Genital Herpes in Men

Reviewed by Ruthann Cunningham, MD., July 7, 2017

Genital herpes is an infection caused by the virus HSV-2 (herpes simplex virus 2). HSV-2 infection can cause painful outbreaks in the genital region, but often has no symptoms. Herpes is a lifelong disease. It can be treated but there is no cure.

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About one out of nine men aged 14 to 49 years in the US has genital herpes, making it one of the most common STDs that affects men. This number only represents a small number of actual cases of HSV-2 in men, as nearly 90% of men with HSV-2 aren't aware of their infection because they don't have symptoms and it’s not routinely tested for like other STDs.

What are the common symptoms of genital herpes in men?

HSV-2 can cause painful blisters in the genital region, among other painful symptoms. More commonly, there are no symptoms. This makes it easier to transmit the disease between partners and more difficult to prevent the disease from spreading. Symptoms do not need to be present to spread the infection to a sexual partner. It’s easier for a male to infect a female partner than vice versa. All of these reasons make it important for males to get tested for the HSV-2 virus either yearly or periodically, depending on individual risk factors.

Most men discover they have HSV-2 only after they've experienced an outbreak of painful blisters in the genital region. This initial outbreak typically occurs within several days to weeks after exposure to the virus. The CDC reports that 90% of men with HSV-2 are not aware of their infection, and approximately 11% of the male population that is sexually-active carries the virus. Less than 40% of newly-infected males develop blisters during their initial outbreak. It is important to keep in mind that herpes can produce other symptoms that are commonly overlooked:

  • Abnormal sensations (irritation, itching, burning, tingling) in the genital region.
  • Flu-like symptoms (fever, fatigue, headaches and chills)
  • Pain with urination (due to blisters in the urethra)
  • Swollen, tender lymph nodes in the groin
  • Muscle aches and pains in the groin and low back

When these symptoms occur, typically within a couple of days of sexual intercourse, they can be a signal that HSV-2 has invaded the body and produced an infection. For men who have had outbreaks previously (and should be aware of their infection), these recurring symptoms are recognized as an "early warning" of an impending outbreak. However, for the majority of men who have never experienced an outbreak, these signs may be their only indication of infection.

It is important to tell your previous and future partners if you have herpes. Testing and knowing your status allows you to have a complete picture of your sexual health.

Is it possible to have any complications or long-term consequences with herpes infection?

Luckily for most otherwise healthy people, HSV-2 rarely causes any complications or long-term medical problems.

How is herpes in men spread?

Herpes is spread by genital-to-genital, skin to skin contact. This means that herpes can be transmitted when skin touches skin (even if an outbreak isn't present). Condom use can decrease the risk of spreading herpes but doesn't completely eliminate it.

What is required for herpes testing and how accurate is it?

Screening for herpes type 2 (HSV-2) is easy. It’s a simple blood test. Most men are just required to give a blood sample. The test detects HSV-2 whether or not you're having symptoms. Diagnosing and managing genital herpes can decrease the risk of spreading the virus to a partner.

What is the treatment for herpes in men?

The treatment for HSV-2 is antiviral medication, which is aimed at reducing the number, frequency, and severity of outbreaks. It can be taken daily (called suppressive therapy) or only when an outbreak occurs. It's not always necessary to treat herpes, but medication can be helpful to reduce the duration and severity of outbreaks, or to lessen the chance of transmission to a sexual partner who is negative for HSV-2.

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