What Are the Stages of Genital Herpes?

Genital herpes is a common sexually transmitted infection (STI). Many people with genital herpes are unaware they have it because they may not have symptoms, or they may not notice them if symptoms are mild.

Genital herpes is caused by two closely related herpes simplex viruses known as HSV-1 (herpes simplex virus type 1) and HSV-2 (herpes simplex virus type 2). Genital herpes appears in stages that come and go. Genital herpes cannot be cured, but it can be managed to reduce pain and speed healing.

Read on to learn more about the stages of genital herpes and how to live with them.

Genital Herpes Stages

If you become infected with genital herpes, you may not develop symptoms. If you do, the first outbreak generally occurs within two days to three weeks of exposure through vaginal, anal, or oral sex. The first outbreak tends to be the most severe, with clusters of red bumps that develop into blisters and pop, causing ulcers that can be very painful.

Experts categorize genital herpes stages in slightly different ways, but they include the same disease processes.

Prodrome/Outbreak Stage

The prodrome stage is an early indication that you're about to have an outbreak. It may start with a tingling or itching sensation in the buttocks, thighs, lower back, or even the knees, a few hours before blisters appear. You may feel like you have the flu, with symptoms that can include:

• Headache
• Fever
• Fatigue
• Swollen lymph nodes, especially in your groin
• Muscle pain

The skin around your genitals, anus, or, sometimes, your thighs may become red and swollen. The prodrome stage leads to the outbreak, which includes small red bumps that blister and then break, causing painful ulcers. You may also notice you have difficulty urinating.

Genital herpes sores heal without treatment within six weeks and don't leave scars. When the outbreak is over, you still have the infection. Herpes does not go away and stays in your body for the rest of your life.

Latent Stage

After the sores have healed, the virus retreats to nerves near the outbreak and then travels to the base of the spine. It may stay there for weeks, months, or years, during which time you have no symptoms, though you can still transmit the infection.

This is called the latent stage, which means the virus is not active in your body. It's often described as "sleeping."

Shedding Stage

The virus "wakes up" and starts to multiply in your nerve endings. If the nerves are in parts of the body that produce bodily fluids, the virus can get into saliva, semen, or vaginal fluids.

In this stage, you do not have symptoms, but you can still infect other sexual partners.

What Triggers Outbreaks?

Some triggers that may wake the virus from the latent stage and lead to an outbreak include:

• Infections
• Menstruation
• Stress
• Sunlight
• Wind
• Fever
• Injury
• Surgery
• Suppressed immune system
  

Managing Outbreaks

Antiviral medications, including Zovirax (acyclovir), Valtrex (valacyclovir), and Famvir (famciclovir), can be effective at speeding up healing and reducing pain. They are most effective if you start taking them within 24 hours of the first signs of an outbreak.

These medications can also help reduce the chance of transmission, and your healthcare provider may recommend you take them on a long-term basis. They can also reduce outbreaks by up to 80%.

It's also helpful to:

• Keep the area clean and dry.
• Soak in an Epsom salt bath.
• Wear loose-fitting cotton underclothes.
• Use a cool compress on the painful area.
• Don't use a bandage on the area.

Call your healthcare provider as soon as you feel you may be having symptoms, even in the prodromal stage.

What to Expect

The first outbreak of genital herpes is generally the worst. Recurring outbreaks will be milder and less frequent in most people.

Genital herpes does not generally represent a serious threat to your health, but if you are immunocompromised, discuss your condition with your healthcare provider. You may be at some risk for rare complications, including brain and spinal cord inflammation, as well as issues with your eyes or skin.

Even if you have no symptoms, it's important to tell all sexual partners about the infection. A condom can help reduce the chance of transmission, but it is far from a sure thing. Don't use lubricants or other topicals that may cause irritation and make transmission easier.

If you're pregnant, it's very important that you tell your healthcare provider that you have genital herpes, as it can cause life-threatening complications in newborns.

Summary

Genital herpes is a common STI that is passed from one person to another during vaginal, anal, or oral sex. You may not have symptoms, but if you do, they include clusters of blisters that pop and become very painful. If you have more than one outbreak, the recurrences come in stages.

The stages may include a tingling sensation and flu-like symptoms, followed by blisters that pop and then heal (prodrome/outbreak), a stage when the virus is not active in your body (latent), and a period when the virus becomes active in parts of your body without causing symptoms (shedding). You can infect other people at any time during these stages, though you are most likely to transmit genital herpes when you have sores.

A healthcare provider can give you medication that will make the sores heal more quickly and may prevent some future outbreaks. Keep the area dry and clean, and wear loose clothing during an outbreak to help speed healing.

A Word From Verywell

Living with genital herpes can be irritating, painful, and even embarrassing for some. However, if you know you have genital herpes, it's important to discuss it with any sexual partners and your healthcare provider for the most effective treatment and management options. Reducing outbreaks is possible with the right treatment plan.