What Is It?

Genital herpes is a sexually transmitted disease (STD) that causes blisters and skin ulcers in the genital area. It can be caused by either of two types of herpes simplex virus, HSV-1 or HSV-2. HSV-2 is the more common cause.

HSV spreads from person to person through kissing and skin-to-skin contact, as well as through vaginal, oral or anal intercourse. An infected person often transmits the virus when skin blisters or ulcers are visible, but the virus also can be spread when there are no symptoms at all. The virus also can be transmitted by people who are unaware that they are infected.

In a pregnant woman with HSV infection (usually HSV-2), the virus can pass to the baby during delivery, causing infections of the newborn’s skin, mouth, lungs or eyes. If the herpes virus spreads through the baby’s bloodstream, it can cause serious infections of the brain and other vital organs.

According to government health experts, approximately 45 million people in the United States older than age 12 are infected with HSV-2. Among Americans between the ages of 15 and 45, genital herpes affects approximately one in every four females and one in every five males. In the past two decades, the number of genital herpes infections has increased significantly among Americans, with the most dramatic increases seen in adolescents and young adults.

Most people with an HSV-2 infection have no symptoms. When symptoms appear, they are usually mild and can include:

• Itching, burning, soreness and small blisters in the genital area
• Small ulcers (skin sores) when the blisters break
• Local pain if urine touches the genital ulcers
• Enlarged or painful lymph nodes (swollen glands) in the groin
• Headache, fever and a generally sick feeling

In some people with genital herpes, cold sores or fever blisters also can erupt around the mouth.

The first episode of herpes symptoms is usually the worst. When symptoms develop, they occur about one week after contact with an infected person. About 40 percent of infected people never have a second attack. In others, however, symptoms return four to five times per year. In people who have repeated herpes episodes, symptoms are most common after sexual intercourse, after sunbathing, and during times of physical or emotional stress.

In newborns who are infected with herpes during delivery, symptoms usually appear nine to 11 days after birth and can include skin blisters, red eyes and an abnormal eye discharge. If the virus spreads through the baby’s bloodstream to the brain, there can be lethargy, irritability and seizures. If the virus spreads to the baby’s lungs, the baby may have difficulty breathing and may need to be placed on a ventilator to help with breathing.

Your doctor may suspect that you have genital herpes based on your sexual history, your symptoms and the results of your physical examination. Your doctor may want to confirm the diagnosis by scraping the affected skin area for laboratory testing. Because people who have one type of STD are at risk of others, your doctor may wish to test for other STDs, such as syphilis, gonorrhea, chlamydia, trichomoniasis and human immunodeficiency virus (HIV).

The HSV infection that causes genital herpes is a lifelong illness whose symptoms tend to return periodically. The pattern of recurrence is different for every person.

To help prevent the spread of genital herpes, people who have the illness should abstain from sexual activity when they have symptoms. They also should tell all sex partners about their herpes infection and use condoms during sexual activity. Even without symptoms, the virus can be shed and transmitted.

Pregnant women who have visible ulcers from genital herpes at the time of delivery usually are encouraged to have a Caesarean section to prevent HSV from spreading to the newborn. Because the decision to have a Caesarean section is based on many factors, a pregnant woman with HSV infection should discuss the subject with her physician as early as possible in her pregnancy.

People with genital herpes are more likely to become infected with HIV if they are exposed through sexual intercourse. If you have HIV and you are infected with HSV-2, you may be more likely to spread HIV to others.

Episodes of genital herpes can be treated with oral antiviral medications, including acyclovir (Zovirax), famciclovir (Famvir) and valacyclovir (Valtrex). These medications do not cure the herpes infection. They can shorten the duration of skin symptoms, but they are used most often to prevent symptoms from returning or to make recurrences less severe. When herpes infection spreads through the bloodstream and causes widespread infection, it can be treated with antiviral medication given intravenously (directly into a vein).

Call your doctor if you have blisters or sores in your genital area, especially if you are pregnant or have frequent bouts of symptoms.

Although there is no cure for genital herpes, the frequency of recurrences often decreases with time. Daily oral antiviral medication also can decrease the number of recurrences by at least 75 percent in people who have six or more herpes episodes per year.

Diseases and Conditions Center

All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.