Genital Warts: Key Questions and Answers for Women

Cauliflower Questions

Hello, Doctor.
I have a few questions I would like to ask you:
1.
I have two white lesions in my genital area.
Two days ago, I went to the hospital, and the doctor said they are warts.
However, I have only had one sexual partner, who is my current boyfriend, and his genital appearance is normal.
Is it possible that he has the virus but is asymptomatic and transmitted it to me?
2.
Since his appearance is normal, can he get tested at the hospital now? Besides refraining from sexual relations with me, is there anything else he needs to do?
3.
During my examination, the doctor prescribed me a topical treatment called Podophyllin cream, but did not check the vaginal wall or inside the anus for any lesions.
Should I go back to the hospital for the doctor to check the areas where I should apply the medication?
4.
If I apply the medication as directed and do not see improvement or if the condition worsens within one to two weeks, should I go to the hospital for cryotherapy?
5.
In the future, will I be unable to have a natural birth to avoid vertical transmission to my child?
6.
If I appear normal after six months of observation and do not have a recurrence, does that mean I am cured, and I do not need to worry about transmitting the infection to my partner during subsequent sexual activity?
Thank you, Doctor, for your patient responses.
After getting sick, I have researched a lot of information but still feel very helpless.
I appreciate your help, and I wish you all the best.

D, 20~29 year old female. Ask Date: 2019/04/01

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the current treatment methods for genital warts include various options such as cryotherapy, electrosurgery, topical medications, and laser treatment.
These methods are limited to removing visible warts and do not completely eradicate the virus, with a recurrence rate of approximately 20%.
It is important to follow the prescribed medication or treatment.
Generally, patients who receive appropriate treatment can effectively manage the sexually transmitted virus without causing significant harm to their bodies.
Patients can try the following methods to alleviate symptoms and avoid infecting sexual partners: 1.
Keep the genital area clean and dry.
2.
Avoid using scented soaps or bath oils to prevent irritation of the wart-affected areas.
3.
Condoms can reduce the risk of transmission, but if the infected area appears on other parts of the body, such as the scrotum, condoms may not provide protection.
4.
It is recommended that regular Pap smears be performed for female partners to reduce severe complications.
5.
Maintain a healthy lifestyle, including a balanced diet, regular exercise, and boosting immunity, to decrease the chances of recurrence.
6.
The prognosis for genital warts is generally good, but the recurrence rate is high.
7.
There is currently a vaccine for prevention, but it cannot be used for treatment.
8.
If treatment is combined with healthy behaviors, there is a chance for the virus to clear, which must be evaluated by a physician.
For males, a urologist can provide examination and treatment, while females can apply an appropriate amount of topical medication to the vulvar area, which will affect the perineal region.
The necessity for a cesarean section can be determined by the obstetrician during pregnancy.
After treatment, follow-up appointments should be scheduled as per the physician's instructions to assess the infection status.
Thank you! Wishing you peace and health, Dr.
Zhang.

Reply Date: 2019/04/01

More Info

Understanding genital warts, also known as condylomata acuminata, is crucial for women, especially when it comes to prevention, diagnosis, and treatment. Here are answers to your questions, along with some additional information that may help clarify your concerns.

1. Transmission of HPV: Yes, it is possible for your boyfriend to have the human papillomavirus (HPV) without showing any visible symptoms. HPV can be asymptomatic, meaning that individuals can carry and transmit the virus without knowing it. Since you mentioned that you have had only one sexual partner, it is likely that the virus was transmitted during your sexual activity. HPV is highly contagious and can be spread through skin-to-skin contact, even if there are no visible warts.

2. Testing for HPV: Your boyfriend can undergo testing for HPV, but it is important to note that there is no standard test for HPV in men. Doctors typically diagnose genital warts based on their appearance. If he has any lesions or warts, a healthcare provider can examine them. If he is concerned about HPV, he should discuss this with his healthcare provider, who may recommend further evaluation or monitoring.

3. Follow-up Examination: It is advisable to return to the doctor for a thorough examination, especially if you have concerns about the presence of warts in other areas, such as the vaginal wall or anal region. A healthcare provider can perform a more comprehensive examination to ensure that there are no additional lesions that need treatment. It’s important to follow the prescribed treatment regimen, but also to ensure that all affected areas are being treated.

4. Monitoring Treatment: If you are using the prescribed medication (such as imiquimod cream or podofilox), it is essential to follow the instructions carefully. If you do not see improvement within a couple of weeks, or if the warts seem to be increasing in size or number, you should return to your healthcare provider. They may recommend alternative treatments, such as cryotherapy (freezing the warts) or electrosurgery.

5. Childbirth Considerations: While having genital warts does not automatically mean you cannot have a natural birth, it is important to discuss your situation with your obstetrician. In some cases, if warts are present during delivery, there may be a risk of transmission to the baby. However, many women with HPV have healthy pregnancies and deliver vaginally without complications. Your healthcare provider can give you personalized advice based on your specific situation.

6. Recurrence and Future Sexual Activity: If you observe that the warts have not recurred after six months of monitoring, it may indicate that the treatment was effective. However, it is important to understand that HPV can remain dormant in the body, and there is still a possibility of transmission to a partner. Using barrier methods, such as condoms, can help reduce the risk of transmission, but they do not provide complete protection since HPV can infect areas not covered by a condom.

In summary, it is essential to maintain open communication with your healthcare provider regarding your condition and treatment. Regular follow-ups and examinations are crucial to ensure that you are managing your health effectively. Additionally, educating yourself about HPV and its implications can empower you to make informed decisions about your sexual health and relationships. Remember, you are not alone in this, and seeking support from healthcare professionals can help alleviate feelings of helplessness.

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