Common Genital Herpes Symptoms in Women

What To Look Out for If You Think You Have This STI

Doctor comforting upset patient
PhotoAlto/Odilon Dimier/Getty Images

Genital herpes is a lifelong disease that causes painful outbreaks of blisters in the genital area. Both men and women can get the herpes simplex virus, but the pattern of infection is different.

Genital Herpes Transmission

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

Facts About Transmission Specific To Women

Women are approximately four times more likely to acquire a herpes simplex type 2 infection than men. Susceptible women have a higher likelihood of contracting genital herpes from an infected man than vice versa. In other words, if a non-infected man and woman each have intercourse with an infected partner, the woman is more likely than the man to contract a herpes simplex virus infection.

Why Women Are at Greater Risk with Genital Herpes

Women may be more susceptible to genital herpes infections because for two reasons. For one thing, women's genital area has a greater surface area of cells moist with body fluids (mucosal cells) than men. In addition to this, hormone 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 the First Genital Herpes Outbreak in Women Will Look 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 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.

In addition to 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.

Confusing Symptoms You May Notice

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

It is important that women with vaginal discharge or recurrent vaginal symptoms be tested for herpes.

Further Reading


CDC. "Sexually Transmitted Diseases Treatment Guidelines, 2006." Morbidity and Mortality Weekly Report. 55(2006): 16-20.

Habif, Thomas. "Warts, Herpes Simplex, and Other Viral Infections." Clinical Dermatology, 4th Edition. Ed. Thomas Habif, MD. New York: Mosby, 2004. 381-388.

Yeung-Yue, Kimberly. "Herpes simplex viruses 1 and 2." Dermatologic Clinics 20(2002): 1-21.

Continue Reading