Beware of Genital Wart Infection Before Symptoms Appear
April is Sexually Transmitted Diseases Awareness Month. What are some common STDs that are difficult to treat?
Genital warts are a form of sexually transmitted disease, or STD, caused by a subtype of the same virus that causes other warts. This virus is the human papilloma virus (HPV). Genital warts also are known as condyloma or venereal warts. They can develop anywhere near the vagina, cervix, genitals or rectum. They are spread through sexual activities, and can affect both men and women.
Because genital warts can take 6 months or longer to develop, you can have the infection without having any symptoms. HPV also causes virtually all cases of cervical cancer, if it is the high risk subtype, and these are different from those that usually cause external genital warts. However, people may be infected with more than one subtype. Therefore, people with genital warts are more likely to be infected with a cancer-causing virus as well.
What are the symptoms?
Genital warts appear on moist surfaces, especially at the entrance of the vagina and rectum in women. In men and women, they can appear anywhere in the genital or anal area. They may be small, flat, flesh-colored bumps or tiny, cauliflower-like bumps. Single warts may be less than 1/8 of an inch, much smaller than a pencil eraser but clusters can be quite large. In some cases, warts can be so small that you can’t see them. Genital warts may not cause any symptoms, or they may cause itching, burning, tenderness or pain.
You should contact your health care provider if you notice warts or bumps on your genital area, or if you have itching, burning, tenderness or pain in that area. Call immediately if you develop signs of infection, such as fever, chills or muscle aches.
How are they diagnosed?
Your health care provider will ask about your medical history and about your sexual habits and whether or not you’ve had or been exposed to any STDs. Then, an exam to look for warts will be done. Sometimes, a vinegar-like solution will be placed on the skin that turns warts white and makes them seen more easily. Other tests may include:
All sex partners also should be tested for warts and other STDs.
How do I prevent them?
Avoid sex or have sex with only one partner who has never had them or been exposed to them. Using condoms also may help to prevent them. However, condoms can’t always cover the entire affected skin, or all over the genitals. Factors that increase your risk of getting genital warts include:
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Having other STDs
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Multiple sex partners
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Smoking
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Certain vitamin deficiencies
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Medications or medical conditions that shut down the immune system, or make it less able to fight off infection, such as AIDS.
Cervical cancer can be prevented with regular screening (Pap tests), and can be cured in most cases when it is found early. There are differing opinions on how often one should have cervical cancer screenings. The American Cancer Society recommends cervical screening be done on a yearly basis if a traditional pap is done, and every 2 years if a liquid-based pap is done. If you’re not sure which was done, ask your health care provider. The American Cancer Society also recommends you have your pap done at age 21 or when you’ve been sexually active for 3 years, whichever comes first. If you are at risk with other STDs, health conditions, or been with multiple sexual partners, the American Cancer Society recommends you have cervical screening done more frequently than every 2 years. Since some health care providers prefer cervical screening be done on a yearly basis regardless of the type of pap, it is best if you check with your own health care provider and do what he or she recommends. In most cases, it takes years for cervical cancer to develop, and if you’re getting routine check-ups and cervical cancer screenings at least every 2 years, something will be found before it progresses into a cervical cancer.
What is the treatment?
It depends on the size and location of the warts. Even though warts may be removed, the viral infection can’t be cured, which is why the warts often return. Some of the medications used to treat genital warts can’t be used during pregnancy, so it’s important to tell your health care provider if you could be pregnant.
Small warts may be treated with medications applied to the skin. Sometimes, applying liquid nitrogen (cryotherapy, or freezing) to warts will freeze the tissue and make warts disappear. Some larger warts require laser treatment, or surgical removal. Don’t treat them yourself with over-the-counter drugs used for wart removal on hands, because these chemicals can make the genital area very sore. You may be given a medication that you apply to the warts at home. Apply this medication carefully to avoid damaging surrounding healthy tissue, keep it out of your eyes and wash it off after 4 hours. Your health care provider may also suggest you apply a protective coating of petroleum jelly on delicate surrounding tissue before you apply your medication. Sometimes, a small needle to inject medication into each wart is used, and this is usually only considered if other treatment methods are not working or if warts come back after being removed. You will need to avoid sex until treatment is completed.
What is the prognosis?
Genital warts may go away on their own or with treatment. It is common for them to return. Certain strains of the HPV virus causing genital warts may also be capable of causing almost all cases of cervical cancer, though only a small percentage of women who become infected will develop cancer. Cervical cancer develops slowly over decades. If you have genital warts, you are also likely to have been infected with a cancer-causing strain of the virus. You should be sure to get your Pap smear regularly.
Diana Jones, RNC, MSN, WHNP, is an OB/GYN and Women’s Health Nurse Practitioner at the BSU Women’s Center, managed by Cardinal Health System. For more information contact info@chsmail.org.
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