According to the the Centers for Disease Control and Prevention (CDC), genital herpes is a very common, very contagious virus that’s the No. 1 cause of genital ulcers worldwide. (1) In the U.S., approximately 25 percent of all adult women (about one in four, although some studies have found the rate to be much higher) and 20 percent of men (one in five) have genital herpes. And about 85 percent don’t even know it! (2, 3)
Because the herpes virus is sexually transmitted and incurable, a diagnosis of genital herpes can seem overwhelming and often causes a lot of shame and anxiety, in addition to cold sores that can sometimes be very uncomfortable. But the good news is that there are plenty of ways to lower your risk, help stop herpes from spreading and treat outbreaks.
What Are Genital Herpes?
A genital herpes infection is caused from the herpes simplex virus (HSV). There are two primary types of HSV that are responsible for the vast majority of genital herpes cases: HSV-1 and HSV-2. Once infected, someone with genital herpes develops skin sores/ulcers around their genitals and sometimes also feels other symptoms associated with having a virus — such as achiness, tenderness near the groin and fatigue.
The virus can live dormant inside a person’s immune system for a lifetime, periodically causing blisters that burst and turn into open sores or ulcers before healing. Both HSV-1 and HSV-2 infections are acquired from direct contact with someone who carries the virus.
The infectious secretions that pass on herpes live on oral, genital or anal mucosal surfaces. Herpes is a skin-to-skin transmission infection, but you don’t need to have sex to cause the virus to reach the genital track. Any form of intimate/skin-to-skin contact is capable of passing the virus, including contact with sores on the buttocks or mouth.
Research shows that the majority of patients with genital herpes have virtually no symptoms at all, aren’t aware that they have the virus and shed the virus in the genital tract before it causes discomfort. It’s also very common to experience a noticeable outbreak only one time and then for the virus to remain dormant and unnoticeable, sometimes for an entire lifetime.
How long does a herpes outbreak last? Everyone is different, but healing of “uncomplicated lesions” (those that are not very severe) usually takes about two to four weeks.
Genital Herpes Causes and Risk Factors
In the past, experts found that HSV-2 was responsible for causing most genital herpes infections, but today an increasing proportion of genital herpes infections are due to HSV-1, commonly thought of as “mouth herpes,” which only causes cold sores on the lips or mouth. Contrary to what most believe about herpes, HSV-1 doesn’t just affect membranes on the lips or inside the mouth — it can also be spread to the genital area. In addition, although it’s rarer, genital herpes can also be acquired from contact with cold sores on the eyes, secretions on the fingers, or ulcers/sores on buttocks and upper thighs.
Experts now believe that oral transmission (primarily due to transmitting HSV-1 from mouth to genitals) is the leading way that people are acquiring genital herpes for the first time, especially teens and young adults. About 50 percent of the new genital herpes infections in young adults are due to HSV-1 and about 40 percent in older adults.
In addition to engaging in oral sex, other risk factors include having any form of unprotected sex, having sex with multiple partners (since the infection rate is so high) and having certain other illnesses that lower immune function (such as HIV, an autoimmune disorder or hepatitis).
Genital Herpes Symptoms, Plus What Herpes Looks Like
Genital herpes affect everyone very differently, but here are some general facts about common genital herpes symptoms and signs:
- Usually the first genital herpes outbreak produces the strongest symptoms, and then symptoms from subsequent outbreaks (that reactivate the virus ) are milder. (4)
- A newly infected person with genital herpes experiences the first outbreak usually within 14 days of infection. Outbreaks are more common within the first year of infection and then tend to decrease substantially as time goes on.
- It’s possible to carry both HSV-1 and HSV-2, which might cause separate symptoms in different locations of the body, at different times.
- “Primary genital herpes” is the term for the first episode in an individual with no pre-existing antibodies to either type of herpes virus.
