Genital herpes and discharge

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Can You Get Genital Herpes From a Cold Sore?

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Can you get genital herpes from a cold sore?
– Lucy*

Yes — it is possible to get genital herpes from oral sex.

Genital herpes is caused by the herpes simplex virus (HSV). There are two types of herpes viruses — HSV-1 and HSV-2. Genital herpes is usually caused by HSV-2; oral herpes (cold sores) is usually caused by HSV-1.

However, genital herpes can also be caused by HSV-1. Someone with HSV-1 can transmit the virus through oral contact with another person’s genitals, anus, or mouth, even if they don’t have sores that are visible at the time.

Other than abstinence (not having sex) the best way to help prevent herpes is to use a condom during any type of sex (oral, vaginal, or anal). Girls should have their partners use a

every time they receive oral sex to help protect against genital herpes. And if either partner has a sore, it’s best to not have sex until the sore has cleared up.

*Names have been changed to protect user privacy.

Reviewed by: Julia Brown Lancaster, MSN, WHNP-BC Date reviewed: January 2015

I get cold sores every month, which I suppress pretty well with medication. My concern is that I may autoinoculate and spread it to my genitals; in fact, every time I have a pimple, ingrown hair or tear down there I panic! How does the appearance of genital Herpes Simplex Virus Type 1 (HSV-1) differ from other more benign conditions? Is it unreasonable to end up at the gynecologist every time one of these other things appears?

Great questions. Let’s tackle them one by one.

Is it unreasonable to end up at the gynecologist every time something looks funny down there?

Absolutely not. The only way to truly find out what you’re dealing with in these situations is by consulting with an expert whose advice you trust. Sometimes even your doctor won’t be able to tell by just looking – the same problem can look very different in different people, or even at different times in the same person – so she can do other tests to help you figure out what’s going on.

Can you autoinoculate yourself and spread HSV-1 it to your genitals?

Unfortunately, the answer to this one is yes. People tend to think of Herpes Simplex Virus 1 (HSV-1) as the “cold sore” virus and HSV-2 as the “genital herpes” virus. But both HSV-1 and HSV-2 are spread by direct skin-to-skin contact, and either can infect the mouth or genitals. So if you were to touch a cold sore on your mouth and then touch your genitals, you could theoretically cause an outbreak down there. The good news is that medication lessens the duration and severity of outbreaks (which tend to decrease in frequency and severity over time on their own anyway), so if you are staying on top of your cold sore outbreaks with suppressive medication, the odds of you doing this are very, very small.

How does the appearance of genital Herpes Simplex Virus Type 1 (HSV-1) differ from other more benign conditions?

This is a tough one. Like I said, many conditions that can affect the genitals look like Herpes and sorting them out isn’t always as easy as laying eyes on the situation. That being said, some of the more common conditions do have typical characteristics.

Folliculitis: is inflammation of a hair follicle (“ingrown hair” or “shave bump”). It happens when hair follicles are damaged by friction from clothing, a pimple or shaving and then get infected with Staphylococcus Bacteria (“Staph infection”). They are red, inflamed areas that usually look like a pimple and have a hair in the center of it. They can be treated with anything from warm compresses to antibiotics.

Molluscum Contagiosum: are small, painless bumps that are flesh-colored and usually have a dimple in the center. They may be red if they get irritated. They’re caused by a poxvirus and are treated like genital warts caused by HPV.

Herpes: typically appears as a group of red blisters or ulcers. Unlike molluscum, genital warts and (usually) folliculitis, these lesions are VERY painful and can be preceded by flu like symptoms.

There’s a picture of each of these conditions to the right. Can you tell which one is which? (Click to enlarge. Answers below)

This list is far from complete, and again, no one can make a diagnosis from looking at a picture online, so if something doesn’t look right down there, be sure to see your women’s health care provider right away. If you are a student at Ohio State, you can make an appointment with our Women’s Services Clinic; they’re always happy to help.

John A. Vaughn, MD
Student Health Services
The Ohio State University

Answers: A = Molluscum Contagiosum, B = Herpes, C = Folliculitis

A herpes simplex lesion on the lower lip on the second day after onset. Image: CDC

Herpes simplex virus is mystifying, fascinating, and sneaky. Mystifying because we have yet to unravel all of its secrets; fascinating because when we do uncover one of its mysteries, we are amazed by the capabilities of such a tiny, microscopic object; and sneaky because it enters our bodies by stealth and conceals itself in our cells, taking us by surprise when it comes out of hiding and causes outbreaks of blisters and other lesions.

