Identifying & Treating Genital Herpes in Women

Genital herpes is a sexually transmitted infection (STI) caused by two different but related forms of herpes simplex virus (HSV), known as HSV-1 and HSV-2. If you have genital herpes, you may experience outbreaks of painful sores or have symptoms that are so mild that you don't notice them. Up to one in five women have genital herpes, but most are unaware of their infection.

The following is an overview of genital herpes in women, including symptoms, transmission, prevention, diagnosis, and treatment.

Genital Herpes Symptoms in Women

Genital herpes symptoms occur in outbreaks that come and go.

The primary symptom is blisters that pop and become ulcers. When they first appear, they are usually small red bumps that can be subtle and easy to overlook. When the blisters pop, they can be very painful.

Some people get a tingling or burning sensation where herpes sores are about to develop. This is called a prodrome, which is an early sign of a disease or infection.

When you do have an outbreak, the blisters or ulcers can appear in several areas of the body, including:

• Female genitals (vulva, vagina)
• Male genitals (penis, scrotum)
• Rectum
• Anus
• Thighs
• Mouth (genital herpes transmitted through oral sex)
  

After the blisters pop, the ulcers that develop can take several weeks to heal, and you may feel a burning sensation in the area. They do not leave scars.

The first outbreak of genital herpes is generally the most severe. It can last for a few weeks, and you may have other symptoms including:

• Fever
• Swollen glands
• Itching or burning in the affected area
• Pain in the affected area
• Feeling of fullness in the abdomen
• Unusual vaginal discharge

Some people may not have an outbreak, others have only one outbreak, and others will have repeated outbreaks (though they usually become less severe over time).

Even if you have had no symptoms for years, you can still transmit the virus, though it's less contagious when you are asymptomatic.

When to See a Healthcare Provider

Contact your healthcare provider if you have symptoms of genital herpes, particularly ulcers or sores on your genitals or mouth. If you know you have herpes, call if you have a fever, pain or itching in the area, swollen glands, or other symptoms during an outbreak.

If you are pregnant and have genital herpes, you can pass the infection to the baby, which can then travel to the brain. It's very important to tell your healthcare provider if you have a herpes sore, or have had an outbreak in the past, so they can take steps to protect your baby.

Diagnosing Genital Herpes

If your healthcare provider thinks you may have genital herpes, they will take a small sample of fluid from a sore and have it tested in a lab. The most accurate test is a PCR (polymerase chain reaction) test.

If you don't have sores when you see your provider, a blood test will still be able to identify antibodies that indicate the herpes virus is present in your body.

If someone who has not had an outbreak gets a positive test, it means they have been exposed to the virus in the past. They can still infect other people, even if they've never had a sore.

Treatment

There is no cure for genital herpes, but antiviral medication can relieve symptoms and make them go away more quickly. These treatments may also make the spread of the infection less likely.

If your immune system is compromised, you will likely need medication to help the sores heal. Medication for genital herpes works best when started within 24 hours of an outbreak. The most common medications for genital herpes are:

• Denavir (penciclovir)
• Famvir (famciclovir)
• Valtrex (valacyclovir)
• Zovirax (acyclovir)

Steps you can take to relieve herpes symptoms when you have an outbreak include:

• Keep the area clean and dry.
• Wear cotton underwear that doesn't bind.
• Place a cool compress on painful areas.
• Soak in a bath of Epsom salts for up to 20 minutes.
  

What to Expect

Herpes cannot be cured. If infected, you will carry the virus for your lifetime.

However, some people will not have an outbreak, some will have only one outbreak, and others may have them frequently. You may be able to identify triggers that set off an outbreak, like stress, fatigue, illness, or menstruation.

If you are immunocompromised, talk to your healthcare provider about what to watch for to avoid serious complications that require medical treatment and hospitalization.

Summary

Genital herpes is a common sexually transmitted infection, usually spread by skin-to-skin contact with a herpes blister or ulcer. A person with genital herpes can infect others even if they don't have a sore or are unaware of a sore.

Symptoms are not always present, but if you experience an outbreak, blisters will form and then pop. They can be very painful and take weeks to heal. They usually are located around the genitals but can also be on the mouth, anus, or rectum.

There is no cure for genital herpes, but there are antiviral medications that can make an outbreak go away more quickly and reduce the pain. It's important to know if you have genital herpes so that you take precautions not to spread it.

A Word From Verywell

If you know you have genital herpes, it's your responsibility to tell your sexual partners about it before you engage in sex. Using a condom can help, but it's no guarantee. Genital herpes is not dangerous to most people's general health, but it is potentially painful, so it's important to have an open conversation.