HPV: Symptoms, Recurrence, and Treatment Insights

Human Papillomavirus - Warts

Hello Doctor: On July 27, I went for a gynecological examination and found a small white spot resembling a granuloma in the skin between the labia minora and the anus.
The doctor directly excised the white spot, and the examination indicated it was a wart.
During my follow-up on August 4, no other lesions were found, and I received the HPV vaccine before leaving.
About three weeks later, on August 25, I noticed a white spot on the skin below the excised area, but it was not raised.
On September 1, I observed that the symmetrical skin area also showed signs of whitening, but it was slightly larger.
The skin tissue appeared somewhat like it had been soaked in water for too long, and it was not raised.
After observing for a few days, the condition remained the same, with a slight itching sensation.
I would like to know if this could be a recurrence of the wart.
Additionally, during my menstrual period, I experience brief cramping in the genital area, and there are noticeably larger blood clots.
Could this indicate a bacterial infection? My vaginal discharge is normal.
Since I am currently abroad on a business trip and there is a language barrier, I am unable to return home quickly, so I am seeking help through this website.
Thank you for your assistance.

Ms. Han, 30~39 year old female. Ask Date: 2019/09/05

Dr. Huang Jianzhong reply Obstetrics and Gynecology

On July 27, during a gynecological examination, a small white spot resembling a granulation tissue was found on the skin between the labia minora and the anus.
The doctor immediately excised the spot, and the examination indicated it was a wart.
During a follow-up visit on August 4, no additional lesions were found, and after receiving the HPV vaccine, I left.
About three weeks later, on August 25, I noticed a white spot on the skin below the excised area, but it was not raised.
On September 1, I observed that the symmetrical skin area also showed signs of whitening, but it was slightly larger.
The skin tissue appeared somewhat like it had been soaked in water for too long, and it was not raised.
After observing for a few days, the condition remained the same, with a slight itching sensation.
I would like to know if this could be a recurrence of the wart.

Answer: You need to return to the gynecologist for further examination of the perineum.
Additionally, during my menstrual period, I experience brief cramping and notice an increased amount of blood clots.
Could this be a bacterial infection? My vaginal discharge is normal.

Answer: No, it is not.

Reply Date: 2019/09/05

More Info

Understanding HPV: Symptoms, Recurrence, and Treatment Insights
Human Papillomavirus (HPV) is a common sexually transmitted infection that can lead to various health issues, including genital warts and cervical cancer. Your concerns regarding the recurrence of symptoms and the implications of HPV are valid and important to address.

Firstly, the small white bump you initially had, which was diagnosed as genital warts (also known as condylomata acuminata), is caused by certain strains of HPV. The fact that you had it surgically removed is a common treatment approach. However, it is essential to understand that while the visible warts can be treated, the underlying virus may still remain in the body. This is why monitoring for recurrence is crucial.

Regarding the new white spots you have observed, it is difficult to definitively say whether these are a recurrence of HPV without a physical examination. The change in skin color and texture you describe could be due to several factors, including irritation, a new HPV infection, or even a different dermatological condition. The slight itching you mentioned could indicate irritation or an infection, but it is not enough to conclude definitively that it is a recurrence of HPV. It is advisable to seek medical attention as soon as you can, as a healthcare professional can provide a more accurate diagnosis through examination.

As for the menstrual pain and the presence of blood clots, these symptoms could be related to various factors, including hormonal changes, uterine conditions, or infections. While it is possible for infections to cause changes in menstrual patterns, the normal appearance of your discharge is a positive sign. However, if the pain persists or worsens, or if you notice any unusual changes in your menstrual cycle, it is essential to consult a healthcare provider for further evaluation.

In terms of treatment and management of HPV, there are several key points to consider:
1. Monitoring and Follow-Up: Regular follow-ups with your healthcare provider are essential. If you notice any new symptoms or changes, it is crucial to report these during your visits. Typically, after treatment for HPV-related conditions, follow-up examinations may be recommended every 6 to 12 months, depending on your specific situation.

2. Vaccination: The HPV vaccine is effective in preventing infection from the most common high-risk strains of the virus. If you have not completed the vaccination series, it is advisable to discuss this with your healthcare provider, as it can help protect against future infections.

3. Immune System Support: Maintaining a healthy immune system can help your body manage HPV. This includes a balanced diet, regular exercise, adequate sleep, and stress management. Some studies suggest that a robust immune response can help clear the virus more effectively.

4. Safe Practices: If you are in a relationship, it is essential to communicate openly with your partner about HPV. Using protection during sexual activity can reduce the risk of transmission, although it does not eliminate it entirely.

5. Psychological Support: Dealing with an HPV diagnosis can be stressful. Consider seeking support from counseling or support groups to help manage any anxiety or concerns related to your health and relationships.

In conclusion, while HPV can be a challenging condition to manage, understanding the nature of the virus, its potential for recurrence, and the importance of regular medical care can empower you to take proactive steps in your health journey. Please make sure to consult with a healthcare professional as soon as you are able to address your current symptoms and concerns effectively.

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