It can also be confusing. Herpes simplex virus actually comes in two flavors: HSV-1 and HSV-2. HSV-1 is associated more with oral herpes, which can cause “cold sores,” a type of blister that appears on the lips or face. HSV-2 is associated more with genital herpes, which can cause blisters and other lesions in the genital area. It used to be standard to describe HSV-1 as an “above-the-waist” infection and HSV-2 as a “below-the-belt” infection — but now many researchers are pointing out that it’s more appropriate to say that HSV-1 is both an orally and genitally transmitted infection while HSV-2 is a predominantly genitally transmitted infection. If HSV-1 enters the body in the genital area, it can cause a genital herpes infection — and likewise, if HSV-2 enters the body in the facial area, it can cause an oral herpes infection.

Using condoms and dental dams during oral sex reduces risk of herpes transmission.

What exactly is a cold sore, anyway? A cold sore, also known as a fever blister, is a cluster of blisters that can pop up around the lips or even in the mouth. Sometimes, cold sores are so painful that eating or drinking is difficult, and in extreme cases sufferers must be treated for dehydration. An especially severe infection could also cause high fever or swollen lymph nodes, and in young adults a first oral HSV-1 infection might be misdiagnosed as tonsillitis, possibly leading to unnecessary tonsillectomies. Most symptomatic first-time cold-sore outbreaks occur during childhood, and take about two or three weeks to clear up. Luckily, the first infection is almost always the most severe, and when the infection is reactivated it usually happens without symptoms.

Because both cold sores and genital herpes are caused by herpes simplex viruses, and because oral herpes is so common, many people are concerned that they might be more vulnerable to acquiring a genital herpes infection than they previously thought. They might have a lot of questions, and if they’ve sought answers to those questions, they might have heard a lot of conflicting answers. Let’s see what the scientific literature has to say.

  • Can I get genital herpes if someone with cold sores performs oral sex on me?

Because HSV-1, the virus responsible for most oral herpes infections, can also cause genital herpes, many people wonder if someone with cold sores can transmit the virus to someone else by performing oral sex, resulting in a genital herpes infection. Other people wonder if HSV-1 can be transmitted via oral contact with the anus, resulting in a herpes infection in the rectal area. The answer to these questions is: Yes!

While HSV-1 only accounts for around 30 percent of genital herpes infections overall, many research teams are finding that HSV-1 is the predominant cause of genital herpes in some countries (such as Sweden) and in some U.S. populations, especially of younger females. For example, among students at a large Midwestern public university, researchers found that HSV-1 caused 31 percent of genital herpes cases in 1993 and grew to 78 percent in 2001. The increase was even more pronounced in females. This trend, in which HSV-1 infections in the genitals predominate over HSV-2, seems to be most common among younger people, women, and men who have sex with men. This change might be due to the fact that condom use for vaginal and anal intercourse is considered normal in most populations — while most people don’t use condoms or dental dams during oral sex, leaving them vulnerable to acquiring HSV-1 (and other infections!) from a partner.

This might sound like terrible news, since most of us are infected with HSV-1 and we might enjoy oral sex. But there is some good news. First of all, HSV-1 likes to live in the trigeminal ganglion — in the face. Because HSV-1 feels more at home in the trigeminal ganglion, an infection in that location is more likely to reactivate and cause cold sores periodically throughout a person’s life. When HSV-1 finds itself living in the sacral ganglion in the genital area, it doesn’t reactivate very often. So, if you are infected with HSV-1 in your genital area after receiving oral sex, recurrences will be uncommon and your infection will be milder than if you were infected with HSV-2, which is a related virus that is more strongly associated with genital herpes.

  • Can I be infected with HSV-2 in my facial area if I perform oral sex on someone with an HSV-2 infection in their genitals?

Just as HSV-1 can pass from the mouth to the genitals to cause a genital herpes infection, so too can HSV-2 pass from the genitals to the mouth to cause an oral herpes infection. However, oral HSV-2 infections aren’t as common as genital HSV-1 infections. Although there are some documented cases of oral HSV-2 infections, they aren’t very widespread. Furthermore, just as a genital HSV-1 infection is milder and less prone to recurrences than an HSV-2 infection in that area, so too is an oral HSV-2 infection milder and less prone to future outbreaks.

  • Can the virus be transmitted if someone isn’t showing any symptoms?

Unfortunately, just because someone lacks a telltale cold sore doesn’t mean they’re not infectious. It is quite possible for the virus to reactivate, not cause symptoms, but still “shed” from a carrier, at which point it can be transmitted to someone else — via skin-to-skin contact, saliva, or even tears. One large study, using a sensitive DNA amplifying technique called PCR, detected the asymptomatic shedding of HSV-1 on 33.3 percent of days. Another study of 50 people found that 90 percent of them had HSV-1 in their saliva at least once during a 30-day period.

Shedding patterns can be further influenced by what triggered the virus to reactivate — for example, higher-than-average amounts of virus are found in saliva samples from patients with oro-facial fractures.

