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Genital Herpes


Once a person gets genital herpes, it stays in the body for life. In some people, symptoms come and go. When symptoms appear, it is called a "herpes outbreak."

What causes genital herpes?

Genital herpes is spread by having vaginal, anal, or oral sex with a person who has the herpes simplex virus, or HSV. There are 2 types of HSV:
Type 2, known as HSV-2. It is the main cause of genital herpes.
Type 1, known as HSV-1. It is the main cause of oral herpes lesions, often called fever blisters or cold sores. HSV-1 is a less frequent cause of genital herpes, but it is becoming more common.

Most cases of genital herpes are caused by HSV-2, which is transmitted primarily during vaginal or anal sex. In recent years, however, HSV-1 has been causing more and more genital herpes cases. Genital HSV-1 is spread mainly through oral sex with a partner who has a sore on the mouth or lips, but some cases may result from vaginal or anal sex. HSV-1 is much less likely to cause repeat outbreaks of genital herpes than HSV-2. Almost all people who have recurrent genital herpes are infected with HSV-2.

Who is more likely to get genital herpes?

Anyone who has vaginal, oral, or anal sex with an infected partner can get genital herpes. But women get it more often than men do.

What are the signs and symptoms of the first outbreak of genital herpes?

Some people experience very mild genital herpes symptoms or no symptoms at all, so they don't even know they are infected. However, for many people the first outbreak is often the worst, and genital herpes symptoms can be quite painful.

The main signs of genital herpes are sores around the vagina, on the penis, or near the anus. Sometimes genital herpes sores appear on the scrotum, buttocks, or thighs. The sores may appear about 4 to 7 days after infection. They usually begin as a rash of red bumps. The bumps then turn into blisters. It is common for the blisters to open up, sometimes causing severe pain. In time, the sores will scab over and heal. The first outbreak of genital herpes usually lasts 10 to 20 days until healing is complete.

During the first outbreak, many people have other genital herpes symptoms:

Swollen glands in the groin
Discharge from the vagina or penis
Painful or difficult urination
Muscle ache

More women than men report severe herpes symptoms, especially during the first outbreak.

What are the signs and symptoms of recurrent (repeated) genital herpes outbreaks?

The signs of recurrent (repeated) outbreaks of genital herpes are similar to the signs of the first outbreak, but they may not be as severe. Some people may have no herpes symptoms, but they can still spread the virus.

Recurrent outbreaks are usually shorter than the first outbreak, typically 7 to 10 days from onset to healing. Some people with recurrent outbreaks have warning signs, called a prodrome. These signs can appear a few hours or up to a day before an outbreak. The most common prodrome is tingling in the area where the rash will appear. Although warning signs are different for everyone, many people can recognize when an outbreak is coming. It's important to recognize your prodrome, because starting Single-Day FAMVIR at this critical time can stop the virus from reproducing. If you can stop the virus during this time, you may be able to stop a full-blown outbreak.

After the warning signs pass, sores may develop. Sores generally develop in stages:

Small red areas appear and may be sensitive, itchy, or painful.
These areas may swell slightly.
Next, small blisters filled with fluid form in the same area as the rash.
The blisters can open up and form open sores, which may be quite painful.
As the sores start to heal, they crust over. New skin grows beneath the scab.
When the crust falls off, the sore is healed.

During repeated outbreaks with herpes symptoms, the sores almost always appear on the same side of the body each time.

Genital Herpes Treatment

What medications can be prescribed to manage genital herpes symptoms?

The 3 oral antiviral prescription medications available are FAMVIR (famciclovir), Zovirax®* (acyclovir), and Valtrex®* (valacyclovir). These genital herpes treatments can help lessen your symptoms and how long they last.

These genital herpes treatments can be taken in 2 ways:

As each outbreak occurs. This is called episodic treatment.
Continuous daily treatment. This is called suppressive treatment.

The Centers for Disease Control and Prevention (CDC) recommends suppressive genital herpes treatment for people with 6 or more outbreaks per year. And statistics show that 7 out of 10 people have less than 6 outbreaks per year. If you're one of these people, or if you don't want to take an antiviral medication every day, episodic treatment may be right for you.

Only Single-Day FAMVIR has been proven to stop or shorten a recurrent genital herpes outbreak with just a single day of treatment. Take at the first sign or symptom. The effectiveness of FAMVIR has not been established when treatment is started more than six hours after the onset of symptoms or lesions. FAMVIR can also be used suppressively to treat genital herpes. Speak to your doctor about which method of genital herpes treatment is most appropriate for you.

*Zovirax® and Valtrex® are registered trademarks of GlaxoSmithKline.

What else can I do when I have a genital herpes outbreak besides taking medicine?

During an outbreak when you have sores or blisters, these steps may help provide comfort.

Keep the affected areas clean and dry.
Loose-fitting clothing may help.
If you have especially painful sores, you may want to dry yourself after a bath or shower with a hair dryer (on low power) instead of a towel.
Soothe the affected areas with a cool cloth.
Soak in a warm bath.
Try not to touch the sores or break open the blisters.
If you do touch the sores, wash your hands afterward. It is especially important to avoid touching your face and eyes after you touch your sores.
Women should not use feminine sprays, feminine deodorants, or douches during a herpes outbreak.
Don't use any creams or ointments on sores unless prescribed by your healthcare provider.

Ask your healthcare provider which of these steps may be helpful for you.

How can I help make sure I don't spread genital herpes to others?

Talking openly about genital herpes can be difficult. However, there is no need for you to feel embarrassed or ashamed about having genital herpes. In the long run, it is best to be honest with your partner. Telling your partner that you have genital herpes is an important step in protecting him or her from getting the infection.

Genital herpes can still be spread to a sex partner even when you have no symptoms. Most new cases of genital herpes are caught from someone who has an active herpes infection with no symptoms. So, if you've ever had genital herpes, it is important to always practice safer sex.

This means you should not have vaginal, oral, or anal sex with uninfected partners when you have active symptoms, such as sores. You should wait until they are completely healed. Between outbreaks, use a condom during sex. Neither of these methods is perfect, but they will help prevent the spread of herpes.

If I think I have genital herpes, do I have to treat it?

If you think you have genital herpes, it's important to see your healthcare provider because:

Genital herpes causes repeated outbreaks that may be painful. Treatment can help relieve pain.
It can be spread to sex partners.
A pregnant woman can pass it to her unborn baby during vaginal delivery. This is called neonatal herpes and can be serious or even fatal to the infant.
Fear of outbreaks or of spreading genital herpes to a partner or your baby can cause stress, anxiety, or depression.

Although there is no cure for genital herpes, the symptoms can be treated. In most healthy people, herpes doesn't usually cause other health problems. Yet, many people choose to treat their herpes to help make outbreaks shorter and less severe. This can help many feel more comfortable. Only Single-Day FAMVIR can stop or shorten a recurrent genital herpes outbreak with just a single day of treatment. Take at the first sign or symptom. The effectiveness of FAMVIR has not been established when treatment is started more than six hours after the onset of symptoms or lesions.