Symptoms of genital herpes infections in both primary and recurrent outbreaks tend to be more severe in women than in men.

Primary infection of genital herpes (First-time outbreak)

The primary outbreak of genital herpes is the first infection with HSV. The incubation period lasts approximately 2-10 days after contact. It tends to last longer time and be more severe than the subsequent (recurrent) outbreaks. Symptoms of a primary outbreak might include:
* Flu-like symptoms, such as fever, headache, and muscle aches. These symptoms usually will get better within a week.
* Tingling, burning, itching, and redness will be at the site where an outbreak is about to occur (prodrome).
* Painful, itchy blisters are on the skin. They might be barely noticeable or as large as a coin.
* Blisters that break and become painful, shallow, oozing sores.
* Swollen and tender lymph will node in the groin.
Occasionally people would first experience symptoms months or even years after being infected.
Typically, another outbreak could appear weeks or months after the first, but it almost always is less severe and shorter than the first episode. Although the infection could stay in the body indefinitely, the number of outbreaks tends to decrease over a period of years.

Recurrences of genital herpes

After invading the skin or mucous membranes, the virus that causes genital herpes travels to the sensory nerves at the end of the spinal cord. Even after the skin lesions have disappeared, the virus still remains inside the nerve cells in a latent state. In most of the persons, the virus reactivates from time to time. When this happens, the virus will travel along the nerves to the skin, where the virus multiplies on the surface at or near the site of the original herpes sores, which cause new lesions to erupt. It also could reactivate without any visible sores. At these times, small amounts of the virus might be shed at, or near, sites of the original infection, in genital or oral secretions, or from unapparent lesions.  Recurrent episodes will be after about 1-3 months of primary infection of genital herpes, the recurrent person who infected by HSV-2 will be higher than HSV-1. About 60% person will be recurrences of genital herpes, and 4-6 times in one year, some might reach 10 times. Usually, the symptoms of recurrent episodes are milder than those of the first episode and typically last appropriate a week. A recurrent outbreak might be signaled by a tingling sensation or itching in the genital area or pain. These are called prodromal symptoms and, for some people, they could be the most painful and annoying part of a recurrent episode. Sometimes no visible sores is developed. At other times, blisters appear that might be very small and barely noticeable or might break into open sores that crust over and then disappear. The severity and frequency of the recurrent episodes vary greatly. While some people recognize only one or two recurrences in a lifetime, others might experience several outbreaks a year. The pattern and number of recurrences often change over time for an individual. Scientists do not know what causes the virus to reactivate at presently. Although some persons with herpes report that their recurrences are brought on by, such as other illness, stress exposure to sunlight or menstruation, recurrences often are not predictable.
Recurrent outbreaks of HSV lead to painful blisters that rupture, become sores, and then heal after about 6 to 12 days. Usually, symptoms of recurrent outbreaks are limited to genital blisters, swollen glands and sores. After the blisters appear, they are most painful during the first 24 hours. Most of people do not have flu-like symptoms when recurrent outbreaks. Usually, recurrent outbreaks are less severe and do not last as long as the primary outbreaks.