  • If I’ve already been exposed to HSV-1 in my facial region, am I immune to reinfection in my genitals?

Some people think that already being orally infected with the cold sore virus makes them immune to HSV-1 infections in their genitals. It’s true that if you have an oral HSV-1 infection, you might have some degree of protection against acquiring HSV-1 infection in your genitals — but we don’t know to what degree a previous HSV-1 infection protects us from subsequent infections elsewhere in our bodies. More study is needed to answer this question more fully, but the short answer is that yes, reinfection in the genitals is possible.

  • Does a previous HSV-1 infection protect me from a subsequent HSV-2 infection?

As mentioned previously, most of us are orally infected with HSV-1 as children. Unfortunately, a preexisting HSV-1 infection doesn’t protect us from acquiring an HSV-2 infection later in life, though it’s possible that it will help mitigate symptoms of a first HSV-2 outbreak. Those who already have an HSV-1 infection are much less likely to experience symptoms upon an initial HSV-2 infection. Likewise, a previous HSV-2 infection does not protect someone from acquiring an HSV-1 infection. It’s possible for HSV-1 and HSV-2 to infect the genitals at the same time — it just might not be as likely.

  • Can my genital HSV-1 infection be transmitted to my partner’s genitals?

When HSV-1 infects the genitals, it usually got there as a result of oral sex. Because genital HSV-1 infections have fewer recurrences and are associated with less asymptomatic shedding, the genital-to-genital spread of HSV-1 is not as common.

If you want to find out if you’ve been infected with HSV-1 or HSV-2, you can get a blood test at a Planned Parenthood health center. This test will only tell you if you’ve been infected with either of these viruses, but in the absence of symptoms it won’t tell you where in your body the infections are located. We can also answer any questions you have about herpes and discuss antiviral medications with you.

Why Herpes Isn’t as Bad as You Think (and a Lot More Common)

Herpes is very common—and often hidden

Genital herpes is caused by one of two viruses, either herpes simplex virus (HSV) type 1 or type 2. HSV-1 also causes cold sores or fever blisters around the mouth, “but the disease trends have changed over time and now they can both cause genital sores,” Talia Swartz, MD, assistant professor of infectious diseases at the Icahn School of Medicine at Mount Sinai in New York City, tells Health.

In most cases, genital herpes is a “manageable infection without long-term physical health consequences,” Christine Johnston, MD, associate professor of allergy and infectious diseases at the University of Washington, tells Health. It’s also surprisingly common: About one in six American adults has HSV-2. Even more have HSV-1, though most people don’t realize it.

RELATED: How to Tell if You Have Herpes

The pain of herpes can be more emotional than physical

“I don’t know why genital herpes has this pariah, fearful component to it,” H. Hunter Handsfield, MD, professor emeritus of medicine at the University of Washington Center for AIDS and STD, tells Health. “People are more afraid of herpes than they are of chlamydia, and in the long run chlamydia is more likely to cause serious damage to their reproductive and general health than herpes ever is.”

But getting a herpes diagnosis does come with emotional baggage. “If you are infected, you have a duty to warn partners and that is a big deal for lots of people,” says Dr. Handsfield. “You’re impairing the natural development of a relationship, which is a big psychological burden for people to carry.”

It’s usually spread by people who don’t have symptoms

Most people with genital herpes don’t know they’re infected, says Dr. Johnston, and the disease is usually spread “during periods of asymptomatic shedding, when people do not have symptoms.” Women are at higher risk of contracting herpes than men, and risk increases for people with higher numbers of sexual partners.

“It is true that the partner can lie and say they are clean, but the story we hear more often is that the partner did not know they had the infection,” says Dr. Johnston. Warning signs can include genital blisters and open sores, she adds, “but the findings can often be subtle.” There is also a blood test that can diagnose herpes—but because false-positives are possible, it’s generally only recommended for people who have symptoms or who know they’ve been exposed to the virus.

RELATED: Herpes Simplex 1 vs. Herpes Simplex 2—and Why the Difference Matters

Condoms and antiviral meds can reduce transmission risk

Using a condom can decrease the risk of spreading or acquiring genital herpes—but it’s not 100% effective, says Dr. Swartz, because the virus can be on parts of the genital area that are still exposed. For people who know they have an infection, taking daily antiviral medication can also cut the odds of spreading it to partners.

In one study from the University of North Carolina, researchers followed couples (in which one partner had genital herpes) for eight months. All couples were offered condoms, but half of the infected partners took the antiviral drug valacyclovir (Valtrex), while the other half took a placebo. Overall, use of antiviral medicines reduced the risk of transmission between partners by 48%—from 3.6% in the placebo group to 1.9% in the medication group.