- A “non-primary first episode” is the term for someone having a first-time outbreak even if that person already has pre-existing antibodies to the other type of herpes virus (for example, he or she was infected with HSV-1 as a child and then becomes infected with HSV-2 as an adult).
What does herpes look like, and what does it feel like to experience an outbreak? Signs of symptoms of a genital herpes outbreak can include:
- Either a single cold sore or cluster of multiple cold sores (called vesicles) that form on the genitals, buttocks, upper thighs or near the groin. In primary outbreaks, sores can sometimes be severe, rupture and cause fluid to be secreted out.
- Cold sores might ulcerate (become exposed and painful), develop a white coating and burn for a period of time before healing.
- Around the cold sores, it’s common to feel pain, tenderness and other symptoms of a rash, such as redness or signs of swelling.
- In men, genital herpes sores/ulcers usually occur mainly on the base of the penis and around the surrounding area.
In women, sores usually occur on the vulva, vagina and cervix.
- Other symptoms of a viral infection that are similar to a cold or the flu. This may include fatigue, aches or a fever. Some people are able to tell before an outbreak if one is going to occur because they feel tingling, itchy sensations, irritable or other signs of getting sick.
- Unfortunately, a side effect of genital herpes caused by the HSV-2 virus is that in some people they develop a higher susceptibility to future viruses, including the HIV virus. The CDC has found that HSV-2 infection has been shown to double the risk of becoming infected with HIV through sexual transmission.
- Other complications, which are rare, include nerve damage (neuropathy) near the genitals, trouble going to the bathroom normally (urinary retention) and higher risk for acquiring meningitis.
Conventional Treatments for Herpes Simplex
Is herpes curable? Like most viruses, herpes cannot be fully cured, even with early detection and prescription medications.
Researchers characterize HSV by “lifelong infection and periodic reactivation,” although this doesn’t mean that every person with herpes will actually experience breakouts of cold sores throughout his or her life. How often someone has an outbreak, how severe the outbreak is, how contagious the person is and how long the sores take to heal all depend on someone’s individual immune response.
Conventional medical doctors often use certain medications and preventive measures to help keep genital herpes outbreaks to a minimum and lower their duration and severity when they do happen. These can include:
- Nucleoside analogues and antiviral medications, such as aciclovir, famciclovir and valaciclovir, which work to control outbreaks and reduce the risk of transmission but usually need to be taken daily (forever) and are not 100 percent effective
- Creams/ointment to help lower pain and inflammation near the site of sores
- Over-the-counter painkillers to reduce aches, tenderness or fever
- For pregnant women who develop herpes during the late stages of pregnancy, doctors also recommend C-sections to help lower the baby’s risk of catching the virus (5)
- Education on safe sex and limiting the risk of transmitting the virus is also usually discussed
Natural Treatments for Genital Herpes
1. Practicing Safe Sex
There’s no definitive cure for genital herpes (caused by either HSV-1 or HSV-2), which is spread through direct contact. The likelihood of transmitting the herpes virus to someone else is highest during an outbreak period whenever symptoms are present, but it’s also possible to spread the virus when someone is asymptomatic (don’t have any noticeable symptoms).
Avoid any type of sex or intimate contact if symptoms or sores are present (an ulcer, canker sore, swelling, etc.). If you’re infected, safe sex is crucial for protecting your partner; research shows that when partners avoid sex during active outbreaks, especially if they use condoms, there is a generally low risk of transmission (only 1 percent to 10 percent depending on the partner’s gender and medical history). (6)
That being said, there’s still always a chance that the virus can be spread, so there are no guarantees. According to the Journal of the American Medical Association, some research shows that most HSV-2 infections are actually acquired from people who didn’t know they had herpes and report having no history of symptoms. (7)
One of the reasons so many people don’t know they have genital herpes (up to 85 percent of those carrying the virus!) is because doctors rarely check for herpes when they perform standard STD checkups. Because up to 80 percent of people carry the HSV-1 virus, 30 percent carry antibodies of the HSV-2 virus and many people even carry both viruses, tests aren’t always able to reveal much useful information.
