Genital Herpes Symptoms: What to Watch Out For

Medically Reviewed by Zilpah Sheikh, MD on September 26, 2024
Written by Joseph Saling, Stephanie Booth
8 min read

Genital herpes causes painful sores on your genitals (sex organs). It is one of the most common sexually transmitted infections (STIs) in the U.S. It's caused by the herpes simplex virus (HSV).

Most cases of genital herpes are due to the herpes simplex virus type 2 (HSV-2).

Herpes simplex virus type 1 (HSV-1) mostly causes cold sores or fever blisters. But it can also cause genital herpes.

A lot of people with genital herpes don't know they have it. If you do, you might not have any symptoms or only have very mild ones. But because treatment can help prevent complications and make it less likely that you'll spread this STI to others, it's a good idea to be aware of genital herpes symptoms.

Genital herpes virus is passed from one person to another through sexual contact. This happens even if the person with the virus doesn't have symptoms or signs of infection.

Once the virus enters through your skin, it travels along your nerve paths. It can then become dormant (inactive) in your nerves and remain there.

From time to time, the virus can become active again. It travels back along the nerve path to the surface of your skin, where more virus is shed. At this point, it may cause an outbreak of symptoms, or what's called an outbreak or flare. But not everybody has noticeable symptoms.

In either case, the active virus can easily be passed from you to your partner through sexual contact. Even wearing a condom may not be enough protection, as the virus can be present on the skin that remains uncovered.

When you're first infected, you're likely to have an outbreak within 2 days to 3 weeks after contact. But it could also take years.

The first outbreak is usually the longest and most uncomfortable. It could last 2-4 weeks. After that, herpes outbreaks tend to become shorter and less intense.

The number of outbreaks you can have varies. Some people have many flare-ups in the first year after being diagnosed, but these may decrease over time.

Genital herpes can show up on your:

  • Vagina
  • Vulva (outside of your vagina)
  • Cervix (lower part of your uterus, that connects to your vagina)
  • Anus 
  • Penis
  • Scrotum 
  • Buttocks
  • Inner thighs

If you have a mild case, you can easily mistake herpes sores for a patch of ingrown hairs or pimples on your genitals.

They may start as small blisters that eventually break open and ooze fluid. Over time, they'll turn into raw sores that may be painful. Then, they'll scab over and heal up within a few weeks.

First signs of genital herpes

About half of all people with genital herpes can tell when an outbreak is about to happen. A few days or hours before, you could notice any of the following in the areas where sores will form:

  • Itching
  • Burning
  • A tingling feeling
  • Small bumps (white or discolored)
  • Pain
  • Trouble peeing

You could also feel like you're coming down with the flu, with symptoms such as fever, headache, swollen lymph nodes, and feeling tired for no reason.

When symptoms occur soon after you're infected, they tend to be severe.

You could have:

  • Cracked, raw, or red areas around your genitals without pain, itching, or tingling
  • Itching or tingling around your genitals or your anal region
  • Small blisters that break open and cause painful sores. These may be on or around your genitals (penis or vagina) or on your buttocks, thighs, or rectal area. More rarely, blisters may occur inside the urethra — the tube urine passes through on its way out of your body.
  • Pain when you pee (from urine passing over the sores)
  • Headaches
  • Backaches
  • Flu-like symptoms, including fever, swollen lymph nodes, and fatigue

Genital herpes is not the only condition that can cause these symptoms. Sometimes, HSV is mistaken for vaginal yeast infections, bacterial infections, or bladder infections. The only way to know for sure whether you have herpes or another condition is to be checked by a doctor.

At your visit, the doctor may take a tiny sample of the fluid from one of your blisters, which is then analyzed at a lab. Or they could do a blood test to look for HSV antibodies. Either way, these tests can confirm if you have genital herpes, but they can't show how you got it or how long you've had it.

All of the symptoms mentioned above can happen in women and people assigned female at birth. You might also be more likely to have pain when you pee. You could have a feeling of pressure below your stomach. And you could notice a discharge from your vagina.

You're at higher risk of getting herpes. That's because the virus spreads more easily from men to women.

The list of symptoms above also apply to you if you're a man or assigned male at birth. Having a partner who's also a man raises your risk of being diagnosed with herpes.

There is no cure for genital herpes. But your doctor can prescribe antiviral medication, which can help:

  • Manage your symptoms
  • Reduce pain or discomfort
  • Heal sores quickly
  • Prevent future outbreaks
  • Reduce your risk of infecting others

How often you take medication will depend on how often you get outbreaks and how severe they are. In some cases, your doctor may suggest you take your medication every day. Doctors call this "chronic suppressive therapy."

