Frequently Asked Questions - Gynecology

Click on a Question. Feel free to bring you questions to your doctor. ACOG Patient Education
What are my birth control options? Human Papilloma Virus (HPV) is a group of viruses that can cause warts anywhere on the human body. The HPV types that attack the genital tract are 99.4% sexually transmitted. HPV is currently the most common sexually transmitted virus in the USA with a 1,000 percent increase in HPV patients since 1987. Because it is a non-reportable disease, the actual number of patients infected with HPV is unknown although more than 50 million Americans are believed to be currently infected with the virus. The number is estimated to be growing by almost a million every year.
   
Venereal warts (also known as genital warts or condylomata) are the "clinical" form of this infection because they can be easily seen and diagnosed. Venereal warts look like a fleshy bump of tissue on the labia, clitoris, or around the anus.
What is a Colposcopy?
What is Endometriosis?
What are Fibroids?
What are Fibrocystic Breast Changes?
What is Menorrhagia?
What is Hormone Replacement Therapy?
What is Human Papilloma Virus (HPV)?
What is a Laparoscopy?
What is a Loop Electrosurgical Excision Procedure (LEEP)?
What is Menopause?
Why should I perform a monthly breast exam?
What is Osteoporosis?
What is a PAP Test?
What is Pelvic Inflammatory Disease?
What is Polycystic Ovarian Syndrome?
What is Premenstrual Syndrome (PMS)?
What are Sexually Transmitted Diseases (STDs)
What are Thyroid Disorders?
What are Vaginal Infections?

The "sub-clinical" version is more common. The infection resides under the skin and cannot be seen. The sub-clinical varieties have been linked to cancers of the genital tract so it is important for sexually active women to have yearly Pap tests to detect pre-cancerous changes.

Risk Factors If you have sex with more than one partner or had a partner who has had sex with more than one partner you are at risk for HPV

Symptoms Whether there are symptoms depends on the strain of HPV present. If there are warts, you will notice a raised, fleshy area. If left untreated, the wart may disappear or it may grow and merge with other warts to take on a cauliflower-like appearance. Some people complain of burning or itching and occasionally a wart may bleed if irritated. You may see warts from one to eight months from exposure, or they may appear many months or years later. It may be difficult or impossible for you to determine when you were exposed.

Evidence of a sub-clinical infection may first show up on a Pap test. Your test may show HPV changes or dysplasia (pre-cancerous cells). HPV infection on the cervix usually has no symptoms at all.

Diagnosis of warts is usually made by sight. If a suspected wart is flat and difficult to see, your doctor may look at the area with a Colposcope (a binocular-like instrument). Warts or HPV infection on the cervix is suggested on a Pap test. Definitive diagnosis is usually made with a colposcopic exam and biopsies.

There is a test available that can identify HPV DNA and may be ordered by your physician. This test will only tell if you are shedding the HPV virus when the test is performed. A negative result does not necessarily mean you have not come into contact with the virus.

Treatment for Venereal Warts Like with other viruses, there is no cure for HPV. Over time though, the warts usually stop developing on their own. However, the warts can be treated as they appear so you should consult your doctor for treatment. Some possible treatments are:
  • Trichloroacetic Acid (TCA) - This is a strong chemical painted on the warts to destroy them. The application may cause some burning and should be applied by an experienced practitioner.
  • Podophyllin – perhaps the oldest drug used to treat venereal warts it cannot be used in pregnancy, has to be painted on the warts to destroy them and has to be carefully washed off. Podophyllin is rarely used anymore.
  • Interferon - This is a new drug that can be injected directly into the wart itself.
  • Prescription Drugs for Home Use - There are two medications (Condylox and Aldara) your doctor can prescribe for home use as treatment for venereal warts. Your doctor will show you how to apply them. They can cause burning and inflammation.

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