Genital Herpes (HSV-2 infection)
What is Genital Herpes (HSV-2 infection)?
Genital herpes is a common sexually transmitted infection caused by herpes simplex virus type 2, or HSV-2. The virus enters the body through small breaks in the skin or mucous membranes during sexual contact. Once inside, it travels along nerve pathways and stays in the body for life.
HSV-2 causes 70 to 90 percent of genital herpes cases. After the first outbreak, the virus becomes dormant in nerve cells near the spine. It can reactivate later, causing new outbreaks. Many people with HSV-2 have mild symptoms or no symptoms at all, which is why the infection often goes undetected.
About 1 in 6 Americans aged 14 to 49 have genital herpes. The infection is more common in women than men. While there is no cure, antiviral medications can reduce outbreaks and lower the risk of spreading the virus to partners.
Symptoms
- Painful blisters or sores in the genital area, buttocks, or thighs
- Itching or tingling in the genital area before blisters appear
- Painful urination when urine touches open sores
- Flu-like symptoms during the first outbreak, including fever and body aches
- Swollen lymph nodes in the groin
- Headache and fatigue during outbreaks
- Recurrent outbreaks that are usually shorter and less severe than the first
Many people with genital herpes have no symptoms or very mild symptoms that go unnoticed. The first outbreak is typically the most severe. After that, outbreaks tend to decrease in frequency and intensity over time.
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Causes and risk factors
Genital herpes spreads through skin-to-skin contact during vaginal, anal, or oral sex with someone who has HSV-2. The virus sheds from the skin even when no visible sores are present, which is called asymptomatic shedding. This means you can get or transmit herpes without knowing it. People are most contagious during active outbreaks, but transmission can happen at any time.
Risk factors include having multiple sexual partners, starting sexual activity at a young age, having another sexually transmitted infection, and having a weakened immune system. Women are more likely to get HSV-2 than men because the virus transmits more easily from men to women. People with HSV-2 are also at higher risk for contracting HIV if exposed.
How it's diagnosed
Doctors diagnose genital herpes through physical examination of sores and laboratory testing. During an active outbreak, a healthcare provider can swab a blister or sore and send it to a lab for testing. This swab test can confirm whether HSV-2 or HSV-1 is causing the infection.
Blood tests detect antibodies your immune system makes in response to the virus. HSV-2 IgG antibody testing shows whether you have been exposed to the virus, even without symptoms. Rite Aid offers HSV-2 IgG testing as an add-on to our blood test panel at Quest Diagnostics locations. A positive result means you have HSV-2 antibodies, indicating past or current infection.
Treatment options
- Antiviral medications like acyclovir, valacyclovir, or famciclovir to shorten outbreaks and reduce frequency
- Daily suppressive therapy with antivirals if you have frequent outbreaks or want to reduce transmission risk
- Over-the-counter pain relievers like ibuprofen or acetaminophen for discomfort
- Keeping sores clean and dry to promote healing
- Avoiding sexual contact during outbreaks to prevent transmission
- Using condoms consistently, though they do not provide full protection since HSV-2 can shed from areas not covered
- Managing stress, getting enough sleep, and eating well to support immune function and reduce outbreak frequency
- Talking openly with sexual partners about your status
Need testing for Genital Herpes (HSV-2 infection)? Add it to your panel.
- Simple blood draw at your nearest lab
- Results in days, not weeks
- Share results with your doctor
Frequently asked questions
No, there is no cure for genital herpes. Once you have HSV-2, the virus stays in your body for life in a dormant state. However, antiviral medications can control symptoms, reduce outbreak frequency, and lower the risk of transmission. Many people have only a few outbreaks or none at all after the first year.
HSV-2 IgG blood tests are very accurate when performed at least 12 to 16 weeks after potential exposure. The body needs time to produce detectable antibodies. Testing too early can result in a false negative. A positive HSV-2 IgG result is highly specific and confirms you have been infected with the virus.
Yes, many people with HSV-2 have no symptoms or such mild symptoms they do not notice them. Studies show that most people with genital herpes are unaware they have it. The virus can still be transmitted even when no symptoms are present through asymptomatic viral shedding.
Outbreak frequency varies widely from person to person. Some people have frequent outbreaks in the first year, while others have only one or two ever. On average, people with HSV-2 have 4 to 5 outbreaks in the first year. Outbreaks typically become less frequent and less severe over time.
Yes, stress is a common trigger for genital herpes outbreaks. When you are stressed, your immune system weakens, allowing the dormant virus to reactivate. Other triggers include illness, fatigue, menstruation, sun exposure, and surgery. Managing stress through sleep, nutrition, and relaxation techniques may help reduce outbreaks.
No, they are typically caused by different viruses. Genital herpes is usually caused by HSV-2, while cold sores around the mouth are usually caused by HSV-1. However, either virus can infect either location through oral-genital contact. HSV-2 rarely causes oral infections and tends to recur more often in the genital area.
Yes, but transmission during childbirth is rare. The highest risk occurs if you get your first HSV-2 infection late in pregnancy. If you have genital herpes, tell your doctor so they can monitor you and consider antiviral medication near your due date. A cesarean delivery may be recommended if you have active sores during labor.
Testing without symptoms depends on your situation. If you have a new partner, multiple partners, or a partner with herpes, testing can be helpful. Some doctors do not recommend routine screening for everyone because it can cause anxiety and positive results do not change management much for people without symptoms. Talk to a healthcare provider about your specific risk factors.
Condoms reduce the risk of HSV-2 transmission but do not eliminate it completely. The virus can be present on skin not covered by a condom, such as the thighs, buttocks, or scrotum. Studies show condoms reduce transmission risk by about 30 to 50 percent. Using condoms plus daily antiviral medication provides the best protection.
Genital herpes does not weaken your overall immune system like HIV does. However, having HSV-2 increases your risk of getting HIV if exposed because the sores create breaks in the skin. If you already have a weakened immune system from another condition or medication, you may have more frequent or severe herpes outbreaks.