Although the cause is unknown, outbreaks are often associated with periods of weakened immune systems, skin wounds, menstruation, fever, nerve damage, tissue damage from surgery, or exposure to extreme climate situations. A genital herpes outbreak or episode occurs when the HSV-1 or HSV-2 virus is reactivated from its dormant stage. Genital herpes is an incurable disease, and once you contract it, you may experience outbreaks throughout your lifetime. Those who are experiencing their first herpes episode of genital herpes can expect to have several (typically four or five) outbreaks within a year. Over time these recurrences usually decrease in frequency and severity. The first outbreak of herpes is often the longest outbreak experienced. After that, short and inconsistent episodes can be managed and treated with antiviral medication.
You are not alone .... Yes take valtrex ....I take mine every day I found out in July and I didn't have outbreak like others on here have. I had my first experience just this week of going to bathroom and when urine hit the sore I almost passed out. It got better but now I an having awful lower back pain. I am taking it one day at a time. I am still learning all I can and a lot has been from this site. You have all on this site to support you. You really need someone besides this to talk to I will be on here so you have me to talk to I am old enough to be your Grandmother yep Grannys got it too .
Some people experience very mild genital herpes symptoms or no symptoms at all. Frequently, people infected with the virus don't even know they have it. However, when it causes symptoms, it can be described as extremely painful. This is especially true for the first outbreak, which is often the worst. Outbreaks are described as aches or pains in or around the genital area or burning, pain, or difficulty urinating. Some people experience discharge from the vagina or penis.

Worldwide rates of either HSV-1 and/or HSV-2 are between 60 and 95% in adults.[4] HSV-1 is more common than HSV-2, with rates of both increasing as people age.[4] HSV-1 rates are between 70% and 80% in populations of low socioeconomic status and 40% to 60% in populations of improved socioeconomic status.[4] An estimated 536 million people or 16% of the population worldwide were infected with HSV-2 as of 2003 with greater rates among women and in those in the developing world.[10] Rates of infection are determined by the presence of antibodies against either viral species.[81]

Until the 1980s serological tests for antibodies to HSV were rarely useful to diagnosis and not routinely used in clinical practice.[39] The older IgM serologic assay could not differentiate between antibodies generated in response to HSV-1 or HSV-2 infection. However, a glycoprotein G-specific (IgG) HSV test introduced in the 1980s is more than 98% specific at discriminating HSV-1 from HSV-2.[40]
Many HSV-infected people experience recurrence within the first year of infection.[14] Prodrome precedes development of lesions. Prodromal symptoms include tingling (paresthesia), itching, and pain where lumbosacral nerves innervate the skin. Prodrome may occur as long as several days or as short as a few hours before lesions develop. Beginning antiviral treatment when prodrome is experienced can reduce the appearance and duration of lesions in some individuals. During recurrence, fewer lesions are likely to develop and are less painful and heal faster (within 5–10 days without antiviral treatment) than those occurring during the primary infection.[14] Subsequent outbreaks tend to be periodic or episodic, occurring on average four or five times a year when not using antiviral therapy.
Herpesviral encephalitis and herpesviral meningitis Herpes simplex encephalitis (HSE) is a rare life-threatening condition that is thought to be caused by the transmission of HSV-1 either from the nasal cavity to the brain's temporal lobe or from a peripheral site on the face, along the trigeminal nerve axon, to the brainstem.[16][17][18][19] Despite its low incidence, HSE is the most common sporadic fatal encephalitis worldwide. HSV-2 is the most common cause of Mollaret's meningitis, a type of recurrent viral meningitis.

Prescription antiviral medications are also commonly used to reduce the duration, severity, and incidence of outbreak. These medications include (but are not limited to) valacyclovir, acyclovir, and famciclovir. Remember that these medications will not cure HSV-1 or HSV-2. Instead, they will help reduce the amount of time the outbreak is present, and help control the severity of symptoms.


That being said, if on paper the HSV titres are high, indicating a high viral load in the body, this can be an indicator of an impending flare. Knowing this, we can prescribe antiviral medications with the aim of suppressing the virus activity. The idea is that we reduce the viral load of HSV, therefore helping the body’s immunity better contain the virus.

'Using condoms or dams can help to protect against STIs, but herpes can also be passed on by skin-to-skin contact with the affected area, so it’s strongly recommended that you don’t have sex during this time,' she adds. 'This includes direct genital contact or skin-to-skin contact with the affected area, and doesn’t have to be penetrative sex,' says O’Sullivan.
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