Do I Have Herpes and Not Know It?
Updated Dec 20, 2023. Medically reviewed by Rosanna Sutherby, PharmD. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.
Table of contents
- What Is Herpes and What Causes It?
- Is Asymptomatic Herpes Less Contagious?
- How Common is Herpes?
- Who Is Most At Risk for Herpes?
- Herpes Complications and Risks
- Herpes Diagnosis and Treatment
- Best Practices for Preventing Herpes
- Check Your STI Status with Everlywell
It might come as a surprise, but it’s possible to have herpes and not even know it. [1] In fact, many people with herpes don’t know they have this sexually transmitted infection (STI) because they don’t experience any symptoms. This is what’s known as asymptomatic herpes.
Herpes is just one of several STIs that can be asymptomatic, making regular testing a crucial part of any sexual care plan. Whether you’re currently concerned about your STI status or simply revising your approach to sexual well-being, understanding what herpes is, how it spreads, and how it’s diagnosed can help reduce the risk of transmission between you and your partners.
What Is Herpes and What Causes It?
Herpes is the second most prevalent STI in the US, affecting an estimated 18.6 million people. [1] It’s a viral infection caused by the herpes simplex virus, or HSV. [1]
Herpes is classed into two types:
- HSV-1 – HSV-1 typically causes cold sores or fever blisters that appear on the lips. This form of herpes spreads via skin-to-skin contact with an infected person. Sometimes, it can affect the genitals.
- HSV-2 – This is the most common cause of genital herpes, which can lead to symptoms like:
- Small blisters on the genitals
- Painful urination
- Swollen lymph nodes near the groin
HSV-2 is primarily contracted through sexual contact with someone who has it. Skin-to-skin contact with a herpes sore, infected saliva, or genital fluids can all lead to transmission. HSV-2 is highly contagious, regardless of whether your partner has open sores or obvious symptoms.
Herpes is one of several incurable STIs. After you’ve been infected with it, the virus doesn’t go away. Rather, it goes dormant between each outbreak. [2] Some people may experience a symptomatic recurrence multiple times a year, while others may go years between flare-ups. [2] In the case of asymptomatic herpes, you may not observe any symptoms at any point of your genital HSV infection, including during outbreaks.
Is Asymptomatic Herpes Less Contagious?
No—the herpes simplex virus type can still be transmitted even if your infection is asymptomatic. The myth that it’s not possible to contract asymptomatic genital herpes can be damaging for those who have it, as well as their intimate partners.
Fortunately, whether or not a herpes infection causes symptoms, the risk of transmitting the virus can be reduced by using condoms when having sex—especially if you’re not yet sure of your STI status. [2]
Herpes Symptoms
As with many other STIs, people who’ve contracted HSV-2 may not be aware of their infection status because they don’t have any noticeable symptoms. In cases where herpes does express symptoms, some infected people may notice [3]:
- Itching, pain, or tenderness around the genitals
- Small red bumps or white blisters
- Sores or ulcers that develop when blisters rupture, causing bleeding or “oozing” ulcers
- Scabs that develop as ulcers heal
The first herpes outbreak typically causes the most obvious symptoms (if any). If you notice symptoms, you’re likely to see them 2 to 12 days after you’ve been infected. [3]
During a first outbreak, you may notice flu-like symptoms such as [2]:
- Fever
- Headache
- Body aches
- Swollen lymph nodes (especially near the groin)
In most cases, symptoms become significantly less severe with each outbreak following the initial infection. Before the reappearance of sores in a recurring outbreak, symptomatic patients may notice:
- Burning, itching, or tingling where they first had the sores
- Pain in the buttocks, legs, and/or lower back
How Common is Herpes?
Both HSV-1 and HSV-2 are quite common. The World Health Organization reports that an estimated 67% of the global population has HSV-1 and 13% has HSV-2 infection. [4] However, many people don’t know they are infected.
Who Is Most At Risk for Herpes?
