Genital herpes is a sexually transmitted disease caused by the herpes simplex virus (HSV), which is in the same family of viruses that causes chickenpox, shingles and mononucleosis. There are two types of HSV. HSV 1 infects approximately 80% of the U.S. population and typically manifests on the lips in the form of cold sores. HSV 2 refers to genital herpes and is typically found in the genital area. It is possible to spread HSV 1 to the genital area through oral sex. Likewise, HSV 2 can be transmitted to a person’s mouth or lips through oral sex.
Immediately after the virus is contracted, there is a genital herpes incubation period, which refers to the time between contracting the virus and the first sign of a symptom. This is typically two to twenty days. For some people, symptoms are never visible, so it is hard to identify when the genital herpes incubation period is over. For most people, the first outbreak is the most severe and the most painful. Symptoms typically include sores or lesions, to appear in and around the vaginal area and within the cervix in women, and on the penis and scrotum in men. It is possible to develop lesions in the urinary tract, around the anal opening, and on the buttocks or thighs of both men and women.
Once HSV has infected an individual and during the genital herpes incubation period, the virus travels through the nervous system and settles at the base of the spine. When there are no outbreaks or other symptoms of herpes, the virus is considered dormant. It is common for the virus to later “wake up,” travel the nerve paths to the surface of the skin, and cause another outbreak. Periods of outbreak are typically a highly contagious time and sex should absolutely be avoided.
Another period of increased contagiousness is during shedding. Shedding can occur anytime after the genital herpes incubation period and can be asymptomatic (no symptoms are present and an individual will likely not know they are shedding). During these shedding periods, small amounts of the virus are present on the skin, often at the place of first infection. This reactivation without symptoms may also occur in rectal tissue or in fluids from the penis and vagina. It is believed that people with HSV-2 genital herpes tend to have more shedding than those with HSV-1. Also, people with new infections are more likely to shed the virus than those with an infection more than a year old.
