Symptoms and causes

Most people infected with HSV don't know they have it because they don't have any signs or symptoms or because their signs and symptoms are so mild.

When present, symptoms may begin about two to 12 days after exposure to the virus. If you experience symptoms of genital herpes, they may include:

  • Pain or itching. You may experience pain and tenderness in your genital area until the infection clears.
  • Small red bumps or tiny white blisters. These may appear a few days to a few weeks after infection.
  • Ulcers. These may form when blisters rupture and ooze or bleed. Ulcers may make it painful to urinate.
  • Scabs. Skin will crust over and form scabs as ulcers heal.

During an initial outbreak, you may have flu-like signs and symptoms such as swollen lymph nodes in your groin, headache, muscle aches and fever.

Differences in symptom location

Sores appear where the infection entered your body. You can spread the infection by touching a sore and then rubbing or scratching another area of your body, including your eyes.

Men and women can develop sores on the:

  • Buttocks and thighs
  • Anus
  • Mouth
  • Urethra (the tube that allows urine to drain from the bladder to the outside)

Women can also develop sores in or on the:

  • Vaginal area
  • External genitals
  • Cervix

Men can also develop sores in or on the:

  • Penis
  • Scrotum

Recurrences are common

Genital herpes is different for each person. The signs and symptoms may recur, off and on, for years. Some people experience numerous episodes each year. For many people, however, the outbreaks are less frequent as time passes.

During a recurrence, shortly before sores appear, you may feel:

  • Burning, tingling and itching where the infection first entered your body
  • Pain in your lower back, buttocks and legs

However, recurrences are generally less painful than the original outbreak, and sores generally heal more quickly.

When to see a doctor

If you suspect you have genital herpes — or any other sexually transmitted infection — see your doctor.

Two types of herpes simplex virus infections can cause genital herpes:

  • HSV-1. This is the type that usually causes cold sores or fever blisters around your mouth. HSV-1 is often spread through skin-to-skin contact, though it can be spread to your genital area during oral sex. Recurrences are much less frequent than they are with HSV-2 infection.
  • HSV-2. This is the type that commonly causes genital herpes. The virus spreads through sexual contact and skin-to-skin contact. HSV-2 is very common and highly contagious, whether or not you have an open sore.

Because the virus dies quickly outside of the body, it's nearly impossible to get the infection through contact with toilets, towels or other objects used by an infected person.

Your risk of becoming infected with genital herpes may increase if you:

  • Are a woman. Women are more likely to have genital herpes than are men. The virus is sexually transmitted more easily from men to women than it is from women to men.
  • Have multiple sexual partners. Each additional sexual partner raises your risk of being exposed to the virus that causes genital herpes.

Complications associated with genital herpes may include:

  • Other sexually transmitted infections. Having genital sores increases your risk of transmitting or contracting other sexually transmitted infections, including AIDS.
  • Newborn infection. Babies born to infected mothers can be exposed to the virus during the birthing process. This may result in brain damage, blindness or death for the newborn.
  • Bladder problems. In some cases, the sores associated with genital herpes can cause inflammation around the tube that delivers urine from your bladder to the outside world (urethra). The swelling can close the urethra for several days, requiring the insertion of a catheter to drain your bladder.
  • Meningitis. In rare instances, HSV infection leads to inflammation of the membranes and cerebrospinal fluid surrounding your brain and spinal cord.
  • Rectal inflammation (proctitis). Genital herpes can lead to inflammation of the lining of the rectum, particularly in men who have sex with men.