Women tend to have a higher risk of HSV-2, the most common cause of genital herpes, compared to men. This is because transmission of the herpes virus occurs more effectively from men to women than vice versa. Having multiple sex partners also increases one’s risk of getting herpes.
Herpes Complications and Risks
Every untreated STI has its own set of associated health hazards, particularly if the infections remain undiagnosed and untreated.
Herpes, including asymptomatic herpes, can advance to several health risks, including [3]:
- Inflammation – Both HSV viruses can trigger an inflammatory response inside the body, particularly in the sexual and urinary organs. For instance, you may experience difficulty urinating due to inflammation of the urethra (the tube that carries urine from your bladder).
- Other STIs – Genital herpes can make you more vulnerable to contracting other STIs. You are also more likely to have AIDs or HIV infection.
- Infected newborns – Pregnant individuals can pass herpes infection onto their babies during labor. This can put babies in danger of infection that targets their internal organs and nervous system.
In rare cases, the herpes virus can lead to more severe complications like herpes meningoencephalitis, an inflammation of the brain and spinal cord. [5] The infection can also affect the fingers, eyes, and other internal organs by transiting the bloodstream. [3]
The best way to avoid these complications is to practice safe sex and make screening for STIs a regular part of your sexual hygiene routine.
Herpes Diagnosis and Treatment
If you think you might have genital herpes, one of the best things you can do is to get tested as promptly as possible. You can make an appointment with your healthcare provider or a clinic in your area, or you can take an at-home STD test.
While there is no cure for either herpes type, healthcare providers can prescribe antiviral medication to reduce outbreak frequency and the severity of your symptoms, including [3]:
- Acyclovir
- Famciclovir
- Valacyclovir
Many medications can also minimize the risk of transmitting the herpes virus to someone else.
Because many STIs share overlapping symptoms, at-home testing can also clarify whether you have herpes or another STI. A telehealth provider can offer an evaluation alongside testing to help you arrive at a definitive diagnosis.
Best Practices for Preventing Herpes
The single most effective way to reduce your risk of herpes exposure is to use protection when engaging in sexual activity. Currently, the best defense is considered barrier methods of contraception, like latex condoms. [2]
If you or your partner is experiencing a herpes outbreak, it’s also important to consult your healthcare provider about when you may resume sexual contact with each other safely.
Check Your STI Status with Everlywell
If you have symptoms of genital HSV-2 or think you might have asymptomatic genital herpes, consider learning how to test for herpes to know for sure.
With CLIA-certified labs and physician-reviewed results, Everlywell helps make maintaining your sexual well-being more convenient and accessible. Get started by browsing the complete Sexual Health at-home test range today.
References
- Centers for Disease Control and Prevention. (2021, January 25). At a glance. Centers for Disease Control and Prevention. URL. Accessed December 18 2023.
- Centers for Disease Control and Prevention. (2022, January 3). Std Facts - Genital herpes. Centers for Disease Control and Prevention. URL. Accessed December 18 2023.
- Mayo Foundation for Medical Education and Research. (2022, November 22). Genital herpes. Mayo Clinic. URL. Accessed December 18 2023.
- World Health Organization. (n.d.). Herpes simplex virus. World Health Organization. URL. Accessed December 18 2023.
- Herpes meningoencephalitis. Johns Hopkins Medicine. (2019, November 19). URL. Accessed December, 18 2023.
Rosanna Sutherby, PharmD holds a PharmD and is a retail pharmacist who has worked in the industry for roughly 20 years. Sutherby has extensive knowledge about medications, diseases, and conditions, and knows how to confidentially educate patients. Sutherby also creates content revolving around anything in the medical sphere with a focus on conditions and articles. Her published work has appeared in Managed Healthcare Executive, Formulary Watch, and PsychCentral, and spans a variety of topics, including cardiovascular health, immunology, sleep disorders, mental health, alcohol and opioid use disorders, vaccine education, and medication use and safety.