Small, fluid-filled blisters (vesicles) or ulcers around the genital area, including the penis, scrotum, and rectum, are signs of genital herpes.
Genital herpes is caused by herpes simplex virus type 2 (HSV-2) and type 1 (HSV-1).
While most cases of genital herpes are caused by HSV-2, more and more infections by HSV-1 are appearing, in particular among young women, and men who have sex with men. It is a contagious, lifelong infection.
But even without symptoms, a person sheds the virus and can transmit the disease to others.
While there is no cure for it, effective antiviral treatments can help manage your symptoms.
In this article, I’ll talk about the symptoms of genital herpes, including how quickly they appear.
I’ll explain its causes, and describe how it’s diagnosed and treated. I’ll cover whether genital herpes can make you infertile. And I’ll tell you when to see a doctor.
Initial symptoms of genital herpes tend to appear between 2-12 days after having sexual contact with an infected person ,and can last 2-4 weeks.
The first outbreak is often more severe than subsequent outbreaks, and can cause additional symptoms you may not experience in recurring outbreaks.
If you suspect you are having a genital herpes flare-up, you may have any of the following:
- Painful sores or tiny white blisters on and around the genitals and anus
- Ulcers that can be caused by ruptured blisters
- Scabs that form from ruptured blisters
- Pain during urination due to ulcers
- Swelling or a tingling sensation in the genital area
An initial outbreak may include the following symptoms:
- Tender, swollen glands
- Flu-like symptoms
- Itching or burning feeling in the genital or anal area or with urination
How are symptoms different in males?
For the most part, symptoms are the same between people with penises and people with vaginas.
However, genital herpes is far more prevalent in people with vaginas than people with penises.
According to the CDC, around 16% of people identifying as female and 8% of people identifying as male under the age of 50 contract the infection each year, making it more likely for people with penises to pass on the infection to those with vaginas during sexual intercourse.
People with vaginas are at a greater risk of contracting genital herpes, as the virus can enter the body more easily.
How soon do symptoms appear?
Symptoms for genital herpes typically emerge 2-12 days after initial exposure.
Many people will experience only mild symptoms and some experience no symptoms at all, making it easy for the condition to go unnoticed or be mistaken for another skin condition.
The average incubation period is four days.
How to get rid of herpes symptoms
Antiviral medications, such as acyclovir (Zovirax), famciclovir (Famvir), and valacyclovir (Valtrex), can be taken orally to effectively treat HSV-2.
These medications can reduce the severity and frequency of symptoms, and also shorten the duration of the outbreak, which makes it less likely to pass the virus on to others.
In severe cases of genital herpes, your healthcare provider may recommend intravenous antiviral therapy.
How long does an outbreak last?
Herpes outbreaks tend to last 1-2 weeks.
The initial herpes outbreak tends to be more severe and can last longer.
In some cases, symptoms may be present for 2-4 weeks.
Even though the blisters go away, the virus lies dormant in your body and can reactivate at certain periods brought on by a weakened immune system, hormonal changes, surgery, high sun exposure, and physical or emotional stresses.
It’s common to experience repeat outbreaks, especially during the first year you have herpes.
Causes of Genital Herpes
Genital herpes is caused by close, direct, and intimate physical contact with an infected person.
People with penises can transfer the virus during sexual intercourse or other sexual activity.
You can become infected with genital herpes if you come in contact with one or more of the following:
- A herpes sore of an infected partner (no matter the location of the sore)
- The genital fluids of a partner who has with genital herpes
- The saliva of a partner who has oral herpes
- Skin in the mouth area of a partner who has oral herpes
- Skin in the genital area of a partner who has genital herpes
HSV cannot be contracted by coming into contact with surfaces such as toilet seats, bedding, towels, or swimming pools.
It is very unlikely you will get genital herpes from sex toys, but there is a slight risk if you use the toy immediately after it has been used by an infected person and come into contact with a significant amount of infected fluid.
Testing and Diagnosis
An active genital herpes infection is diagnosed by healthcare providers by physical examination and/or taking a swab from a blister to test it for HSV.
There are blood tests, but this does not distinguish an active infection from past exposure.
Your doctor or an STD clinic can run these tests for you.
Because of this, it is important to visit your healthcare provider to confirm a diagnosis and get treatment for your symptoms.
Recurrences are common
HSV-2 is a lifelong condition with no cure.
Initially, people will go through an acute phase where symptoms are usually more severe than subsequent outbreaks.
The virus will then enter your nerve cells and lie dormant in the body.
You may experience flare-ups at any time, usually brought on by a weakened immune system, surgery, pregnancy, high sun exposure, or periods of physical or, most commonly, emotional stress.
It is more common to have several outbreaks in the first year of the infection and have it taper off as time goes on.
Can Herpes Make You Infertile?
There is currently no evidence to support the notion that herpes can make you infertile.
However, a study carried out regarding seminal fluid and HSV-2 found that although HSV infection was not associated with sperm motility and morphological defects, it can be linked to lower sperm count in the seminal fluid.
These findings suggest that asymptomatic seminal infection of HSV can affect the sperm count in people with penises, which could lead to a greater likelihood of male infertility.
While there is no cure for genital herpes, there are effective antiviral medications such as acyclovir (Zovirax), famciclovir (Famvir), and valacyclovir (Valtrex).
These can be taken orally to manage the severity and frequency of symptoms.
These medications can also shorten the duration of the infection, which makes it less likely to pass the virus on to others.
You can also use a covered ice pack a few times a day to reduce inflammation caused by painful blisters.
Avoid picking the scabs that form from herpes sores.
This will help the infection be less inflamed and speed up the recovery process.
Your doctor may also prescribe other medications to treat flu-like symptoms that can occur from an initial outbreak.
Over-the-counter options are also available to help manage flu-like symptoms.
In some circumstances where genital herpes is severe, your doctor may suggest intravenous antiviral therapy.
When to See a Medical Provider
If you have never been formally diagnosed with HSV-2 and you notice signs or symptoms of possible infection, visit your doctor to confirm the diagnosis.
They will do a physical examination and may wish to do additional testing to determine if you have any other STDs.
Visit a doctor or STD clinic frequently to protect yourself and your partners from STDs.
Get regular sexual health checkups to reduce the chances of exposing yourself or others to potentially harmful STDs.
If you test positive for HSV-2, you are at a greater risk of contracting HIV.
This is because the open sores or breaks in the skin or lining of the mouth, penis, scrotum, and rectum that are symptoms of herpes can make it easier for HIV to enter the body.
Herpes also increases the number of immune cells in the lining of the genitals which HIV targets to enter the bloodstream.
If you are experiencing a flare-up, a doctor can prescribe you antiviral medications to help alleviate your symptoms.
For the safety of your sexual partners, you should abstain from sexual activity until the sores have cleared up.
How K Health Can Help
Did you know you can get affordable primary care with the K Health app? K doctors are able to treat herpes with medication, but patients must be diagnosed already. If you’re worried that you might have genital herpes, a K doctor can refer you to a physician for an in-person visit.
Download K to check your symptoms, explore conditions and treatments, and if needed text with a doctor in minutes. K Health’s AI-powered app is HIPAA compliant and based on 20 years of clinical data.
Frequently Asked Questions
K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.
Asymptomatic seminal infection of herpes simplex virus: impact on male infertility. (2013).
Genital Herpes – CDC Fact Sheet (Detailed). (2021).
Genital Herpes Treatment and Care. (2021).
Herpes Simplex Virus. (2022).