What’s the first image that comes to mind when you think of herpes?
For doctors, it’s a rose. (Yes, the beautiful flower.)
“The classic description of genital herpes is ‘dew drops on a rose petal,’” says Peter Leone, M.D., an adjunct professor of medicine at the UNC School of Medicine. “You get these little blisters on a red base that hurt—and if you have that, the probability that you have herpes is pretty high.”
The problem is that most people with genital herpes don’t have any symptoms. Herpes is a super-common STD, and according to the Centers for Disease Control and Prevention, more than one in every six people has it. They just probably don’t know it.
Genital herpes spreads through skin-to-skin contact and is caused by two types of viruses: herpes simplex virus type 1, or HSV-1, and herpes simplex virus type 2, or HSV-2. The kind you have matters because it determines how you’ll be treated.
Herpes isn’t curable, but don’t freak out: It’s totally possible to manage it with the help of antiviral medications or daily suppressive therapy, and yes, you can still have a normal sex life.
Most doctors don’t test for herpes unless a woman is showing symptoms, and since that’s probably not going to happen, it’s one reason why so many people never know they have it.
In the U.S., 87.4 percent (!) of infected 14 to 49 year olds with HSV-2 have never been diagnosed, according to the CDC.
But if you’re curious or worried, stand your ground. “Women have a right to be proactive about this—it’s very easy for clinicians to be dismissive about the concern around herpes,” Leone says. “Don’t take no for an answer if you want to know your status.”
There are the most common herpes symptoms in women:
1. PIMPLES—AND NOT ON YOUR FACE
Well, at least it’s not as obvious as a big zit on your forehead? These tiny blisters don’t always occur, but when they do, there’s a good chance you have genital herpes. Like any miserable pimple, they eventually crust over and scab, says Jennifer Berman, M.D., a co-host on The Doctors. “It’s not necessarily on the genital area—sometimes it’s in the crease of the underwear or closer to the buttock,” she says.
2. A TINGLING SENSATION
It’ll be all over the affected area: your genitals, butt, or thighs. Tingling is one of the first symptoms of herpes in women, so if you just feel weird down there, take note, says Leone.
3. IRRITATION OR ITCHING IN YOUR LADY PARTS
“Sometimes women ignore this because they’ve been exercising or wearing yoga pants, and they just assume the itching or irritation is from wearing tight clothing,” Berman says. In reality, that sensation is often a symptom of genital herpes in women.
4. A FLU-LIKE FEELING
Blah. About 70 percent of women feel like they have the flu, with a headache, muscle aches, fever, and swollen glands during their first herpes outbreak, according to the University of Maryland Medical Center. Of course, you might actually just have the flu (congrats?), which is why it’s always good to get checked out.
5. A DULL, ACHING PAIN IN YOUR PELVIS
If you’re spotting between periods, grimacing during sex (never good), or noticing weird-for-you discharge, you might have cervicitis—a fancy way of saying your cervix is inflamed. It’s caused by a number of STDs, including herpes, and will go away when the underlying infection is treated, says Berman.
6. PAINFUL PEE
When pee splashes on a herpes ulcer or blister, it can burn, according to the Mayo Clinic. That’s just not pleasant, so get to a doctor and find out what’s wrong.