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).