What is genital herpes?

Genital herpes is one of the most common sexually transmitted infections (STIs). The infection can be bothersome.

Most people never have symptoms, or the symptoms are so mild that people don't know that they're infected. But in some people, the infection causes occasional outbreaks of itchy and painful sores in the genital area.

After the first outbreak, the herpes virus stays in the nerve cells below the skin and becomes inactive. It usually becomes active again from time to time, traveling back up to the skin and causing more sores. Things like stress, illness, or menstruation may trigger a new outbreak.

After the first outbreak, some people just have a few more outbreaks over their lifetime. Others may have 4 to 6 outbreaks a year. As time goes on, the outbreaks happen less often, heal faster, and don't hurt as much.

Symptoms of genital herpes can vary greatly from person to person. Most people never have symptoms. Sometimes the symptoms are so mild that you may not notice them. But some people have painful and bothersome symptoms. Symptoms may include:

• Outbreaks of itchy and painful blisters on the penis or around the opening of the vagina. The blisters break open and turn into oozing, shallow sores that take up to 3 weeks to heal.
• Flu-like symptoms, such as fever, headache, and muscle aches. You may also notice an abnormal discharge and pain when you urinate.

If you notice your first infection, the symptoms will generally appear about 2 to 14 days after you were exposed to genital herpes.

Symptoms of later outbreaks are usually limited to blisters, sores, and swollen lymph nodes. As time goes on, the outbreaks happen less often, heal faster, and don't hurt as much.

Your doctor may be able to diagnose genital herpes by examining you, especially if the sores look like herpes. If this is your first outbreak, your doctor may take a sample of fluid from the sore for testing. Testing can help the doctor be sure that you have herpes. You may also have a blood test.

Your doctor may ask about your symptoms. For example, you may be asked if you:

• Have sores in your genital area.
• Have any discharge from your vagina or penis.
• Urinate often, or if it burns or stings when you urinate.

The doctor may ask you questions about your risk factors. These are things that make you more likely to get an infection. For example, the doctor may ask about your sexual practices. You may be asked if you use condoms.

Although there's no cure for genital herpes, treatment can help.

Treatment includes:

• Medicines. Antiviral medicines are the recommended treatment. They can be taken during an outbreak to relieve pain and discomfort and help sores heal faster. They work best if you start them as soon as possible after an outbreak begins. If you have a lot of outbreaks, medicines can also be taken every day. This helps reduce spreading the virus to others and helps limit the number of outbreaks.
• Home treatment. Examples include taking warm sitz baths and wearing cotton underwear. These may help relieve discomfort from sores.

Finding out that you have herpes may cause you to feel a range of emotions. Talking to your partner, a counselor, or a support group may help.

• Be safe with medicines. Take your medicines exactly as directed. Call your doctor if you think you're having a problem with your medicine. You'll get more details on the specific medicines your doctor prescribes.
• To reduce the pain and itching from herpes sores:
  • Take warm sitz baths.
  • Keep the sores clean and dry in between baths or showers. You can let the sores air-dry. This may feel better than using a towel.
  • Wear cotton underwear. Cotton absorbs moisture well.
  • Try pouring warm water over the area while urinating. This can help prevent urine from irritating the sores.
  • Take an over-the-counter pain medicine, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). Read and follow all instructions on the label. Do not take two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.
• Reduce or avoid things that trigger outbreaks for you. These may include fatigue, stress, overexposure to sun, and irritation of the genital area. This can help lower the risk of repeated outbreaks.