According to Columbia University, blood tests for herpes simplex virus type 2 (HSV-2) are available but aren’t always accurate. Tests can be used when someone is concerned about having been exposed to herpes from a partner, however the debate is still ongoing regarding how useful a blood test is for identifying someone’s risk of developing herpes symptoms. (8)
2. Improve Immune Function
Even when someone does become infected with genital herpes, symptoms depend on how strong that person’s immune system is.
Symptoms of genital herpes vary considerably depending how much “viral shedding” someone’s immune system performs, which means how quickly the body can fight off effects of the virus and overcome or prevent symptoms.
This is why many, many people are infected with either type of herpes virus (or both) but don’t show any signs or symptoms — because they develop a strong immune response early in life or after they became sexually active.
What are some ways you can improve overall immune function?
- Eat a healing diet low in processed foods but high in anti-inflammatory foods loaded with vitamins, minerals, essential fatty acids and antioxidants.
- Avoid smoking or using drugs.
- Exercise regularly.
- Manage stress and get enough sleep.
- Limit or avoid use of antibiotics and unnecessary medications to avoid antibiotic resistance.
- Limit exposure to toxic chemicals in packaged foods, chemical cleaners, or synthetic beauty and household products.
3. Antiviral Herbs
Certain herbs naturally act as “suppressive antiviral therapies,” which can help lower the odds of becoming infected with HSV in the first place or of experiencing recurring outbreaks. Antiviral herbs inhibit the development of viruses, help treat infections, and usually cause no or very few side effects. In fact, they have multiple benefits in addition to boosting the immune system, helping lower inflammation and allowing the body to attack viral pathogens more quickly. Antiviral herbs, and antioxidants, that can help you manage genital herpes include:
- Astralagus root: A 2004 study found that astragalus helped decrease symptoms of herpes simplex virus type 1, and it’s also been shown to have antibacterial and anti-inflammatory properties used on the skin for wound care
- Burdock root
- A multivitamin that includes vitamin C, zinc and vitamin D
- Adaptogen herbs: These include ashwagandha, maca, medicinal mushrooms and rhodiola to help lower aches, fatigue, stress and low immune function
- Omega-3 fatty acids to lower inflammation
- Some research shows the amino acid lysine can also lower herpes symptoms
4. Reduce Pain and Improve Healing Time Naturally
When a genital herpes outbreak occurs, some of the ways you can help lower pain from sores include:
- Only use natural, mild soap and warm water on sores. This reduces irritation. Avoid adding anti-itch creams, vaseline, salves or other products that can worsen swelling.
- Press a warm towel against the affected area to decrease pain, or sit in a warm bath or shower to let the heat reach the area where it hurts. Some people also use a blow dryer on a low setting to apply heat directly to the area for several minutes at a time.
- Wear comfortable, loose-fitting clothing to allow air to get to the sores.
- Use a separate towel on your genitals near any open sores than you would use on your mouth. You can transmit the virus from one location of your body to another, but this limits the likelihood.
- Try not to touch any open sores during an outbreak or beforehand. Wash your hands each time you do.
Facts and Statistics About Genital Herpes (Herpes Simplex Virus)
- Genital herpes is the most common viral form of STD in the world, affecting more than 536 million people worldwide.
- Rates of genital herpes have been increasing steadily in both underdeveloped and developed nations. In the U.K., there has been at least a 15 percent increase in the number of diagnoses in the past decade, and the prevalence of genital herpes in developing countries is up to 75 percent of the total population depending on the country.
- In the U.S., an estimated 40 million to 60 million people are infected with HSV-2. Up to 800,00 new/first-time clinical cases of HSV-2 are diagnosed each year.
- Genital herpes can be spread from HSV-1, which usually causes cold sores on the mouth and affects both children and adults. About 50 percent to 80 percent of all Americans have oral herpes (HSV-1).
