Symptoms of Genital Herpes
The symptoms of genital herpes vary widely from person to person. Genital herpes may cause painful and noticeable outbreaks for some individuals, while others experience no symptoms at all. This variability can make the condition difficult to recognise, and many people may unknowingly carry and transmit the virus without ever realising it.
Understanding the range of symptoms—both visible and invisible—is crucial for early detection, safe sexual health practices, and emotional reassurance. Symptoms can differ based on whether someone is experiencing a primary infection, a recurrence, or no outbreak at all.
Primary Infection: The First Outbreak
The first episode of genital herpes, known as the primary infection, is usually the most intense. It typically occurs within two to twelve days after exposure to the virus and can last anywhere from two to four weeks. During this period, the body has no existing antibodies to fight the virus, so the immune response tends to be more pronounced.
Common symptoms of a primary outbreak include:
Clusters of blisters or fluid-filled sores on the genitals, anus, inner thighs, buttocks, or surrounding areas
Pain or burning while urinating, especially in women
Itching, tingling, or discomfort in the area before the sores appear (known as a prodrome)
Swollen lymph nodes in the groin
Fever, chills, headache, or fatigue, mimicking flu-like symptoms
In women, vaginal discharge and internal sores may also occur
In men, sores may appear on the penis, scrotum, or urethral opening
The blisters eventually burst and crust over, forming scabs that heal without leaving scars. However, during this healing phase, discomfort can be significant, particularly when urinating or engaging in any physical activity involving the pelvic area.
Recurrent Outbreaks
After the first outbreak, the herpes virus retreats to the nerves and enters a dormant phase. From there, it can periodically reactivate, causing new outbreaks. These recurrent episodes are usually shorter and milder than the primary infection, often resolving within 3 to 10 days.
Symptoms of a recurrent outbreak may include:
Redness, itching, or mild tingling in the area
A small number of blisters or sores
Slight swelling or sensitivity
Occasionally, flu-like symptoms, though these are less common than during a primary outbreak
Some people may experience frequent recurrences, particularly in the first year after infection. Others may have one outbreak and never experience another. Recurrence frequency often decreases over time, and antiviral medications can help reduce both the number and severity of episodes.
Asymptomatic Shedding
A significant challenge in controlling genital herpes lies in asymptomatic shedding. This refers to the release of the virus from the skin or mucous membranes without any visible symptoms. It’s possible to transmit herpes to a sexual partner even when there are no sores, redness, or discomfort present.
Asymptomatic shedding is most common in the first year after infection and occurs more frequently in those who have regular outbreaks. However, it can also happen sporadically in long-term carriers of the virus who have never had a noticeable episode.
This means that relying on the absence of symptoms as a sign of safety is not effective. Using condoms and suppressive antiviral medication are more reliable strategies for reducing transmission risk.
Gender-Specific Symptoms
Although symptoms of genital herpes are broadly similar across sexes, the experience may differ slightly due to anatomical differences.
In Women:
Sores may occur internally, such as inside the vagina or on the cervix, making them harder to notice
More likely to experience burning during urination due to involvement of the urinary tract
May develop pelvic pain or vaginal discharge during outbreaks
In rare cases, sores can appear on the thighs, buttocks, or perianal area
In Men:
Sores are usually more visible, appearing on the shaft, glans, or scrotum
May experience pain in the urethra or difficulty urinating
Symptoms are often more localised but can still cause significant discomfort
Psychological Symptoms
Aside from physical discomfort, genital herpes can lead to intense emotional and psychological distress. People often report:
Feelings of shame, guilt, or embarrassment
Fear of rejection in romantic or sexual relationships
Concerns about disclosure to partners
Anxiety about recurring outbreaks or long-term health effects
These feelings can be especially pronounced following the first outbreak. It’s important to seek psychological support if needed—counsellors, online support groups, and sexual health clinics offer non-judgemental spaces to discuss concerns.
Complications from Symptoms
Although complications from herpes are rare, they can include:
Secondary bacterial infections of the open sores
Urinary retention, particularly in severe cases in women
Neonatal herpes, when the virus is transmitted to a baby during childbirth
Increased risk of contracting or transmitting HIV, due to breaks in the skin and mucous membranes
Symptoms of Genital Herpes
Recognising the symptoms of genital herpes early and seeking appropriate treatment helps reduce severity, limit transmission, and improve emotional wellbeing.