Symptoms can be serious, mild, or nonexistent

Some people won’t have their first herpes outbreak for months or years after transmission. (Because of that, says Dr. Johnston, it can be very difficult to identify the source.) For others, symptoms can appear as early as six days after infection, and can include pain and blisters in the genital area, pain with urination, and fever, chills, headache, and lymph node swelling.

RELATED: 5 Conditions You Might Confuse for Genital Herpes

Herpes has few serious risks

In developing countries, genital herpes can double a person’s risk of contracting HIV if he or she is exposed to it, says Dr. Handsfield, although that’s not the case in the United States, especially not for heterosexual men and women. “Herpes helps drive the AIDS epidemic internationally,” he says.

Although it’s rare, herpes can be transmitted from mothers to babies as they travel through the birth canal during delivery. Even less frequently, infants can pick up a herpes infection from skin-to-skin or mouth-to-skin contact with another person. These are serious concerns, because newborns can develop dangerous or even fatal complications when infected with the herpes virus.

Treatment can help patients and their partners

There’s no cure for herpes, but antiviral drugs can reduce the intensity and duration of symptoms, and—if taken daily—can also reduce the frequency of outbreaks. Besides Valtrex, the FDA has also approved famciclovir (Famvir) as a one-day treatment of symptomatic herpes.

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Herpes Meningoencephalitis

What is herpes meningoencephalitis?

The meninges are the layers of thin tissue that cover your brain. If these tissues become infected, it’s called meningitis. When your brain becomes inflamed or infected, the problem is called encephalitis. If both the meninges and the brain are infected, the condition is called meningoencephalitis.

Encephalitis involving herpes is a medical emergency. It needs to be promptly diagnosed and treated. This disease is often fatal when it is not treated. Many people who survive it have long-term problems afterward.

What causes herpes meningoencephalitis?

Meningitis and encephalitis may be caused by bacteria, fungi, or other types of germs. But many are caused by viruses, and many kinds of viruses can be to blame.

Encephalitis is caused by the herpes simplex virus. Most are caused by herpes simplex virus type 1 (HSV1), the virus that also causes cold sores. The disease may also be caused by herpes virus type 2 (HSV2). This virus can be spread by sexual contact or from an infected mother to her baby during childbirth. HSV1 infection can also be sexually transmitted to the genital area. These viruses remain in the body throughout a person’s life, even when they’re not causing signs of infection.

Sometimes the meningoencephalitis occurs during the initial infection with the herpes simplex virus, but most often it is caused by reactivation of the virus from an earlier infection.

What are the symptoms of herpes meningoencephalitis?

If you have viral meningitis, symptoms may include fever, light sensitivity, headache, and a stiff neck. If you have other symptoms, such as confusion, seizures, sleepiness, or a focal neurologic deficit—a nerve function problem that affects a specific area — these may suggest that your brain is also affected, and your healthcare provider may diagnose it as meningoencephalitis.

These are possible symptoms of meningoencephalitis:

  • Headache

  • Fever

  • Neck stiffness

  • Sensitivity to light

  • Seizures

  • Trouble thinking clearly

  • Personality changes

  • Hallucinations, visual and auditory

  • Unusual behaviors

  • Unconsciousness

How is herpes meningoencephalitis diagnosed?

If, after reviewing your medical history and symptoms, your healthcare provider thinks you may have herpes meningoencephalitis, he or she will order various tests and exams to confirm the diagnosis. Other tests may include:

  • Neurological exam. Your provider will do a neurological exam to look for changes in motor and sensory function, vision, coordination and balance, mental status, and in mood or behavior.

  • Lumbar puncture. In this procedure, your provider will take a sample of spinal fluid. Cells and other substances in this fluid may give your provider important clues.

  • Imaging. Your provider may want to create images of your brain using a CT or MRI scan.

  • EEG. An EEG measures brain waves by placing electrodes onto your scalp.

  • Blood tests. Testing the blood helps identify infection.

If your healthcare providers think that a newborn has herpes encephalitis resulting from infection with HSV2 while passing through the birth canal, they may check samples of the baby’s blood and spinal fluid.

How is herpes meningoencephalitis treated?

Treating the cause of your infection is the primary treatment. Since most cases of meningoencephalitis are caused by the herpes virus, the antiviral acyclovir is used to treat it. You may need to take this medicine through an intravenous (IV) line for 10 to 14 days. Your healthcare provider may also give you medicine to reduce swelling in the brain and to treat or prevent seizures.

Healthcare providers may treat babies with this disease with acyclovir for several weeks.

Depending on the severity of your infection, you may need to be treated in the hospital.

What are the complications of herpes meningoencephalitis?

