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Genital Herpes

Vulva, Genital Herpes, Menopause Center Los AngelesGenital herpes is a sexually transmitted viral infection caused by the Herpes Simplex Virus. The most outward sign of a herpes infection is the red blisters that form on the genitals during a breakout. The blisters will appear at the site on your body where you made contact with the virus on an infected person.

Blisters or sores are caused by your body’s natural immune response, as it fights the infection. In addition to the genitals, lips, and anus, they may also affect the fingers, tongue, gums, eyes, and nipples.

How is the Herpes Virus Transmitted?

Genital herpes is usually transmitted through direct contact with active blisters or sores, most often during sexual activity. However, it also can be spread even if sores are not visible or present. The virus is able to pass through broken skin or the thin membranes of the genitals, urinary orifice, anus, or cervix.

Herpes can be passed from one part of the body to another, such as from the mouth to the genitals during oral sex. An infected person may also infect another part of his/her own body if he/she touches the sore and then touches another moist or vulnerable area of the body.

Symptoms of Genital Herpes

Most cases of herpes are asymptomatic, meaning there are no outward symptoms. Many people infected with the virus don’t know they have it. This is why herpes is easy to transmit and why it is one of the most common sexually transmitted infections.

Symptoms may appear anywhere from 2 days to 10 days after the initial infection. Some symptoms include:

  • Blisters – The clearest symptom of a herpes infection is the appearance of sores or blisters. Herpes blisters are small fluid-filled bumps that develop in clusters. They may cause a burning sensation, especially when urinating.
  • Swollen glands
  • Fever or chills
  • Nausea
  • Fatigue
  • Achy or sore muscles

What Happens During an Outbreak?

An outbreak of herpes is typically preceded by a prodrome – an early sign of the illness – which includes an itching or burning sensation on the area where the virus is present. You may also experience discomfort in your buttocks, lower back, thighs, or knees.

Within the next few hours, blisters will appear and may be accompanied by swelling or other flu-like symptoms. The symptoms will last 3-4 weeks, during which the blisters will rupture and seep fluids. You may feel itching, burning, or tingling on the affected area. In the next several days, the sores will crust over and eventually heal. Generally the sores won’t leave lasting scars.

The initial outbreak is generally the most uncomfortable, with subsequent outbreaks decreasing in severity.

Diagnosing Genital Herpes

There are three primary tests used to diagnose genital herpes. However, a negative result doesn’t necessarily rule-out herpes.

Cell culture

Your OB-GYN can swab a sample of an active sore and test it for the herpes virus.

PCR blood tests

This test is very accurate and can be conducted even if you do not have sores. It looks for traces of the virus’s DNA in your blood. It’s the most commonly performed test.

Antibody tests

This type of blood test looks for the presence of the specific antibodies your body produces to fight the virus.  The antibodies indicate that your body has been exposed to the virus.

Treatment for Genital Herpes

Unfortunately, there is no cure for genital herpes. Once you are infected with the virus, it stays in your body for life. However, there are ways to manage your symptoms and reduce the likelihood of transmitting the virus to your partner(s).

Oral medications

Your OB-GYN can prescribe oral antiviral drugs that will shorten the duration of a herpes outbreak and relieve some of the symptoms. Taking medications daily can prevent outbreaks and decrease the odds of transmitting the virus to a sexual partner. The three major drugs commonly prescribed are Zovirax (acyclovir), Valtrex (valacyclovir), and Famvir (famciclovir).

What about topical formulas?

There are some solutions available that can be applied directly to the skin.  Ask your physician if these treatments are appropriate for your particular case.

Preventing Transmission of Genital Herpes

Genital herpes can be carefully managed with safe sexual practices and medical treatment. If you and your partner are concerned about transmitting genital herpes, speak with your gynecologist about best practices.

If you start to experience prodromal or outbreak symptoms, abstain from sexual activities until a few days after the outbreak has completely healed. You or your partner will need to avoid any direct contact with the blisters and their fluid secretions. Thoroughly wash your hands with soap after touching, rubbing, or scratching the lesions. Do not touch any other skin, either yours or anyone else’s, immediately after touching a lesion.

Even if you are not experiencing an active outbreak, it is possible to pass the virus to a partner. Using condoms – male or female – can reduce your risk of transmitting genital herpes, but this is not a 100% effective method. Any incidental skin-to-lesion contact can transmit the virus.

How Does Genital Herpes Affect Pregnancy?

An infection of genital herpes can pose risks for your unborn baby, especially if it is your first outbreak. If an expectant mother is infected with the herpes virus during her third trimester, there is a 30-60% chance of transmitting the infection to the baby.

If you are pregnant, and if you or your sexual partner has genital herpes, you should talk with your gynecologist about prevention and treatment.


The baby can become infected during birth if it passes through the vaginal canal during an active outbreak in that region. However, this mode of transmission is rare. For a newborn baby, a herpes infection could cause serious health problems, such as eye infections or brain damage. There are medications available that can reduce the risk of transmission or the likelihood of an outbreak near your due date. If you do experience prodromal symptoms or an outbreak at the time of delivery, your doctor will likely recommend delivery via C-section.


Generally, a genital herpes infection should not prevent a woman from breastfeeding. The virus cannot be transmitted through breastmilk. However, if there are blisters on the nipple, the baby should not touch or nurse from that breast. Instead, use a pump or manually express the milk from that breast until the sore completely heals. If the part of the pump that touches the milk should brush against a sore, that breastmilk should be discarded.

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