Genital herpes can be a confusing disease. Symptoms can look like other conditions, or there may be no symptoms at all. How to tell if you have it? These questions and answers will help.

Could I have herpes and not know?

Unless no one has ever kissed you, and unless you've never had sex, it is possible that you've picked up a herpes virus.

Oral herpes, usually caused by the herpes simplex virus type 1 (HSV-1), shows up as cold sores or fever blisters on the mouth. Even a casual peck on the lips from someone with a cold sore can give you the virus. That's why it's so common: As many as 50% to 80% of adults in the U.S. have oral herpes.

Genital herpes, most often caused by the second type of herpes virus (HSV-2), is less common, but plenty of people still have it. Roughly one in five American adults has genital herpes. But up to 90% of those who have it don't know they are infected. You could be one of them.

What are some signs that I might have genital herpes?

Often it's hard to tell by looking. The textbook symptom of genital herpes is a cluster of small fluid-filled blisters that break, forming painful sores that crust and heal during several days. Affected areas include the penis, scrotum, vagina, vulva, urethra, anus, thighs, and buttocks.

But many people don't get these sores. Some people have no symptoms at all, while others get symptoms that can be easily mistaken for razor burn, pimples, bug bites, jock itch, hemorrhoids, an ingrown hair, or a vaginal yeast infection.

After you're infected, the symptoms go away, but can flare up from time to time. Luckily, the first outbreak usually is the worst. And some people may have just one or two outbreaks in their lifetime.

Is there a test for genital herpes?

Yes. A doctor can take a sample from what appears to be a herpes sore and examine it under a microscope. You can also have a blood test. The blood test looks for antibodies to the virus that your immune system would have made when you were infected. HSV-2 almost always infects the genitals, so if antibodies to HSV-2 are detected in your blood, you probably have genital herpes.

A blood test that shows antibodies to HSV-1 means you could have genital or oral herpes. That's because oral herpes, typically caused by HSV-1, can be spread to the genitals during oral sex.

If I don't have it now, how can I avoid it in the future?

The only sure-fire way to avoid getting genital herpes is to abstain from sex or have sex only with someone who is also herpes-free. Short of that, a latex condom offers some protection if it covers the infected area. Remember, you can get genital herpes by receiving oral sex (fellatio, cunnilingus, analingus) from someone with a cold sore on the mouth. Likewise, you can get oral herpes from someone's genitals by way of oral sex.

If you know that a sex partner has genital herpes, you can reduce your risk by having sex (vaginal, anal, or oral intercourse) only when he or she has no symptoms. Nevertheless, genital herpes can be contagious even when there are no visible symptoms, so you should always use a latex barrier, such as a condom or a dental dam.

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