Could I have genital herpes and not know it?

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Herpes Virus, artwork. David Mack/Science Photo Library/Getty Images

Question: Can you have herpes and not know it?

One of the most frequent questions I get is from people who want to know if it's possible to have herpes and not know it. Surprisingly, the answer is yes. In fact, it's quite common to have herpes and not know it!

Answer: Yes, you can have herpes and not know it. 

It may be difficult for some people to believe -- particularly for those people who have extremely painful herpes symptoms.

However, it is quite possible for a person to have genital herpes and not know it.

There are two ways that someone can have genital herpes without realizing they're infected.

  • They could have an asymptomatic infection. This means that they have an infection with no symptoms. Doctors believe that the vast majority of genital herpes infections never cause patients to have noticeable symptoms.
  • They may not recognize that the symptoms they're having are herpes symptoms. In other words, the symptoms are there but people attribute them to something else. They may think, for example, that they've just had rough sex. 

The Problem of Unrecognized Herpes

In recent years, several studies have been published which suggest that unrecognized genital herpes symptoms may be a significant problem. One found that as many as half of the people who have herpes without knowing it may actually be aware of their symptoms.

However, those people don't know the symptoms they are having are related to an STD infection.

This, to me, seems like an education problem. That's something which is very different from the problem of dealing with actually asymptomatic genital herpes infections. People with truly asymptomatic genital herpes have infections that are only detectable by a blood test .

(They may also be detected when they infect a sexual partner who develops symptoms.) That's a problem that no amount of education can solve. It's not about correctly identifying symptoms. It's about determining whether screening is worthwhile. 

It's undeniable that a person's awareness of their body is important. However, that's not enough. It's extremely difficult for someone to diagnose their own sexual health problems. For that reason, and many others, it's a good idea to talk to your doctor about STD screening. That's particularly true if you have recurrent genital pain or any other symptoms that might be related to an STD. Testing can help you make sure that nothing's wrong. In addition, if something IS wrong, then your doctor may be able to help you do something about it.

It makes me something of an outlier in the field. However, the combination of asymptomatic and unrecognized herpes infections is one of the reasons why I generally recommend regular herpes testing to certain populations.

Specifically, I recommend herpes testing for people with multiple partners and for people who are about to become intimate with a new sexual partner. In my opinion, t is far better to start a relationship with any risk information that you need than to not discover an infection until you're two years in,. That's something that can lead to unjustified accusations of infidelity and a prolonged lack of trust. It's much easier to have that information in advance. 

Note: It is not possible for someone to diagnose your STD over the Internet. Diagnosing an STD requires testing and/or a visit to a trained medical professional.

Sources:

Löwhagen GB, Berntsson M, Bonde E, Tunbäck P, Krantz I. Acceptance and outcome of herpes simplex virus type 2 antibody testing in patients attending an STD clinic--recognized and unrecognized infections. Acta Derm Venereol. 2005;85(3):248-52.

Sizemore JM Jr, Lakeman F, Whitley R, Hughes A, Hook EW 3rd. The spectrum of genital herpes simplex virus infection in men attending a sexually transmitted disease clinic. J Infect Dis. 2006 Apr 1;193(7):905-11. Epub 2006 Feb 27.

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