What Are the Symptoms of Genital Herpes?

Symptoms of genital herpes, or type 2 herpes simplex, manifest with a broad spectrum. Minor infections may produce no symptoms at all, while severe primary infections can cause systemic flu-like illness.

Itching and pain accompany the initial process as the infected area becomes red and swollen. The infected area is usually the point of contact, or where the virus enters the body. A blister then appears, which later develops into a group of vesicles (small, fluid filled sacs), that eventually ulcerates or turn into sores. These sores then encrust or form scabs, and then heal without leaving any scars. Each blister or ulcer is typically only 1 to 3 millimeters (1/32 inch to 1/8th inch) in size.

Fever and flu-like symptoms of genital herpes may occur 3-4 days after the lesions appear. This includes swollen lymph nodes in the groin, a feeling of discomfort or uneasiness, headache, aching muscles, and pain on urination. Pain is evident during the first week and then decreases. The lesions subside in about two weeks unless secondary infection occurs.

In women, the labia are the usual primary site, although the cervix, vagina, and the area surrounding the anus may be affected. In men, the tip of the penis, foreskin, or penile shaft is typically affected. Severe infections can eventually cause extensive damage to the vaginal or anal canal.

In most people, the virus can become active and cause outbreaks several times a year. Typically, symptoms of genital herpes recurrence manifest as a feeling of burning, tingling, or itching about twenty four hours before the vesicles appear. People diagnosed with a first episode of genital herpes can expect to have several (typically four or five) outbreaks (symptomatic recurrences) within a year. Over time these recurrences usually decrease in frequency.

Various factors may trigger outbreaks including stress, menstruation, immune system suppression (from medications such as steroids or chemotherapy, or due to infections, such as HIV/AIDS), illness, surgery, friction (such as that caused by vigorous sexual intercourse), and fatigue.

Often, people don't recognize their first or subsequent outbreaks. People who have mild or no symptoms at all may not think they are infected with herpes. It is possible that a person becomes aware of the "first episode" years after the infection is acquired. They can still transmit the virus to others, however.

In some cases, the infection can be active and contagious even when lesions aren't present. During these times, small amounts of the virus may be shed at or near places of the first infection, in fluids from the mouth, penis, or vagina, or from barely noticeable sores. This is called asymptomatic shedding. Asymptomatic shedding is an important factor in the spread of herpes.