- Genital herpes increases the risk of HIV infection and makes both viruses easier to transmit. In some African countries, around 70 percent of people have the genital herpes virus, adding to the HIV/AIDS epidemic.
- 85 percent of people with genital herpes don’t know they have the virus, since approximately 60 percent of infected people don’t show any symptoms.
- People infected with genital herpes experience four to five outbreaks per year on average, but some only experience one to two outbreaks in the course of their whole lives.
- People experiencing an active genital herpes outbreak have at least double the chances of spreading the virus compared to those who are infected but not showing symptoms. When an outbreak isn’t occurring, there is a 4 percent to 10 percent chance of transmitting the virus.
Genital Herpes vs. Other Sores (Genital Warts, HPV, Pimples & Shingles)
Is it herpes or something else? How can you tell if sores/ulcers you’ve developed are related to HSV-1 or HSV-2 and not caused by other common conditions? (9)
- Genital warts are caused by the human papilloma virus (HPV). There are believed to be more than 70 types of HPV, which is very is common in both men and women and also very contagious. Like herpes, there is no definitive cure for HPV.
- Genital warts usually develop on the walls of a woman’s vagina or cervix, on a man’s penis and near the base of the groin, or in the anus. They can spread to the scrotum, thighs, lips, mouth, tongue, throat and hands. Most warts are white, and some have a raised “cauliflower top.”
- Just like with herpes, someone without visible warts or symptoms can still spread HPV. The virus can stay dormant for years before producing warts. Sometimes in addition to warts, HPV symptoms can include abnormal vaginal odor or discharge, vaginal bleeding during sex, itching, and dampness. Symptoms of warts usually take several weeks to fully heal.
- Shingles is also caused by a virus that causes skin sores/bumps. The virus that causes shingles is called HHV3 (known as varicella zoster virus or VZV, which also causes chickenpox). There are actually eight types of herpes human viruses (HHV): HSV1-, HSV-2 and HHV3 are three of the eight. VZV first causes chickenpox when someone becomes infected (usually as a child) and can then lay dormant in someone’s system until it causes shingles later in life. HHV3 cannot turn into genital herpes or cause the herpes virus to be spread. (10)
- Pimples or other signs of acne can also form near the genitals and be painful, but are very different than genital herpes because they’re not caused by a virus. Pimples near the genitals can be caused from bacteria, an ingrown hair, a dirty razor when shaving or from other types of irritation. Pimples are not contagious and usually go away within about one week.
Precautions Regarding Genital Herpes
- When it comes to preventing transmission of herpes, experts recommend you think of “safer sex” rather than “safe sex.” Sex is never entirely safe, and condoms reduce the risk of transmission by about 50 percent but not 100 percent.
- Make sure to use protection consistently, get tested if you suspect you have the virus and avoid sex during outbreaks. Talk to your partner about any concerns, but remember that just because someone is absent of symptoms doesn’t mean that person is necessarily free from the infection.
- Keep in mind that acquiring genital herpes doesn’t mean you will suffer from outbreaks your whole life. Many people do not.
- Use condoms for reasons other than to prevent herpes (such as preventing pregnant and HIV transmission), and keep up with regular doctor visits for screenings.
- If you have an outbreak that’s very painful and doesn’t resolve within two weeks, visit a doctor to get checked for other similar viruses.
Final Thoughts on Genital Herpes
- Genital herpes is a common sexually transmitted disease) caused by the HSV-1 or HSV-2 viruses, which causes breakouts of skin sores or ulcers.
- The greatest risk for becoming infected with genital herpes is having unprotected sex, especially with someone who is experiencing an active outbreak.
- Herpes cannot be cured, but natural treatments can help control symptoms and lower pain from breakouts. Treatments include practicing safe sex, taking antiviral herbs, boosting immune function and warming the affected area to lower pain.