent outbreak. Recurring symptoms are usually milder than the first outbreak. Symptoms also don’t last as long with later outbreaks. Some people may only have one or two outbreaks during their lifetime. Others may have as many as four or five outbreaks a year.
First genital herpes outbreak
When symptoms occur, they’re usually worse during the first outbreak. Symptoms typically appear within two to 20 days after infection. Your symptoms may last up to four weeks.
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You may experience:
- Flu-like symptoms, like fever, chills, fatigue and body aches.
- Genital itching, burning or irritation.
- Painful genital blisters or sores that break open.
- Headaches.
- Painful urination (dysuria).
- Swollen lymph nodes.
- Unusual vaginal discharge or discharge from your urethra (the tube that carries pee out of your body).
How do genital herpes appear during recurrent outbreaks?
Recurrent outbreaks or flare-ups happen any time after the first outbreak (even if it’s years later). You can’t control when a recurrent outbreak occurs or how often it occurs. But your symptoms are usually less severe, and the outbreak is generally milder and shorter.
What does genital herpes look like?
Genital herpes typically begins as small, blister-like bumps. They tend to appear in a cluster. You may feel itchiness or tingling in the area 24 to 48 hour before a sore appears. The blister will take on a sore or ulcer-like appearance, then eventually open and ooze. Then, a scab will appear as the ulcer heals. Once the ulcers fully heal, the scabs fall off and that outbreak is complete.
What causes genital herpes?
Genital herpes is a sexually transmitted infection or STI, also called a sexually transmitted disease or STD. The two types of herpes simplex virus (HSV-1 and HSV-2) cause genital herpes. HSV-2 is the most common cause of genital herpes.
How does genital herpes spread?
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The herpes virus that causes genital herpes spreads through saliva, semen and vaginal secretions. It’s possible to get genital herpes from someone who doesn’t have visible symptoms. You can have the infection, not know it and infect someone else.
Genital herpes can spread through:
- Intercourse, including anal, vaginal-penile and vaginal-vaginal.
- Oral sex (giving or receiving) with someone who’s infected.
- Skin-to-skin genital contact.
- Touching open sores, including while breastfeeding (chestfeeding).
- Childbirth by birthing parent who has an active infection.
You can’t get genital herpes from objects like toilet seats. It’s not likely that you’ll get genital herpes from surfaces like towels or clothing, either. But you could pass genital herpes through shared sex toys. To stay safe, wash sex toys before and after using them, and don’t share them. If you do, protect them with a condom.
How contagious is genital herpes?
Genital herpes is highly contagious. You’re most contagious when you have an open sore. Even if you don’t have open sores or symptoms of an outbreak, it’s still possible to infect another person with the herpes virus. This is called asymptomatic shedding.
Can you get genital herpes from someone who has cold sores?
Yes. Both HSV-1 and HSV-2 can infect your mouth and your genitals. You can get herpes sores on your genitals if you receive oral sex from someone who has a cold sore from HSV-1.
Can I get genital herpes more than once?
There isn’t a cure for HSV-1 and HSV-2, the virus that causes genital herpes. Because the virus lives dormant (or inactive) in your body, you can get a genital herpes outbreak again (called a recurrence or flare-up). There’s no rhyme or reason as to why some people get more outbreaks and others get fewer. But healthcare providers know that certain activities tend to reactivate the virus. These include:
- Stress.
- Illness.
- Menstruation.
- Sun exposure.
- Surgery.
How did I get herpes if my partner doesn’t have it?
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Some people never develop symptoms. They don’t know they have the virus that causes genital herpes. They may unknowingly infect others. You can have the herpes virus for years and not have symptoms, so it’s hard to know when or from whom you got it.
Can my partner have genital herpes and not me?
Yes. If your partner has genital herpes and takes precautions not to spread it to you (like wearing condoms and taking medication), it’s possible that you won’t get it.
Who is most at risk for genital herpes?
Genital herpes affects anyone who’s sexually active and not taking precautions to prevent the spread of STIs. Your risk may be higher if you:
- Don’t use condoms or dental dams every time you have sex.
- Have sex with multiple partners. Your odds of getting genital herpes increase with each new sexual partner. Many people with genital herpes don’t know they have it.
- Have a history of other STIs.
- Have a vagina. The virus can spread more easily to people with a vagina because delicate vaginal tissue can tear, making it easier for the infection to get in.
- Are Black. Black people assigned female at birth (AFAB) are especially vulnerable.
What are the complications of genital herpes?
Complications from genital herpes include:
- Increased risk of getting HIV: People who have open sores from genital herpes are twice as likely to get HIV. This risk is yet another reason why it’s important to use condoms.
- Infecting your baby: A newborn can get genital herpes from their birth parent at delivery. Let your provider know if you’ve had genital herpes so they can give you medication to prevent an outbreak (usually beginning at 36 weeks). If you have an active genital herpes outbreak, you can’t have a vaginal delivery.
- Internal inflammatory disease: Genital herpes can cause swelling or inflammation in organs associated with sexual activity, including your urethra, cervix, uterus or rectum.
- Eye or finger infection: You could spread the virus to other parts of your body like your finger (herpetic whitlow) or your eye.
If you’re immunocompromised, you may experience more severe outbreaks. Rarely, genital herpes can cause infections in your brain (encephalitis) or the membranes around your brain and spinal cord (meningitis).
How does genital herpes affect pregnancy?
Genital herpes doesn’t affect fertility or your ability to conceive. Pregnant people with genital herpes should start a daily antiviral at 36 weeks of pregnancy to prevent outbreaks during delivery. If you have an active infection at the time of childbirth, you can pass the herpes virus to your baby. Your healthcare provider will perform a C-section to lower this risk.
Is it safe to breastfeed if I have genital herpes?
Yes, as long as there isn’t an open lesion on your chest or breast, you can breastfeed (chest feed). If you have an active outbreak while breastfeeding, it’s possible to spread the infection to your nipples through touch. Careful handwashing can prevent this spread. You shouldn’t nurse from a breast that has herpes sores. You can pump breast milk until the sores heal. Don’t give your baby expressed breast milk if the pump comes into contact with an open sore.
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