Genital Herpes in Women (cont.)

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What are genital herpes symptoms and signs?

Symptoms of genital herpes are similar in men and women. Once exposed to the virus, there is an incubation period that generally lasts three to seven days before a lesion develops. During this time, there are no symptoms and the virus cannot be transmitted to others. An outbreak usually begins within two weeks of initial infection and manifests as an itching or tingling sensation followed by redness of the skin. Finally, a blister forms. The blisters and subsequent ulcers that form when the blisters break are usually very painful to touch and may last from seven days to two weeks. The infection is definitely contagious from the time of itching to the time of complete healing of the ulcer, usually within two to four weeks. However, as noted above, infected individuals can also transmit the virus to their sex partners in the absence of a recognized outbreak.

Specific signs and symptoms of herpes in women include tiny, fluid-filled blisters (vesicles) on the vulva and vaginal opening. When the vesicles rupture, painful ulcers are the result. In a majority of patients, inflammation of the cervix is involved (cervicitis). Cervicitis may be the only sign of genital herpes in some women. Women with genital herpes may have pain on urination along with infection and inflammation of the urethra (urethritis).

How is genital herpes diagnosed?

Genital herpes is suspected when multiple painful blisters occur in a sexually exposed area. During the initial outbreak, fluid from the blisters may be sent to the laboratory to try and culture the virus, but cultures only return a positive result in about 50% of those infected. In other words, a negative test result from a blister is not as helpful as a positive test result, because the test may be a false-negative test. However, if a sample of a fluid-filled blister (in the early stage before it dries up and crusts) tests positive for herpes, the test result is very reliable. Cultures taken during an initial outbreak of the condition are more likely to be positive for the presence of HSV than cultures from subsequent outbreaks.

There are also blood tests that can detect antibodies to the herpes viruses that can be useful in some situations. These tests are specific for HSV-1 or HSV-2 and are able to demonstrate that a person has been infected at some point in time with the virus, and they may be useful in identifying infection that does not produce characteristic symptoms. However, because false-positive results can occur and because the test results are not always clear-cut, they are not recommended for routine use in screening low-risk populations for HSV infection.

Other diagnostic tests such as polymerase chain reaction (PCR) to identify the genetic material of the virus and rapid fluorescent antibody screening tests are used to identify HSV in some laboratories.

Medically Reviewed by a Doctor on 12/2/2013

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