Symptoms of Genital Herpes

Genital herpes is a common STI caused by the herpes simplex virus (HSV), most often HSV-2, but sometimes HSV-1, which more commonly causes cold sores.

In the UK, approximately 70% of the population is infected with HSV-1 or HSV-2 by the age of 25. The virus causes painful blisters or sores on or around the genitals, anus, and thighs, although some people will get no symptoms.

How do you get genital herpes?

You can catch genital herpes in a few ways:

1. Most commonly, it’s passed on through skin-to-skin contact usually during vaginal, anal, or oral sex with someone who has the virus, even if there are no visible sores. However, it's more likely to be passed on if you have sexual contact during an outbreak, where there are visible sores.
2. If you come into contact with infected fluid, such as if you get discharge or ejaculate on your fingers, then touch your genitals, or share a sex toy that has not been washed and covered with a condom between partners.
3. Rarely, genital herpes is passed on during childbirth.

Once you have been infected with the virus, it will remain in your body for the rest of your life, and some people will get frequent outbreaks of painful sores and blisters around the genital area, whereas others may only get one.

Early signs of genital herpes may appear before the classic small, painful blisters that rupture to form sores. Once you have been infected with the virus, it can take 2 to 12 days for symptoms to arise, if you get any.

Early signs include:

• tingling, itching, or burning in the genital area
• pain when going for a pee
• abnormal vaginal or urethral discharge
• flu-like symptoms (fever, headache, muscle aches, and swollen lymph nodes)

The first genital herpes outbreak is usually the most severe, while recurrent outbreaks tend to be milder and shorter in length.

An active genital herpes outbreak is typically marked by the appearance of blisters and sores, often with other symptoms, such as pain during urination and abnormal discharge. The severity and frequency of genital herpes outbreaks vary from person to person.

Blisters and sores

The classic genital herpes symptom is the appearance of small, painful blisters around the genital or anal area. These sores tend to go through stages:

1. Tingling and redness – Before blisters appear, you might feel some tingling, itching, or burning in a specific area of the skin, which is usually an early sign that an outbreak is coming.
2. Blister formation – Red, itchy bumps form and can quickly develop into small, fluid-filled blisters. They can appear on their own or in clusters, which may resemble the shape of a cauliflower and can be sore or painful to touch.
3. Blisters burst – The blisters eventually burst, releasing a cloudy, white fluid that is filled with the virus. When the blisters burst, the virus is at its most contagious.
4. Scabbing – Once the blisters have burst, they leave behind open sores that will dry out, crust over, and scab. At this stage, healing can take 7 to 14 days.

Pain during urination

It’s common for some people to experience pain when going for a pee when they have genital herpes, especially if the outbreak occurs near the urethra – the tube through which urine passes out of the body.

Abnormal discharge

Some people notice abnormal vaginal or penile discharge during an outbreak. It’s usually clear or white and can be thick and cloudy without a strong or foul odour.

If you have yellow, green, or grey discharge that has an unpleasant or fishy smell, it could be caused by a bacterial infection, like bacterial vaginosis, or another STI, such as gonorrhoea.

Is genital herpes itchy?

Yes, genital herpes can be itchy, especially in the early stages of an outbreak. People commonly experience itching or tingling where blisters are going to form. The itching can be persistent and may feel like a mild rash or an insect bite. It’s important to avoid scratching the area as this can cause irritation and may worsen your symptoms.

Is genital herpes painful?

Yes, genital herpes outbreaks can be painful, especially if this is your first outbreak. The blisters and sores can cause a burning or stinging sensation, particularly if they are touched or come into contact with urine.

If you experience recurrent outbreaks, pain tends to lessen and become milder than the first one. Taking antivirals at the first sign of symptoms can also reduce the severity and length of an outbreak.

Genital herpes symptoms in men and women are generally similar, but women can experience more widespread and severe symptoms at first. Both can experience blisters, pain, itching, and tingling around the genitals as well as flu-like symptoms, but there may be some differences in the areas affected, as shown in the table below:

Anyone can be infected with the virus and have no symptoms at all, but are still able to pass it on to sexual partners. That’s why it is important to get tested as soon as you think you may have been exposed to the herpes simplex virus.

Genital herpes follows a cyclical pattern, with periods of active symptoms and times when the virus lies dormant in the body. Understanding the different stages can help you recognise an outbreak, manage the condition more effectively, and avoid passing it on to others.

1. Primary infection (first outbreak)

The first outbreak occurs after you have been exposed to the virus for the first time. It can occur 2 to 3 weeks after you have been infected and is usually the most severe episode, with symptoms lasting between 2 and 4 weeks. You may experience the following genital herpes symptoms during your first outbreak:

• tingling, burning, or itching in the genital area
• flu-like symptoms
• pain when going for a pee
• abnormal discharge or internal sores
• clusters of small, red bumps or blisters

However, some people may experience such mild symptoms or none at all that they do not realise they have been infected.

2. Dormancy

After the first outbreak has occurred, the virus will not leave the body, even if you have received treatment. Instead, it becomes dormant, hiding in your nerve cells near the base of your spine. During this time, you:

• will have no active symptoms or sores
• may get recurrent outbreaks later on if the virus reactivates

3. Recurrence

HSV can reactivate, leading to recurrent outbreaks. These flare-ups vary from person to person and can be triggered by factors, including:

• stress
• illness
• tiredness
• the menstrual cycle or other hormone changes
• weakened immunity

Recurrent genital herpes outbreaks tend to be milder than the initial infection, with fewer sores that often heal quicker. Early signs include tingling or itching just before sores develop.

The frequency of recurrent infections can vary, with some people getting an outbreak several times a year, whereas others may only get 1 or 2 outbreaks in their lifetime. If you keep getting outbreaks, your doctor may suggest preventative treatment.

You should see a doctor or visit a sexual health clinic as soon as possible if you think you have been exposed to HSV. For example, if you have had vaginal, anal, or oral sex with someone who has genital herpes or you have active symptoms. Alternatively, you can request a genital herpes home test kit from Superdrug Online Doctor for a quick and accurate diagnosis.

Although there is no cure for genital herpes, treatments are available to help shorten the length of an outbreak and even suppress future outbreaks.

The treatments for genital herpes are oral antiviral medications, which work by stopping the virus from growing and spreading. They are available on prescription at Superdrug Online Doctor and include:

Genital herpes is a common STI that’s caused by HSV, resulting in recurrent outbreaks of painful blisters and sores around the genital area. Common genital herpes symptoms include itching, burning, or tingling, painful urination, and flu-like symptoms.

Although there is no cure, you can request genital herpes treatment from Superdrug Online Doctor by completing a short online health questionnaire for one of our registered doctors to assess. Once approved, you can collect your treatment in as little as 2 to 3 hours from your local Superdrug Pharmacy or choose to have it sent to your address as early as the next day.