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Genital Warts in Women

Genital warts are a sexually transmitted infection that causes small, flesh-colored or pink growths on the labia, inside the vagina, and on the cervix, as well as around the anus.

They are the most easily recognized sign of infection by the human papilloma virus (HPV). Although genital warts affect both woman and men, the infection is more common in women than men.

Genital warts are caused by the human papillomavirus (HPV). There are more than 100 types of HPV. Some HPV viruses cause common warts (verruca vulgaris) that appear on the fingers or hands. Other HPV viruses cause genital warts. HPV viruses are also the cause most cases of cervical cancer, but the HPV viruses that cause genital warts are not the same as those that can cause cancer.

Does it hurt to have genital warts?

Some warts are so small and painless they are unnoticeable. Others are three or more inches around and make it painful for a woman with genital warts to sit or walk. Sometimes the warts itch or burn, and scratching them can cause irritation.

How do women become infected with genital warts?

Genital warts are very contagious and are spread by direct skin-to-skin contact, including sexual intercourse, oral sex, anal sex, or any other contact involving the genital area (for example, hand-to-genital contact).

Most people with the virus do not have visible warts but can still transmit the virus. Treating the warts may not decrease the chance of spreading the virus. Therefore, all people who are sexually active should be regarded as potential sources of HPV, not just those with visible warts.

A woman infected with HPV may not see warts appear for weeks to a year or more after being exposed; it is not usually possible to know when or how you became infected.

How are genital warts diagnosed in women?

To diagnose genital warts, a doctor will usually conduct a physical exam and biopsy any suspicious-looking growths.

How is HPV diagnosed in women?

The most common way of diagnosing HPV is with a Pap test. While a Pap test by itself doesn’t usually definitely diagnose an HPV infection, it can identify infected abnormal cells and precancerous changes in the cervix that may be precursors to cancer.

If there is an abnormal pap smear, the doctor often will do advanced testing on the material to determine if, and which kind, of HPV may be present.

In some cases, during a physical examination, the appearance of genital warts in any sexually exposed area will prompt some doctors to diagnose HPV without futher testing. Some physicians may confirm the diagnosis by doing a biopsy (collecting a tissue sample from the wart) and sending it to a to a lab for analysis.

How are genital warts treated?

Genital warts often recur and are easily spread, so getting rid of them can be a challenge. Part of the treatment involves evaluating the woman’s sexual partner(s) as well as discussing techniques to prevent the spread of the warts. Obviously, the woman must avoid sexual contact with any partner(s) who infected with HPV.

There are several topical treatment options for genital warts:

If warts persist or return after treatment, the doctor will make sure they are not cancerous by doing a biopsy, using a topical or local anesthetic. Once cancer has been ruled out, the doctor may try these treatments:

Because it is hard to tell if all warts have been removed, a woman should be rechecked by her doctor after six months. Additional treatment may be necessary. The doctor will probably want to do a Pap test every six months thereafter for at least a few years to make sure no cancerous changes have occurred.

Are there health complications for women from genital warts?

Pregnancy and childbirth

Genital warts may cause a number of problems during pregnancy. Because genital warts can multiply and become brittle, your doctor will discuss options for their removal, if necessary.

Genital warts also may be removed to ensure a safe and healthy delivery of the newborn. Sometimes the warts become larger during pregnancy, which may make it difficult to urinate if the warts are in the urinary tract. If the warts are in the vagina, they can make the vagina less elastic and cause obstruction during delivery. If the warts block the birth canal, a woman may need to have a cesarean section (C-section) delivery.

Infants born to women with genital warts can develop warts in their throats. Although uncommon, it is a potentially life-threatening condition for the child, requiring frequent laser surgery to prevent blocking of the breathing passages.

HPV, genital warts, and cervical cancer

There are about 100 known strains of HPV. Of the thirty strains that occur in genital areas, ten are considered high-risk and most likely to cause cervical cancer. They usually do not produce visible genital warts, although they could.

Cervical cancer usually does not have symptoms until it is quite advanced. For this reason, it is important for women to get regular screening for cervical cancer. Screening tests can find early signs of disease so that problems can be treated early, before they ever turn into cancer.

How can women avoid getting HPV?

Preventing the spread of genital warts involves the same safe-sex practices required to prevent the spread of any sexually transmitted disease. Because abstinence from sexual activity while the warts are contagious can be impractical, condom use is important until all warts have been successfully treated. Male condoms, however, do not provide total protection, since a mans scrotum can harbor the wart virus.

There are several ways for both women and men to lower their chance of getting HPV:

People can also lower their chances of getting HPV by being in a faithful relationship with one partner, limiting their number of sex partners, and choosing a partner who has had no or few prior sex partners. But even people with only one lifetime sex partner can get HPV. And it may not be possible to determine if a partner who has been sexually active in the past is currently infected. That's why the only sure way to prevent HPV is to avoid all sexual activity.