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Genital Herpes
Genital herpes is caused by an infection with the herpes simplex virus. This sexually transmitted disease affects more than one in five adolescents and adults. During a herpes outbreak, tender ulcers will generally appear around the genitals or rectum. While there is no cure for genital herpes, many medications are available to help prevent and shorten outbreaks.
Genital herpes is a sexually transmitted disease (STD) that normally affects the genitals, buttocks, thighs, or anal opening. It is caused by an infection with the herpes simplex virus (HSV). HSV is in the same family of viruses that cause chickenpox, shingles, and mononucleosis (mono).
There are two types of HSV that cause genital herpes:
- HSV type 1 most commonly infects the mouth and lips, causing sores known as fever blisters or cold sores. It is also an important cause of sores to the genitals through oral sex. Up to 30 percent of genital herpes cases are caused by HSV-1.
- HSV type 2 is the usual cause of genital herpes, but it can also infect the mouth through oral sex.
(Click Genital Herpes Causes for more information on these two viruses.)
Preventing a herpes infection in the first place is always the best medicine, because there is no cure for genital herpes (see Preventing Genital Herpes). Once you have the virus, it stays in your body, and there is a chance that you will have herpes outbreaks. Medication can shorten and stop outbreaks from happening, but it cannot cure the condition.
Genital herpes is on the rise. According to the Centers for Disease Control and Prevention (CDC), since the late 1970s, the number of Americans infected with the virus has increased 30 percent to about 45 million (see Genital Herpes Statistics).
The disease affects more than one in five adolescents and adults. It is more common in African Americans than in Caucasians, and is more likely to affect women than men. In the United States, one out of four women is infected with HSV-2.
Compared to 20 years ago, genital herpes is about five times more common in Caucasians ages 12 to 19 and twice as common in adults ages 20 to 29.
Most people have no or few symptoms of genital herpes. When symptoms do occur, they typically appear as one or more blisters on or around the genitals or rectum. The blisters then break, leaving tender ulcers (sores) that may take two to four weeks to heal the first time they occur. Typically, another outbreak can appear weeks or months after the first, but it is almost always less severe and shorter than the first outbreak. Although the infection can stay in the body indefinitely, the number of herpes outbreaks tends to decrease over a period of years.
(Click Genital Herpes Symptoms to learn more, including information on early symptoms.)
Genital herpes can reactivate without causing noticeable bumps, blisters, sores, or other symptoms. Sometimes, symptoms are there but are so mild that they aren't noticed. This is called subclinical shedding. During these times, herpes can be transmitted to an uninfected sex partner, even though there are no symptoms. Subclinical shedding is most frequent in the first year after the initial infection, but it continues on and off for several years. Most new cases of genital herpes are caught from a person with subclinical shedding. This is because people with genital sores often avoid sex, but those with subclinical shedding don't know it. As for recurrent outbreaks, subclinical shedding is more common due to HSV-2 than HSV-1.
In order to make a diagnosis of genital herpes, a healthcare provider begins by asking a number of questions and performing a physical exam. The condition can often be diagnosed by looking at the sores. However, some cases are more difficult to diagnose, especially in between outbreaks. In these cases, other tests may be recommended, including a viral culture of a lesion (if one is present) or a blood test.
(Click Diagnosing Genital Herpes or Herpes Blood Tests to learn more, including conditions that share similar symptoms.)
While there is no cure for genital herpes, several prescription medications are effective in speeding up healing and in helping to prevent future outbreaks. They can also decrease the risk of passing herpes to sexual partners.
These medicines are known as antivirals. Antiviral medicines approved to treat genital herpes include:
- Acyclovir (Zovirax®)
- Famciclovir (Famvir®)
- Valacyclovir (Valtrex®).
(Click Genital Herpes Medication to learn more about each of these medicines. You can also read more about treating the disease by clicking Genital Herpes Treatment or about living with herpes by clicking Coping With Genital Herpes.)
If you think you have genital herpes, you should do the following:
- See your healthcare provider for testing and treatment right away.
- Follow your healthcare provider's orders, and finish all the medicine that you are given. Even if the symptoms go away, you still need to finish all of the medicine.
- Avoid any sexual activity while you are being treated for genital herpes and while you have any symptoms of an outbreak.
- Be sure to tell your sexual partners so that they can be tested and treated, if necessary.
- Remember that genital herpes is a lifelong disease. Even though you may have long periods with no symptoms, you can still pass the virus to another person. Talk with your healthcare provider about what you can do to have fewer future outbreaks and how to prevent passing the virus to another person.
There is growing evidence that people with genital herpes are at greater risk of getting HIV (the virus that causes AIDS) if they have unprotected sex with someone infected with HIV. People with HIV who are also infected with genital herpes may have more frequent and severe outbreaks, and their episodes may be more difficult to treat.
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Written by/reviewed by: Arthur Schoenstadt, MD
Last reviewed by: Arthur Schoenstadt, MD