With treatment, most people with this disease start to improve within a day or two and tend to recover fully within about a month. But without treatment, very serious complications can set in, including death.

Even with treatment, some people with severe cases may have long-term brain damage. They may have trouble thinking, controlling their body, and hearing, seeing, or speaking. They may need to take medicines for a long time, and they may require long-term care.

Can herpes meningoencephalitis be prevented?

Avoiding herpes virus infections in the first place can help you prevent herpes meningoencephalitis. Ways to avoid infections from herpes viruses include:

  • Abstain from sex or have only one sex partner who has been tested for the virus and isn’t infected.

  • Use a latex condom, which can reduce — but not entirely prevent — the risk of infection.

  • Avoid kissing people with cold sore blisters. It’s important to keep in mind that most people have already been infected with HSV1 virus by the time they’re 20 years old. If you’ve already been infected, the virus goes dormant inside your body except during outbreaks.

Some pregnant women who have had genital herpes outbreaks may want to have their babies delivered by cesarean section. This may prevent meningoencephalitis in newborns.

When should I call my healthcare provider?

Treating herpes meningoencephalitis as soon as possible is essential. If you’re feeling neck stiffness, having any neurological problems (including seizures, changes in consciousness, or feeling sleepy), are sensitive to light, or are running a fever along with a bad headache, call your healthcare provider and have the problem treated promptly.

If you have already been diagnosed with herpes meningoencephalitis and are being treated, it’s very important to let your healthcare providers know if any of your symptoms get worse or if you develop any new symptoms, as these could be signs that the infection is getting worse despite treatment.

Key points

  • Herpes meningoencephalitis is an infection of the brain and brain covering (meninges) caused by the herpes simplex virus. It is a medical emergency that requires treatment right away.

  • Symptoms can include headache, fever, changes in consciousness, confusion, neck stiffness, sensitivity to light, seizures, and changes in mood, personality, or behavior.

  • Treatment is with antiviral medicine, sometimes along with other medicines such as steroids and drugs to prevent seizures.

Genital Herpes – CDC Fact Sheet

Genital herpes is a common sexually transmitted disease (STD) that any sexually active person can get. Most people with the virus don’t have symptoms. Even without signs of the disease, herpes can still be spread to sex partners.

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What is genital herpes?

Genital herpes is an STD caused by two types of viruses. The viruses are called herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2).

What is oral herpes?

Oral herpes is usually caused by HSV-1 and can result in cold sores or fever blisters on or around the mouth. However, most people do not have any symptoms. Most people with oral herpes were infected during childhood or young adulthood from non-sexual contact with saliva.

Is there a link between genital herpes and oral herpes?

Oral herpes caused by HSV-1 can be spread from the mouth to the genitals through oral sex. This is why some cases of genital herpes are caused by HSV-1.

Genital herpes is common in the United States. More than one out of every six people aged 14 to 49 years have genital herpes.

How is genital herpes spread?

You can get genital herpes by having vaginal, anal, or oral sex with someone who has the disease.

If you do not have herpes, you can get infected if you come into contact with the herpes virus in:

  • A herpes sore;
  • Saliva (if your partner has an oral herpes infection) or genital secretions (if your partner has a genital herpes infection);
  • Skin in the oral area if your partner has an oral herpes infection, or skin in the genital area if your partner has a genital herpes infection.

You can get herpes from a sex partner who does not have a visible sore or who may not know he or she is infected. It is also possible to get genital herpes if you receive oral sex from a sex partner who has oral herpes.

You will not get herpes from toilet seats, bedding, or swimming pools, or from touching objects around you such as silverware, soap, or towels. If you have additional questions about how herpes is spread, consider discussing your concerns with a healthcare provider.

How can I reduce my risk of getting genital herpes?

The only way to avoid STDs is to not have vaginal, anal, or oral sex.

If you are sexually active, you can do the following things to lower your chances of getting genital herpes:

  • Be in a long-term mutually monogamous relationship with a partner who is not infected with an STD (e.g., a partner who has been tested and has negative STD test results);
  • Using latex condoms the right way every time you have sex.

Be aware that not all herpes sores occur in areas that are covered by a latex condom. Also, herpes virus can be released (shed) from areas of the skin that do not have a visible herpes sore. For these reasons, condoms may not fully protect you from getting herpes.

If you are in a relationship with a person known to have genital herpes, you can lower your risk of getting genital herpes if:

  • Your partner takes an anti-herpes medication every day. This is something your partner should discuss with his or her doctor.
  • You avoid having vaginal, anal, or oral sex when your partner has herpes symptoms (i.e., when your partner is having an outbreak).

I’m pregnant. How could genital herpes affect my baby?

