Understanding Herpes Genital Infections

Symptoms, Treatment, and Testing

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Genital and oral herpes are only caused by two of the family of six herpes viruses that can infect humans. These viruses are extremely easy to transmit, and are therefore extremely common. The two herpes viruses associated with genital and oral herpes are:

  • HSV1: Usually causes cold sores, but can also infect the genital region
  • HSV2: The main cause of genital herpes, but it can also cause cold sores on the face


    Herpes (genital or oral) infections are characterized by an outbreak of small, painful sores which may be covered with a thin layer of pus. Frequently, just before an outbreak, people will have what are known as prodromal symptoms, which might include itching or tingling at the site of infection. These symptoms vary from individual to individual, but eventually many people with recurrent outbreaks learn what sensations signal that the active sores are about to appear.

    Most people with genital herpes will never have any symptoms. In general, if symptoms are going to appear, they will show up within two weeks of the initial time of infection. The first outbreak is usually the worst, and many people who experience symptoms will do so only once. For most others, the severity and frequency of symptoms will decrease over time.


    The herpes viruses are extraordinarily common. One out of every four women and one out of every five men in the United States will be infected with HSV2 at some point in their lives.

    HSV1 is even more common. More than half of all Americans are living with herpes - genital or oral - and you can have both oral and genital infections at the same time. Contrary to popular belief, one infection does not protect you from another

    A great deal of negativity is directed at individuals who have genital herpes, but it is important for people to remember that it's a virus which will affect a good portion of the population at some point during their lives.

    Having herpes doesn't mean that someone is dirty, or a bad person. It just means that they have been exposed to an illness that affects more than one quarter of the population. Furthermore, anyone who has ever had a cold sore has experienced an outbreak of a herpes virus. Empathy is a more productive choice than judgment. Herpes tests can have a difficult time distinguishing between types of infection, unless a person is tested during an outbreak.


    Genital herpes can be spread by oral, vaginal, and anal sex, as well as other intimate contact. Because it is spread by skin-to-skin contact, and not simply through the exchange of bodily fluids, condoms cannot entirely prevent transmission, although they do somewhat reduce the risk. As for using medication to prevent infection, there is no research on whether pre-exposure prophylaxis for the uninfected partner is helpful in reducing risk, but suppressive therapy for the infected partner has been shown to reduce transmission.

    It is important to know that herpes can be transmitted even in the absence of any symptoms, though there is a greater risk of infection when sores are visible. Individuals with genital herpes are usually advised to abstain from sex during an active outbreak, and an active herpes infection can also increase an individual's risk of contracting HIV.

    The only guaranteed way to avoid a herpes genital infection is to abstain from sexual contact. The safest sex is that which takes place within a long-term, mutually-monogamous relationship with a partner who has been tested and found to be negative for the herpes virus. HSV1, although normally associated with cold sores, is even more infectious than HSV2, and some scientists believe that the number of cases of genital herpes associated with HSV1 may be on the rise.


    There is no cure for genital herpes, no matter what some may claim, but it can be treated. Anti-viral medications can be used to shorten the duration of outbreaks and reduce their frequency.

    For individuals with frequent outbreaks, or uninfected partners, daily suppressive therapy may be recommended. In this case, anti-viral medication would be taken constantly to reduce the risk of not only symptoms but transmission. However, even when suppressive therapy is entirely effective at eliminating an infected person's outbreaks, he still may be able to transmit the herpes virus to a partner.


    Herpes infection can be deadly in infants. Fortunately, infection transmission from a mother to a child during pregnancy is relatively rare. However, if you know that you are infected with genital herpes, you should discuss your diagnosis with your obstetrician. A cesarean section may be recommended if you have an active outbreak at the time you give birth.

    Living With Herpes

    Genital herpes is a frightening diagnosis for many people. Society may have exposed them to messages suggesting that people with herpes genital infections are dirty or somehow flawed, and it is tempting to lash out and look for someone to blame. However, genital herpes is just a disease like any other -- a disease, in fact, that affects approximately one in five Americans. And, since it's incurable, it's something that they end up having to live with, and deal with for many years. Fortunately, you can do many things to make living with herpes easier.


    The CDC Herpes Fact Sheet: http://www.phppo.cdc.gov/std/Herpes/STDFact-Herpes.htm#prevent

    C-Health: Herpes Virus Page

    Herpes Viruses (Part of Ken Todar's Microbial World at U. Wisconsin Madison)

    Xu, F. et al. (2006) "Trends in Herpes Simplex Virus Type 1 and Type 2 Seroprevalence in the United States" JAMA, 296:964-973