Women and genital herpes

Genital herpes in women is more common than in men (by approximately twice as much, actually). In the United States from ages 14-49 years old, 20% of women have genital herpes while only 11% of men (download the ebook). The average of all Americans who have herpes is 14-49 years old is 16%. There is more of a chance of a male passing genital herpes to a female than female-to-male because vaginas have more mucous membrane than penises. Interestingly, there is a wide variation when race is taken into consideration. Specifically, 48% of black women have genital herpes; overall, 39% of blacks are infected compared to about 12 percent for whites, the CDC said. (Reuters).

What about herpes and pregnancy?

If you get pregnant and have had herpes for longer than a year, then your body has built up a lot of immunity to the virus. This means there is less viral shedding and less chances of outbreak. You can't spread herpes to your baby internally (blood, amniotic fluid, etc.), so the only aspect to pay attention to is minimizing the chance of having a herpes outbreak while you are having a vaginal delivery (since herpes is passed via skin-to-skin contact). There are some rare cases where herpes has created complications in childbirth, but for the vast majority of women, childbirth with herpes doesn't complicate things. From ASHA: "... the evidence to date suggests that acyclovir does not carry increased risk of birth defects or adverse pregnancy outcome. On the strength of this data, the use of daily, suppressive treatment during the last month of pregnancy is becoming increasingly common." The best course of action is to get on daily suppressive herpes medication as the due date approaches. And if an outbreak occurs, then a C-section will be the administered.

Frequently asked questions

Can your menstrual cycle trigger herpes outbreaks?+
Yes, many women report that their outbreaks are connected to their menstrual cycle. Hormonal fluctuations around menstruation can weaken the local immune response and trigger an outbreak. This is one of the most commonly reported triggers among women with genital herpes. If you notice a pattern, talk to your doctor about taking suppressive medication or timing episodic treatment around your period.
Can I have a healthy pregnancy and baby if I have herpes?+
Yes. The vast majority of women with herpes have healthy pregnancies and deliver healthy babies. Your doctor will typically prescribe daily suppressive antiviral medication starting around 36 weeks to reduce the chance of an active outbreak at delivery. If you do have an outbreak when you go into labor, a cesarean section may be recommended to protect the baby.
Does herpes affect fertility or make it harder to get pregnant?+
No. Herpes does not affect fertility in women or men. It does not damage reproductive organs or interfere with conception. The main considerations around herpes and pregnancy are managing outbreaks during delivery and communicating with your OB/GYN so they can create the right care plan for you.
Should I see a gynecologist or a dermatologist for genital herpes?+
Either can diagnose and treat herpes, but a gynecologist is typically the best choice for women with genital herpes because they can also address related concerns like pregnancy planning, menstrual-cycle triggers, and birth control interactions. If you're experiencing frequent or unusual outbreaks, a dermatologist or infectious disease specialist can also provide expertise.