If you are pregnant and have genital herpes, it is very important for you to go to prenatal care visits. Tell your doctor if you have ever had symptoms of, or have been diagnosed with, genital herpes. Also tell your doctor if you have ever been exposed to genital herpes. There is some research that suggests that genital herpes infection may lead to miscarriage, or could make it more likely for you to deliver your baby too early.

Herpes infection can be passed from you to your unborn child before birth but is more commonly passed to your infant during delivery. This can lead to a potentially deadly infection in your baby (called neonatal herpes). It is important that you avoid getting herpes during pregnancy. If you are pregnant and have genital herpes, you may be offered anti-herpes medicine towards the end of your pregnancy. This medicine may reduce your risk of having signs or symptoms of genital herpes at the time of delivery. At the time of delivery, your doctor should carefully examine you for herpes sores. If you have herpes symptoms at delivery, a ‘C-section’ is usually performed.

How do I know if I have genital herpes?

Most people who have genital herpes have no symptoms, or have very mild symptoms. You may not notice mild symptoms or you may mistake them for another skin condition, such as a pimple or ingrown hair. Because of this, most people who have herpes do not know it.

Herpes sores usually appear as one or more blisters on or around the genitals, rectum or mouth. The blisters break and leave painful sores that may take a week or more to heal. These symptoms are sometimes called “having an outbreak.” The first time someone has an outbreak they may also have flu-like symptoms such as fever, body aches, or swollen glands.

People who experience an initial outbreak of herpes can have repeated outbreaks, especially if they are infected with HSV-2. Repeat outbreaks are usually shorter and less severe than the first outbreak. Although the infection stays in the body for the rest of your life, the number of outbreaks may decrease over time.

You should be examined by your doctor if you notice any of these symptoms or if your partner has an STD or symptoms of an STD. STD symptoms can include an unusual sore, a smelly genital discharge, burning when urinating, or (for women) bleeding between periods.

How will my doctor know if I have herpes?

Your healthcare provider may diagnose genital herpes by simply looking at your symptoms. Providers can also take a sample from the sore(s) and test it. In certain situations, a blood test may be used to look for herpes antibodies. Have an honest and open talk with your health care provider and ask whether you should be tested for herpes or other STDs.

Please note: A herpes blood test can help determine if you have herpes infection. It cannot tell you who gave you the infection or how long you have been infected.

Can herpes be cured?

There is no cure for herpes. However, there are medicines that can prevent or shorten outbreaks. One of these anti-herpes medicines can be taken daily, and makes it less likely that you will pass the infection on to your sex partner(s).

What happens if I don’t get treated?

Genital herpes can cause painful genital sores and can be severe in people with suppressed immune systems.

If you touch your sores or the fluids from the sores, you may transfer herpes to another part of your body, such as your eyes. Do not touch the sores or fluids to avoid spreading herpes to another part of your body. If you do touch the sores or fluids, immediately wash your hands thoroughly to help avoid spreading your infection.

If you are pregnant, there can be problems for you and your developing fetus, or newborn baby. See “I’m pregnant. How could genital herpes affect my baby?” above for information about this.

Can I still have sex if I have herpes?

If you have herpes, you should talk to your sex partner(s) and let him or her know that you do and the risk involved. Using condoms may help lower this risk but it will not get rid of the risk completely. Having sores or other symptoms of herpes can increase your risk of spreading the disease. Even if you do not have any symptoms, you can still infect your sex partners.

You may have concerns about how genital herpes will impact your overall health, sex life, and relationships. It is best for you to talk to a health care provider about those concerns, but it also is important to recognize that while herpes is not curable, it can be managed with medication. Daily suppressive therapy (i.e., daily use of antiviral medication) for herpes can also lower your risk of spreading genital herpes to your sex partner. Be sure to discuss treatment options with your healthcare provider. Since a genital herpes diagnosis may affect how you will feel about current or future sexual relationships, it is important to understand how to talk to sexual partners about STDsexternal icon.

What is the link between genital herpes and HIV?

Herpes infection can cause sores or breaks in the skin or lining of the mouth, vagina, and rectum. This provides a way for HIV to enter the body. Even without visible sores, having genital herpes increases the number of CD4 cells (the cells that HIV targets for entry into the body) found in the lining of the genitals. When a person has both HIV and genital herpes, the chances are higher that HIV will be spread to an HIV-uninfected sex partner during sexual contact with their partner’s mouth, vagina, or rectum.

Where can I get more information?

STD information and referrals to STD Clinics
CDC-INFO
1-800-CDC-INFO (800-232-4636)
TTY: 1-888-232-6348
In English, en Español

Resources:

CDC National Prevention Information Network (NPIN)
P.O. Box 6003
Rockville, MD 20849-6003
E-mail: [email protected]

American Sexual Health Association (ASHA)external icon
P. O. Box 13827
Research Triangle Park, NC 27709-3827
1-800-783-9877

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Finding out you have herpes can be tough, but it’s not the end of the world. Millions of people living with herpes have great lives and relationships.

