Genital Herpes: Symptoms, Diagnostic Testing & Treatment

Updated in February 2023

Symptoms of genital herpes usually emerge within 10 to 15 days after initial exposure to the herpes virus. It is generally transmitted through direct, unprotected sexual contact with a person with active, open sores on the mouth, anus or genital region.

Initially, the virus will cause weakening of the immune system and symptoms can be flu-like, with many patients presenting with a low-grade fever, chills, headache, general malaise, loss of appetite, muscular pain and fatigue. More specific symptoms, like open sores and pain, follow soon after.

Genital herpes is a common sexually-translated infection that will persist chronically. Having protected sex and ensuring regular STI checks with sexual partners will help to reduce your risk of contracting these lesions. 

Sensitive content
This file may contain unpleasant images that are not suitable for all audiences.
Imagem ilustrativa número 2

Common symptoms 

Genital herpes mainly affects the penis, vagina and anal area, but it can also occur in the urethra or cervix. The most common symptoms include:

  • Small clusters of blisters and lesions in the genital area that eventually rupture and become open sores,
  • Redness in the area;
  • Itching and discomfort;
  • Burning when urinating if the blisters are near the urethra;
  • Pain;
  • Burning and pain when you defecate, if the blisters are near the anus;
  • Lumps in the groin.

Before the blisters appear, some people can develop warning symptoms such as discomfort or burning with urination. Some people develop mild itching or tenderness in the genital region. These warning symptoms do not always happen, but when they do, they may develop a few hours or even days before the blisters appear.

Diagnostic testing 

Diagnosis is usually confirmed via an assessment by a health care professional and lab testing. The doctor will first review your symptoms and sexual health history, and then visually inspect the blisters. During this assessment, the doctor will likely swab the area to collect a cellular specimen for testing in a laboratory. The doctor may additionally order blood work to confirm the presence of the virus in your bloodstream. 

Treatment options

The treatment of genital herpes should be monitored by your family doctor or gynecologist. The virus can enter into remission, in which no symptoms or open sores are present, and likelihood of transmission is low. During this time, treatment is not always necessary. 

However, flare-ups will cause the virus to become active, resulting in sore and pain. Patients will often seek treatment during flare-ups to relieve discomfort. The gold standard for flare-ups is treatment with oral antivirals, like acyclovir or valacyclovir pills. Antiviral ointments applied directly on the lesions can also help with preventing complications, decrease the rate of virus replication (or virus shedding), and reduce flare-up times. Some doctors may prescribe low doses of antivirals prophylactically to reduce the risk of transmission. 

To help decrease pain, the doctor may recommend the use of local anesthetic ointments or gels, such as lidocaine or xylocaine. These can help keep the skin moisturized while numbing the affected area.