Genital Herpes Symptoms in Women

What to Look out for If You Think You Have This STI

A doctor talks with a patient.
A doctor talks with a patient. Caiaimage/Rafal Rodzoch/Getty Images

Genital herpes is a sexually transmitted infection (STI) that's lifelong and results in painful outbreaks of blisters in the genital area. It's caused by the herpes simplex virus. There are two types of the virus: They are called type 1 and type 2. Both men and women can get the herpes simplex virus, but the pattern of infection is different.

How You Get Genital Herpes

The herpes simplex virus is transmitted through close personal contact via the exchange of saliva, semen, cervical fluid, or vesicle fluid from active lesions.

You can get genital herpes through oral sex (if the someone has a cold sore in the mouth/lip area), vaginal sex, or anal sex. The virus generally does not infect the dead, keratinized cells in the epidermis. It must come in contact with mucosal cells or abraded skin to begin replication and infection. 

Why Women Are at Greater Risk

Women are approximately four times more likely to acquire a herpes simplex type 2 infection than men. Women may be more susceptible to a genital herpes infection for two reasons. For one thing, a woman's genital area has a greater surface area of cells that are moist with body fluids (mucosal cells) than men. In addition to this, hormonal changes during a woman’s menstrual cycle may affect the immune system, making it easier for the herpes simplex virus to cause an infection.

What an Outbreak in Women Looks Like

The first genital herpes outbreak is more painful and lasts longer than recurrent genital herpes outbreaks in both men and women.

However, women tend to have higher rates of complications during the first genital herpes outbreak.

In women, herpes lesions can occur anywhere in the genital area, including on the vulva, inside the vagina, on the cervix, and in the urethra. Herpes lesions can also occur in areas other than the genital area, such as on the buttocks and thighs.

These first lesions are infectious for an average of three weeks, longer than in men and longer than recurrences in women because the blisters contain a large number of infectious viral particles. So if you're experiencing an outbreak, take a temporary break from sexual activity so you don't spread the virus to others.

In addition to developing a rash in the genital area, women can also get swollen lymph nodes in the groin and experience a burning sensation with urination. Additional complications that come with the first outbreak in women include difficulty urinating and meningitis, an inflammation of the fluid surrounding the brain.

During recurrent infections, women may experience only irritation in the genital area without a rash.

Treating Genital Herpes

Though there is no cure for genital herpes, it can be treated, so make sure you see a doctor if you think you may have the condition. Taking an antiviral pill, for instance, may help prevent outbreaks as well as shorten their duration. 

Why It's Sometimes Misdiagnosed

A woman who has herpes lesions inside the vagina or on the cervix may have pelvic pain and discharge that may be misdiagnosed as a yeast infection, cervicitis (an inflammation of the cervix), or pelvic inflammatory disease.

Herpes lesions that involve the urethra may be misdiagnosed as a urinary tract infection or bladder dysfunction. For these reasons, it is important that women with vaginal discharge or recurrent vaginal symptoms be tested for herpes. A lab test can help a doctor make a diagnosis.