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What do I do if I find out I have herpes?

It’s normal to have lots of different feelings after you find out that you have herpes. You might feel mad, embarrassed, ashamed, or upset at first. But you’ll probably feel a lot better as time goes by, and you see that having herpes doesn’t have to be a big deal. People with herpes have relationships and live totally normal lives. There are treatments for herpes, and there’s a lot you can do to make sure you don’t give herpes to anyone you have sex with.

Millions and millions of people have herpes — you’re definitely not alone. Most people get at least one STD in their lifetime, and having herpes or another STD is nothing to feel ashamed of or embarrassed about. It doesn’t mean you’re “dirty” or a bad person — it means you’re a normal human who got a really common infection. The reality is that herpes can happen to anybody who has ever been kissed on the lips or had sex — that’s a LOT of people.

Herpes isn’t deadly and it usually doesn’t cause any serious health problems. While herpes outbreaks can be annoying and painful, the first flare-up is usually the worst. For many people, outbreaks happen less over time and may eventually stop completely. Even though the virus hangs around in your body for life, it doesn’t mean you’ll be getting sores all the time.

The best thing to do when you find out you have herpes is follow your doctor’s directions for treating it. If you’re having a hard time dealing with the news, talking with a close friend or a support group for people living with herpes may make you feel better.

And tell anyone you have sex with that you have herpes. It’s not the easiest conversation, but it’s an important one. Here are some tips:

How do I talk with people about having herpes?

It might feel scary to admit you have herpes, but talking about things can really ease your mind. You could lean on a close, non-judgmental friend that you trust to keep the conversation private. Parents, brothers and sisters, aunts and uncles, and other family members can also be a source of comfort. Remember, herpes is really common, so it’s possible the person you’re talking to has herpes, too.

There are a lot of online support groups for people who have herpes, and the American Sexual Health Association has a list of support groups that meet in person.

What do I need to know about dating with herpes?

Some people feel like their love lives are over when they find out they have herpes, but it’s just not true. People with herpes have romantic and sexual relationships with each other, or with partners who don’t have herpes.

Talking about STDs isn’t the most fun conversation you’ll ever have. But it’s super important to always tell partners if you have herpes, so you can help prevent it from spreading.

There’s no one way to talk about having an STD, but here are some tips that may help:

  1. Keep calm and carry on. Millions of people have herpes, and plenty of them are in relationships. For most couples, herpes isn’t a huge deal. Try to go into the conversation with a calm, positive attitude. Having herpes is simply a health issue — it doesn’t say anything about you as a person.

  2. Make it a two-way conversation. Remember that STDs are super common, so who knows? Your partner might have herpes too. So start by asking if they’ve ever been tested or had an STD before.

  3. Know your facts. There’s a lot of misinformation about herpes out there, so read up on the facts and be prepared to set the record straight. Let your partner know there are ways to treat herpes and avoid passing it on during sex.

  4. Think about timing. Pick a time when you won’t be distracted or interrupted, and a place that’s private and relaxed. If you’re nervous, you can talk it through with a friend first, or practice by talking to yourself. It sounds silly, but saying the words out loud can help you know what you want to say and feel more confident when you talk to your partner.

  5. Safety first. If you’re afraid that a partner might hurt you, telling them in person might not be safe. You’re probably better off with an e-mail, text, or phone call — or in extreme cases, not telling them at all. Call 1-800-799-SAFE or visit the National Domestic Violence Hotline website for help if you think you may be in danger.

So … when do you tell your new crush about your herpes status? You might not need to tell them the very first time you hang out, but you should let them know before you have sex. So when the relationship starts heading down that path and you feel like you can trust the person, that’s probably a good time.

It’s normal to be worried about how your partner’s going to react. And there’s no way around it: Some people might freak out. If that happens, try to stay calm and talk about all the ways there are to prevent spreading herpes. You might just need to give your partner a little time and space to process the news, which is normal. And most people know that herpes is super common and not a big deal.

Try not to play the blame game when you talk to your partner. If one of you has a herpes outbreak for the first time during the relationship, it doesn’t automatically mean that somebody cheated. Herpes symptoms can take days, weeks, months, or even years to show up after you get the infection. So it’s usually really hard to tell when and where someone got herpes. The most important thing is that you both get tested. If it turns out only one of you has herpes, talk about how you can prevent passing it on.

Tell your past partners too, so they can get tested.

Will having herpes affect my pregnancy?

If you’ve had genital herpes for a while and you get pregnant, you probably don’t need to worry — it’s unlikely that you’ll give herpes to your baby during birth. But you should still let your doctor know you have genital herpes if you’re pregnant, no matter what.

