There is a range of signs and symptoms experienced by patients with herpes simplex virus (HSV-2) infections. The classic presentation of genital herpes—a cluster of small vaginal sore, painful blisters, which ulcerate, crust, and heal—occurs only in approximately 20% of seropositive individuals. According to data from the third National Health and Nutrition Examination Survey (NHANES III), many HSV-2 infections are asymptomatic.
HSV-2 Seroprevalence by Age and Race/ Ethnicity
In about 60% of cases, very small blisters or ulcers, or lesions that are located internally, are not recognized by healthcare professionals as genital herpes. In addition, patients with genital herpes often present with a wide range of nonclassic symptoms such as:
* Genitourinary itching, burning, or soreness with or without pain
* General fever, myalgia, and malaise
* Dysuria and back pain
* Genital discharge
* Proctitis and rectal discharge
* Vulvar, penile, and anal fissures
* Internal lesions
* Perianal lesions
* Nonspecific vulvar erythema
* Genitourinary pain without other symptoms
* Redness on buttocks/thighs
* Aching lower limbs
Research has shown that pain, burning, and itching are among the symptoms that frequently drive patients with genital herpes to seek treatment. Many patients are unaware of the symptoms of genital herpes—both classic and nonclassic. Some women may believe that the symptoms of genital herpes they are experiencing are part of their menstrual period, a yeast infection, a bad urinary tract infection, or razor burn. Many men believe that they may have a vaginal sore jock itch, friction burn, a cut, or allergies. Due to this lack of awareness of genital herpes symptoms, many patients will self-treat with over-the-counter medications and natural remedies instead of seeking treatment. Additionally, the fact that symptoms may appear and then resolve on their own makes this disease challenging for healthcare professionals to diagnose. This also indicates that patients may not present with a primary (initial) infection, seeking medical care only after experiencing a recurrence of symptoms.
