Genital Warts and Herpes: Common Concerns and Symptoms

I would like to inquire about cauliflower and genital herpes?

Hello, since I am currently abroad...
I have undergone various examinations at a clinic, but the doctors only did a superficial check without any further in-depth examinations.
Due to language barriers and the appointment-based system here, it has been difficult to schedule a time.
I have many questions but cannot inquire, so I hope to seek answers here.
Around March or April of this year, I was diagnosed with genital warts located in the area below the vulva.
Because they were small, the doctor initially just used scissors to cut off the wart.
Since then, I have had two or three recurrences, all treated with topical medication, healing in about one to two weeks.
However, around June, I noticed small, wart-like growths on both sides of the labia minora.
At that time, I applied medication for a week, and while other areas healed, the labia minora did not improve.
I found some information online suggesting that if the growths are symmetrical, they might be pseudowarts rather than true genital warts, so I stopped applying the medication.

Last month, I experienced pain in the vulvar area and looked in the mirror, noticing that the small growths on the labia minora seemed to be expanding.
I would like to know if the growth rate of genital warts can be so slow.
I have read that genital warts typically grow quickly, but the growths on my labia minora have not become very large, although there are signs of expansion.
Because the growths are so small, it is difficult for me to determine if they are warts.
Additionally, I have had recurrent infections in the vulvar area since middle school, with increased vaginal discharge that is often yellowish, leading me to frequently visit gynecology for examinations (for candidiasis or fungal infections).
Recently, I was diagnosed with genital herpes, and when I asked the doctor if the growths on my labia minora were warts, the doctor just glanced and said they probably were, but the answer was very vague, leaving me feeling anxious.

I would also like to know more about genital herpes.
The literature states that it presents with blisters that break before healing, but my condition does not involve blisters; instead, the area around the labia minora and majora, close to the clitoris, is swollen and painful to touch, with no signs of blistering before healing.
Currently, there is still some swelling and itching near the foreskin, along with a small growth in that area.
Could this still be genital herpes? I am very concerned that it might be early signs of another sexually transmitted infection, as the examination did not include blood tests; the doctor only looked at the area.

Regarding the small growths on the labia minora that I mentioned earlier, I have been applying medication for about two weeks with no improvement, but they have not shown signs of enlarging or spreading.
Could they still be genital warts?

s, 20~29 year old female. Ask Date: 2016/11/25

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, I apologize for not being able to diagnose based on the described symptoms.
If you continue to feel unwell, I recommend returning to Taiwan for a gynecological examination or visiting a Taiwanese business hospital in Mainland China for a check-up.
Wishing you good health.

Reply Date: 2016/11/25

More Info

Understanding genital warts and herpes can be quite complex, especially when dealing with symptoms that overlap or when there is uncertainty about diagnosis. Based on your description, it seems you are experiencing a range of symptoms that could be attributed to both genital warts (caused by the human papillomavirus, HPV) and genital herpes (typically caused by the herpes simplex virus, HSV).

Genital Warts (HPV)
Genital warts are typically small, flesh-colored or gray swellings in the genital area. They can appear as single or multiple bumps and may resemble cauliflower. The growth rate of genital warts can vary significantly from person to person. While some individuals may experience rapid growth, others may notice a slower progression. It is not uncommon for warts to recur after treatment, as the virus can remain dormant in the body.

In your case, the small, grainy bumps on the labia that you described could indeed be genital warts, especially if they have a similar appearance to previous warts you have had. However, the fact that they are symmetrical and have not significantly enlarged may suggest they could also be something else, such as benign skin tags or other benign lesions.

Genital Herpes (HSV)
Genital herpes typically presents with painful blisters or sores in the genital area. The initial outbreak often includes flu-like symptoms, and subsequent outbreaks may be less severe. You mentioned that you have not experienced the classic blistering associated with herpes, which raises some questions. The pain and swelling you are experiencing, particularly near the clitoris and labia, could potentially be related to herpes, but without the presence of blisters, it complicates the diagnosis.

Diagnosis and Treatment
Given the overlapping symptoms and your concerns about the possibility of other sexually transmitted infections (STIs), it is crucial to seek a definitive diagnosis. Here are some steps you can take:
1. Consult a Healthcare Provider: If possible, try to schedule an appointment with a healthcare provider who specializes in sexual health. They may perform a physical examination and could recommend tests such as a Pap smear, HPV typing, or a herpes swab test to clarify your diagnosis.

2. Consider STI Testing: Comprehensive STI testing can provide peace of mind and rule out other infections. This may include blood tests for herpes and other STIs.

3. Monitor Symptoms: Keep track of any changes in your symptoms, including the size and appearance of the bumps, any new pain, or other unusual symptoms. This information can be helpful for your healthcare provider.

4. Avoid Self-Diagnosis: While it is tempting to search for answers online, self-diagnosis can lead to unnecessary anxiety and mismanagement of your condition. Rely on professional medical advice for accurate diagnosis and treatment.

5. Treatment Options: If genital warts are confirmed, treatment options may include topical medications, cryotherapy (freezing), or surgical removal. For herpes, antiviral medications can help manage outbreaks and reduce transmission risk.

Conclusion
Your concerns about the bumps on your labia and the pain you are experiencing are valid and warrant further investigation. It is essential to have a clear diagnosis to guide appropriate treatment. While waiting for an appointment, try to manage any discomfort and avoid any irritants that could exacerbate your symptoms. Remember, you are not alone in this, and many people experience similar issues. Seeking professional help is the best way to address your concerns and ensure your health and well-being.

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