If you get herpes while you’re pregnant, it’s a lot more dangerous — especially late in the pregnancy. It can cause a miscarriage or cause you to deliver too early. If you give herpes to your baby during birth, it can cause brain damage or eye problems. If you have herpes sores when you go into labor, your doctor might suggest that you to have a C-section so you don’t pass the virus to your baby during delivery.

If your partner has herpes and you don’t, don’t have unprotected vaginal, anal, or oral sex when you’re pregnant, since that’s the most common way to get herpes. The doctor might tell your partner to take herpes medication during your pregnancy so they’re less likely to pass on the virus. Check out “How to prevent herpes” to learn more about how to avoid getting herpes.

Oral herpes isn’t dangerous during pregnancy or birth. But if you have a cold sore after you give birth, don’t kiss your baby until the sore is totally healed.

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Dangerous Genital Herpes May Be Hidden, Get Checked!

A new Swedish study has found that herpes may be more hidden than previously thought and just not having visual confirmation of the sexually transmitted disease doesn’t mean you aren’t infected. In the study, just four out of ten patients with genital herpes actually knew that they had the disorder, and a third of those did not realize that they had been infected reported typical symptoms at a follow-up visit.
Matilda Berntsson has presented the information and states:

“1,014 patients who attended sexual health clinics, the Sahlgrenska University Hospital skin clinic and the Sesam sexual health clinic were tested for herpes simplex virus type 2. The presence of antibodies in the blood shows that a person is infected with the virus. The study reinforces our perception that genital herpes is common and that most people carrying it are unaware that they have it. Non-specific recurring genital symptoms could be undiagnosed herpes, which can be detected with a simple test at the doctor’s.”
Basically if you are concerned, go get checked out. Don’t wait for open sores to appear or other visual symptoms.
Genital herpes caused by herpes simplex virus type 2 spreads through sexual contact, and more than 500 million people worldwide have the disorder. In the West 10 to 30% of the population carry the virus, making it one of the most widespread sexually transmitted infections.
The virus causes painful sores and blisters in the genital area and, in rare cases, serious infections in the brain and spinal cord. The infection is for life and there are currently no cures or vaccines for genital herpes. Herpes simplex virus type 1, which generally causes oral herpes/cold sores, can also infect the genitals, but tends not to result in recurring problems.
Berntsson continues:
“If the symptoms and/or findings suggest herpes, there are good methods for testing for the disorder. Pronounced symptoms can be treated with medicines that alleviate discomfort, and a daily preventative treatment can be given for longer periods where recurrences are frequent.”
In a related piece published in the The Journal of the American Medical Association Anna Wald, M.D., M.P.H., of the University of Washington and Fred Hutchinson Cancer Research Center, Seattle adds:
“Our findings suggest that ‘best practices’ management of HSV-2-infected persons who learn that they are infected from serologic testing should include anticipatory guidance with regard to genital symptoms, as well as counseling about the potential for transmission. The issue of infectivity is both a patient management and a public health concern. The primary concern of many HSV-2-seropositive persons is the risk of transmission to sexual partners; in our experience this is the main source of angst in patients with genital herpes.”
Wald concludes with best prevention and transmission practices:
“Condom use, daily valacyclovir therapy, and disclosure of HSV-2 serostatus each approximately halve the risk of HSV-2 transmission. However, these approaches reach a small portion of the population and have not had an influence on HSV-2 seroprevalence in the last decade. One of the reasons for such a limited effect is that few people are aware of their genital HSV-2 infection, and routine serologic testing, although available commercially, is recommended only in limited settings. We hope that these data will result in further discussions regarding control programs for HSV-2 in the United States.”
Sources: News Release and Journal of the American Medical Association
Written by Sy Kraft

Herpes Simplex

Herpes is an infection that is caused by a herpes simplex virus (HSV). Oral herpes causes cold sores around the mouth or face. Genital herpes affects the genitals, buttocks or anal area. Genital herpes is a sexually transmitted disease (STD). It affects the genitals, buttocks or anal area. Other herpes infections can affect the eyes, skin, or other parts of the body. The virus can be dangerous in newborn babies or in people with weak immune systems.

There are two types of HSV:

  • HSV type 1 most commonly causes cold sores. It can also cause genital herpes.
  • HSV type 2 is the usual cause of genital herpes, but it also can infect the mouth.

HSV spreads through direct contact. Some people have no symptoms. Others get sores near the area where the virus has entered the body. They turn into blisters, become itchy and painful, and then heal.

Most people have outbreaks several times a year. Over time, you get them less often. Medicines to help your body fight the virus can help lessen symptoms and decrease outbreaks.

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