We believe the images are helpful to understanding Sexual Health, but some images are graphic, and you may find them offensive.
Would you prefer to see images?


Genital Herpes (HSV 2)

The herpes simplex virus, or herpes, is categorized into 2 types: herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). HSV-1 is mainly transmitted by oral-to-oral contact to cause oral herpes (which can include symptoms known as “cold sores”), but can also cause genital herpes (through mouth to genital contact or vice versa).

HSV-2 is a sexually transmitted infection that causes genital herpes. Both HSV-1 and HSV-2 infections are life-long. An estimated 417 million people aged 15-49 (11%) worldwide have HSV-2 infection. Symptoms of herpes include painful blisters or ulcers at the site of infection. Herpes infections are most contagious when symptoms are present but can still be transmitted to others in the absence of symptoms.


  • Herpes is an infection that is caused by a herpes simplex virus (HSV). It is not present in the blood. People with genital herpes can still donate blood. Genital herpes is only passed through direct skin-to-skin contact, both orally and genitally.
  • Cold sores on the mouth or face are caused by Oral Herpes (HSV-1) and are commonly transmitted to the genitals (causing genital herpes) through oral to genital sex. Up to 40% of genital herpes is caused by Oral Herpes (HSV-1).
  • The herpes simplex virus passes moves through bodily fluids (saliva, semen, fluid in the female genital tract) or in fluid from herpes sores. The virus must have direct access to the non-infected person through injuries in their skin or mucus membranes (such as in the mouth or genital area).
  • Once the virus has contact with the mucous membranes or skin wounds, it begins to replicate. The virus is then transported within nerve cells to their roots where it remains inactive (latent) for some period of time. HSV 1 is commonly harboured in the trigerminal ganglion while HSV 2 is commonly harbored in the sacral ganglia. During inactive periods, the virus cannot be transmitted to another person. However, at some point, it often begins to multiply again without causing symptoms (called asymptomatic shedding). During shedding, the virus can infect other people through exchange of bodily fluids.

How common

Some studies show genital herpes infection is common in the United States. Nationwide, 45 million people ages 12 and older, or one out of five of the total adolescent and adult population, is infected with HSV-2. In the United States, HSV-2 infection is more common in women than in men. This may be because male to female transmission is more efficient than female to male transmission. HSV-2 infection is also more common in blacks (45.9%) than in whites (17.6%).  As for the world data, WHO estimated that 417 million people worldwide aged 15-49 years have HSV-2 infection.

Chances of being infected

Women are more likely to acquire HSV-2 from an infected male partner then men are from women. This is because the majority of the vagina is comprised of mucous membranes. Hence there is less exposed surface area on the male genitalia that is made of mucous membranes as compared to the vagina.

In average, an uninfected woman has the risk of transmission of 10% per year from infected partner, while an uninfected man has the risk of transmission of 4% per year from an infected woman. Those percentages represent what studies consider an ‘average’ sex life incorporating vaginal penetration over the course of one year’s duration.

How to detect if someone has it

genital herpes - detect

Small fluid-filled blisters and sores

The symptom of genital herpes is a cluster of small fluid-filled blisters and sores. Affected areas include the penis, scrotum, vagina, vulva, urethra, anus, thighs, and buttocks. But many people don’t get these sores. Some people have no symptoms at all, while others get symptoms that can be easily mistaken for razor burn, pimples, bug bites, jock itch, and hemorrhoids.


  • Prescribed antivirals – Valaciclovir (500 mg, once daily)

The International Herpes Management Forum (IHMF) recommends that physicians offer suppressive Valaciclovir therapy to immunocompetent individuals concerned about transmitting genital herpes to a heterosexual partner.  Valaciclovir was found to have reduced the risk of transmitting HSV-2 infection by 48%. Furthermore, Valaciclovir reduced the risk of clinical disease in the susceptible partner by 75%.

Condom effectiveness

Six studies on condom use suggested that people who used condoms 100% of the time had a 30% lower risk of contracting genital herpes. The reduction rate is still low compared with condom effectiveness against other virus diseases that’s transmitted through body fluid exchange such as HIV. According to UCSF, this might be because HSV sometimes present on genital skin with no symptoms that might prompt diagnosis and treatment. That also means HSV can be deposited on the condom’s outer surface from viral particles living on the scrotum, penile shaft not covered by the condom or vaginal/vulvar tissues.


There is no cure for genital herpes, but medication can help manage and reduce the severity of symptoms, and also reduce the frequency of recurrences.

Simple treatments to relieve the discomfort of genital herpes sores:

  • Avoiding stressfull conditions like strong sunlight and drugs that suppress the immune system might be of importance in preventing the eruption of HSV blisters.
  • Over the counter salt baths, used to wash the genital area, can clean, soothe and dry the sores. Use 1 teaspoon of salt in 600ml of water or a handful in a shallow bath.
  • Over the counter pain relievers include simple analgesics (such as aspirin and paracetamol), ice (which can be soothing if applied directly to the sores) and creams with an anesthetic component. Creams, however, can slow down drying and should therefore be used sparingly and only for pain relief.
  • Loose underclothes, preferably cotton (not nylon), can help minimize herpes discomfort and allow healing.

There are two types of therapy for genital herpes:

  • Episodic treatment – prescription drug

For fewer than six recurrent outbreaks of genital herpes in a year, patient may take a five-day course of acyclovir each time there’s a tingling or numbness before symptoms begin.

  • Suppressive treatment – prescription drug

For more than six recurrent outbreaks of genital herpes in a year, or if the symptoms are particularly severe and causing distress, patients may need to take acyclovir every day as part of a long-term treatment plan (can be for six to 12 months).

Best sources for more information

  • Herpes simplex virus


  • Genital Herpes Statistics


  • The Basics of Genital Herpes


  • Globally, an estimated two-thirds of the population under 50 is infected with herpes simplex virus type 1


  • Genital herpes


  • Treatment for Genital Herpes


  • Genital Herpes – CDC Fact Sheet (Detailed)


  • Preventing Sexual Transmission of Genital Herpes: Preventing HSV-2 Transmission


  • Condoms Help Cut Risk of Genital Herpes


The risk chart is the heart of this guide, and it can be found here

Leave a Reply

Your email address will not be published. Required fields are marked *