Human Papillomavirus and Its Impact on Vaginal Health - Obstetrics and Gynecology

Dr. Wang Jionglang reply Obstetrics and Gynecology

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Hello: In response to your question, symptoms of a fungal infection (Candida albicans) include itching, burning, swelling, and pain in the vulva, along with discharge that appears white or yellowish-white, resembling cottage cheese.
Pain and redness at the urethral opening or discomfort during urination are also common, and symptoms may worsen before and after menstruation.
Based on your symptoms, it is likely that you have a fungal (Candida albicans) infection.
Candida thrives in warm, moist environments and is particularly prone to recurrence when individual immunity is compromised (such as in cases of diabetes, lack of sleep, colds, premenstrual or postmenstrual periods, pregnancy, antibiotic use, or wearing tight or nylon clothing).

Although fungal infections can be bothersome, they are generally well-treated, with cure rates exceeding 80% for treatments including suppositories, oral medications, or topical creams, and resistance is rare.
Combining treatments (suppositories, creams, and oral medications) often leads to quicker resolution, although there may be a stinging sensation when first applied.
It is estimated that 75% of young women have experienced a fungal infection, with half experiencing recurrence, and 5% having recurrent episodes that are difficult to eradicate.
If recurrences happen frequently, it is important to identify possible underlying causes, such as poorly controlled diabetes, frequent antibiotic use, long-term steroid medication, or inappropriate clothing.
Addressing these issues can significantly aid in the resolution of the fungal infection.

If no specific cause can be identified, consider extending the duration of treatment or providing prophylactic medications after symptoms resolve, rather than waiting for a recurrence to treat.
A convenient approach is to take medication once a week or use a suppository weekly; while this does not guarantee prevention, it can reduce the frequency of episodes.
Vaginal fungal infections, while not life-threatening, can cause significant disruption to daily life.
Some individuals may resort to self-medicating with over-the-counter products, which can worsen the situation if the medication is not appropriate.
If discomfort persists, it is advisable to seek a medical diagnosis and treatment.
Avoid using iodine-based antiseptics for cleansing the genital area, as these can kill beneficial bacteria (such as lactobacilli) that provide natural defense, allowing fungi to proliferate.

Additionally, attention to lifestyle details is crucial; avoid wearing tight clothing, using damp pads or clothing for extended periods, and maintain local ventilation and dryness to prevent recurrence of fungal infections.
Wishing you a speedy resolution to this troublesome issue.

Furthermore, the Human Papillomavirus (HPV) is transmitted through sexual intercourse and seeks suitable sites for infection (such as the cervical or vaginal epithelium), where the viral DNA integrates into the host cell's DNA, leading to cellular proliferation.
Benign proliferation may result in flat warts or genital warts (commonly referred to as "cauliflower"), while more severe proliferation can lead to cellular dysplasia, progressing from mild to moderate, and potentially to severe dysplasia or cervical cancer.

HPV has many subtypes; some cause flat warts or genital warts but are not significantly associated with cervical cancer, while others can coexist with the host without causing any lesions, referred to as low-risk types.
Certain subtypes, such as 16, 18, 31, and 33, are more closely associated with cervical cancer, classified as high-risk types, with up to 90% of cervical cancer or precancerous patients harboring high-risk HPV.
We can now utilize viral DNA subtype identification to determine which risk group is present.

Finally, I wish you good health and all the best!

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Reply Date: 2003/09/04