Many people who have genital herpes experience no symptoms. If symptoms appear during the first outbreak, however, they can be severe. Symptoms may appear within days of contracting the virus, or it may take weeks, months or years. The first outbreak usually occurs within two weeks after the virus is transmitted and typically lasts two to three weeks.

Early symptoms (prodromal phase) of an outbreak may include itching or burning in the genital or anal area. Other early symptoms may include:

• Fever, muscle aches, swollen glands and other flu-like symptoms
• Pain in the legs, buttocks or genital area
• Vaginal discharge
• A feeling of pressure in the area below the stomach

Within a few days, sores appear near where the virus entered the body, such as the mouth, vagina or penis. They can also occur inside the vagina and on the cervix in women and in the urinary passage (urethra) in men.

The sores appear as small red bumps that may become blisters or painful open sores. Over time, the sores crust over and usually heal without scarring within two to 12 days.

Later symptoms may include those listed above, as well as:

• Headache
• Painful urination (dysuria)
• Swollen glands in the genital area

Some people experience mild symptoms that are often mistaken for insect bites, yeast infections, razor burn, ingrown hairs or hemorrhoids. In fact, the American Social Health Association estimates that as many as 90 percent of people with genital herpes are unaware that they have it.

Because the virus remains in the nerve cells, people with genital herpes can have future outbreaks. Most people who experience a first episode of genital herpes have several more within a year, although symptoms tend to be less severe and last only a week.

The frequency of outbreaks experienced by people with genital herpes over the course of a lifetime varies. Some people have one outbreak and never experience another. Some have outbreaks several times a year. According to the American Social Health Association, the average number of outbreaks is four to five a year. In general, the frequency of outbreaks tends to decrease over time.