Some people decide not to get treatment for genital herpes. For instance, you might put it off if your symptoms are very mild or if you're not currently having sex, so you're not worried about spreading the virus to a partner. But because genital herpes raises your risk for other health issues, talk to your doctor about whether this is a safe option for you.

During an outbreak, here's what you can do at home to relieve some of your symptoms:

Try over-the-counter pain relief. If you're not sure whether it's safer for you to take acetaminophenor ibuprofen, check with your doctor.

Bathe sore areas with a warm saltwater solution. Twice a day, mix 1/2 teaspoon salt with 1/2 pint of warm water.

Wear loose-fitting clothes. Letting air around the sores and keeping them dry will help them heal faster. Choose cotton underwear, which will pull moisture away from your skin.

Cool off. Put an ice pack on the affected area. Make sure to wrap the ice pack in a towel first.

Take a sitz bath. Sitting in a warm, shallow bath could make you more comfortable. Air-dry afterward, instead of using a towel.

Make peeing less painful. Peeing while you're in a bath or while your penis is submerged in a bowl of water sounds strange, but it could stop your urine from stinging your sores.

Reduce your triggers. Stress can cause a herpes outbreak, so do what you can to keep calm and stay healthy. Get enough rest, for instance. Try to eat healthy foods. Talk to a counselor if you need tips on managing challenges in your daily life.

To avoid passing the virus to other people, take these steps:

  • Take your antiviral medication exactly as prescribed.
  • Use condoms or dental dams with your partners. 
  • Avoid all sex, including oral sex, when either you or your partner has genital sores. A condom may not be enough to protect you during an outbreak.
  • Hold off on genital and anal contact when any sores are present. Wait until the scabs heal over and fall off.
  • Try not to touch any sores. If you do, wash your hands with soap and water right away.
  • Don't wet your contact lenses with saliva (spit).

Before you have sex with a new partner, it's important to let them know you have herpes. You can share with them that this virus is really common and unlikely to cause any lasting health issues. You can also lay out the steps you'll take to keep them from getting it.

Once you have an initial outbreak following a genital HSV infection, you can expect to have four to five outbreaks within a year.

As time goes on, your body builds up more immunity to the virus, and your outbreaks may become less frequent. Some people see them stop altogether.

Genital herpes symptoms usually flare up during periods of physical or emotional stress. That's because, during these times, your body's immune system may be less able to suppress the virus and keep it from becoming active.

Common symptom triggers can include:

  • Fatigue
  • An illness or infection
  • Taking medication that weakens your immune system
  • Having sex
  • Your period
  • Being under a lot of stress
  • Surgery
  • Trauma (for instance, breaking your leg)
  • Spending time in the sun

You may find it helpful to keep track of how you're feeling and anything going on in your life when an outbreak starts. Over time, that can help you understand what activates your infection. Then, you and your doctor can talk about how to avoid these specific triggers or reduce their effect on you.

Most of the time, genital herpes isn't a major threat to your health. Aside from discomfort during outbreaks, an HSV infection is more of an emotional stressor. It can:

  • Cause anxiety
  • Affect your self-esteem
  • Interfere with how comfortable you feel about your body and being intimate with a partner

In some cases, though, complications from genital herpes can be extremely serious. They include:

Infecting your newborn. If you're pregnant and have genital herpes, you can pass the virus on to your child. This can result in developmental issues and serious physical issues, which can sometimes be life-threatening. So, it's advised to take steps to prevent an outbreak at the time of your delivery, starting at 34 weeks into your pregnancy. If you have signs of an active viral infection when it's time to deliver, your doctor will likely recommend a C-section for delivery to protect your baby's health.

HIV and AIDS. If you've been diagnosed with genital herpes, you have a higher risk of an HIV infection. One reason is that cracks and breaks in the skin that result from an outbreak create openings through which HIV can enter your body. If left untreated, HIV can progress into AIDS.

Infections in other parts of your body. Although it's rare, the HSV virus could lead to severe infections in other parts of your body, such as your eyes or brain.

If you have any reason to think that you have an HSV infection, either genital or oral, contact your doctor.

Once you're infected with genital herpes, you will have this condition for life. Genital herpes symptoms, such as painful, fluid-filled sores on your genitals, will come and go. Antiviral medication can manage your symptoms and prevent you from infecting others. If you're pregnant, it's very important to tell your doctor and get treated. The virus that causes genital herpes can be fatal to your baby.

Is herpes contagious all the time?

Yes, you can be contagious even if you don't have any sores. That's why it's so important to get tested for genital herpes. Once you know you have it, you can take steps to avoid spreading to others.

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