Recognising Genital Herpes

How do I know if I have genital herpes?

Genital herpes symptoms are often mild and infrequent, often going unnoticed. For this reason, the majority of people who have genital herpes may be unaware they have it. Learning to recognise genital herpes symptoms can help an individual avoid sexual contact during a herpes episode and hence reduce the risk of transmitting genital herpes to a sexual partner.

For those people who experience more severe symptoms, an outbreak of genital herpes commonly consists of blisters or sores (like cold-sores) on or around your genitals. If you have concerns or think you may have genital herpes, talk to your healthcare provider.

Genital herpes episodes

Genital herpes usually consists of breakouts or episodes, interspersed with symptom-free periods. The first herpes episode is usually the most severe and can start with tingling, itching, or burning in or around the genitals, and flu-like symptoms, aches, pains – especially down the back, and the back of the legs. This may be followed by pain on passing urine and an outbreak of herpes sores or blisters on or around the genitals.

If left untreated, these herpes symptoms can last up to a month. Subsequent herpes breakouts, called recurrences, are generally milder and don't last as long as the first.

Symptoms vary

Some people do not experience a severe first herpes episode and just notice occasionally recurring herpes sores or blisters on the genitals that come and go at irregular intervals lasting 3 to 5 days.

Other people may have 'atypical' herpes symptoms such as a 'pimple ' that comes and goes or a 'crack ' in their skin around the genital area. Yet other people may experience a severe first herpes episode and then not have any further herpes recurrences.

For some people, herpes recurrences can be reasonably frequent and physically uncomfortable, usually presenting as clusters of blisters which burst, forming ulcers, which crust over and heal.

Areas affected

The areas most commonly affected by genital herpes include the external genitalia, such as the vulva, vaginal entrance, the end of the penis, foreskin, and shaft. Herpes sores may also develop on the cervix or scrotum in some cases. Less commonly, sores can appear around the anus, buttocks, or upper thighs.

Medical diagnosis

Because people's experience of genital herpes varies so greatly, to guide treatment an accurate diagnosis is essential. If you have concerns or think you may have genital herpes, talk to your healthcare professional. A diagnosis of genital herpes is made most easily and correctly at the time of the first herpes infection.

Accurate diagnosis of genital herpes includes taking a history and doing a physical examination. To confirm the presence of the herpes simplex virus, the healthcare professional should perform a swab test, in which a sample of the fluid from a blister, or a swab from ulbers, is taken and sent away for analysis. This test can identify whether the virus infection is caused by HSV-1 or HSV-2. Herpes is not tested for as part of a routine sexual health check up.

Diagnosis is easier if early ulcers or blisters containing the fluid necessary for laboratory confirmation are present, but we would still encourage you to be seen by a clinician and get an HSV swab taken if you have a painful break in the genital or anal skin.

Because it is possible for a person with genital herpes to have another sexually transmitted infection (STI) at the same time, a full check for STIs may be appropriate.