Genital herpes symptoms can vary greatly from person to person. Most people never have any symptoms or have ones that are so mild they may not recognize them. But some people have painful and bothersome symptoms. Sometimes the symptoms are confused with other common problems, like yeast infections or vaginosis.

First-time (primary) outbreak

The primary outbreak of genital herpes is the first infection with HSV. It tends to last longer and be more severe than subsequent (recurrent) outbreaks. Symptoms of a primary outbreak may include:

• Flu-like symptoms, such as fever, headache, and muscle aches. These symptoms usually get better within a week.
• Tingling, burning, itching, and redness at the site where an outbreak is about to occur (prodrome).
• Painful, itchy blisters on the penis, on the vulva, or inside the vagina. Blisters may also appear on the anus, buttocks, thighs, or scrotum, either alone or in clusters. They may be barely noticeable or as large as a coin.
• Blisters that break and become shallow, painful, oozing sores.
• Swollen and tender lymph nodes in the groin.
• Painful urination.
• Abnormal vaginal or urethral discharge.

Sometimes a person will first experience symptoms months or even years after being infected. This can make it very difficult to identify the sex partner who was the source of the infection.

Recurrent outbreaks

Recurrent outbreaks of HSV cause painful blisters that rupture, become sores, and heal after 6 to 12 days. Symptoms of recurrent outbreaks are usually limited to genital blisters, sores, and swollen glands. The blisters are most painful during the first 24 hours after they appear. Most people do not have flu-like symptoms with recurrent outbreaks. Recurrent outbreaks are usually less severe and do not last as long as primary outbreaks.

Symptoms of genital herpes infections in both primary and recurrent outbreaks tend to be more severe in women than in men.