Genital Warts: Causes, Risks, and Treatment Options

Contracting a venereal disease known as "cauliflower disease."

Hello Dr.
Lee, I was recently diagnosed with genital warts, and I still can't believe it.
I have had very little sexual activity, but I do masturbate, about 1 to 2 times a week, using my hands.
I have only had sexual intercourse with one person, who is not my boyfriend, and I see him almost once a year.
In April 2012, we had intercourse once, in May 2013, once, and on January 5, 2014, once.
Up until now, on January 23, I have only had sexual intercourse with the same person.
We never used condoms.
A couple of days ago, while masturbating, I felt something at the vaginal opening.
The next day, I went to see a gynecologist.
The doctor visually diagnosed it as genital warts.
I immediately contacted my sexual partner.
I asked him if he had been with anyone else recently, and he said he had a long time ago, but he hadn't been with anyone else since we last met.
The only thing he did was go to a hot spring.
The last time we had sexual intercourse, I was on my period, and there was oral sex involved.
Now that I have genital warts, I just want to heal quickly.
I am confused about a few things: 1.
Is the genital warts due to masturbation? 2.
Is it related to having sexual intercourse with my long-time partner? Could it be because he went to the hot spring, or did I get infected from a previous partner? I am currently unsure if he is infected, as he lives abroad.
I just want to heal quickly.
I hope Dr.
Lee can give me some advice.
Thank you.

fan nao, 20~29 year old female. Ask Date: 2014/01/23

Dr. Li Yilun reply Urology

Infectious warts, commonly referred to as genital warts, are a type of sexually transmitted infection that cannot heal naturally.
They can be treated with topical medications, electrosurgery, or cryotherapy.
If the infected warty lesions can be completely eradicated, a full recovery is usually possible.
However, since they are primarily transmitted through sexual contact, untreated sexual partners may lead to reinfection.
I hope this explanation alleviates your concerns.
The most important step you should take is to consult a trusted physician for proper treatment and to monitor whether symptoms improve after treatment.
If you are already infected, worrying may not aid in your recovery.
Reducing risky sexual behaviors can decrease the chances of infection; the more sexual partners one has, the higher the risk of transmitting sexually transmitted infections (STIs).
Limiting sexual encounters with multiple partners can reduce the pathways to infection.
Consistent use of condoms can minimize bodily fluid contact, thereby lowering the risk of disease transmission.
Prevention is better than treatment.
Human papillomavirus (HPV) is a small DNA virus (diameter 55 nm) that belongs to the Papovavirus family.
There are over a hundred known genotypes of HPV, with more than thirty types capable of infecting the skin and mucous membranes of the human genitalia, leading to various diseases.
For example, the sexually transmitted disease commonly seen in clinical practice, "condylomata acuminata," colloquially known as "genital warts," is caused by HPV genotypes 6 and 11.
HPV has a high degree of host specificity, meaning it primarily infects human skin and mucous membranes.
Under normal circumstances, the nuclei of human skin and mucous membrane cells are uniform in size; however, upon HPV infection, the nuclei enlarge and vary in size, leading to cellular dysplasia and precancerous changes.
Recent epidemiological studies have shown a strong correlation between HPV and the development of cervical cancer.
Therefore, having a method to test whether women are infected with HPV would significantly aid in the prevention and treatment of cervical cancer.
Additionally, the cervical cancer vaccine mentioned in the news is actually a preventive vaccine against HPV.
If this vaccine can be successfully developed and administered to girls before puberty, it would enable women to produce HPV antibodies before reaching reproductive age, thus preventing HPV infection after puberty.
This could significantly reduce the prevalence of cervical cancer, which would be a major benefit for women's health.
The primary transmission routes for HPV are through "sexual contact" (hands, mouth, genitals) or through "blood and bodily fluids." However, in very rare cases, transmission can also occur during pregnancy or childbirth, or through other means.
According to statistics, the average prevalence of HPV infection among women in Taiwan is 9%.
The prevalence rates for different age groups are as follows: 6.6% for ages 20-30, 7.5% for 30-40, 7.3% for 40-50, 9.2% for 50-60, and 14.8% for those over 70, indicating an increase with age.
In Taiwan, the most common HPV genotype is type 52, followed by type 16 and then type 58.
However, when comparing cases of invasive cervical cancer, type 16 is the most prevalent, followed by type 58, while type 52 is relatively rare.
Physicians often need to conduct a medical history inquiry, visual examination, palpation, and tests to confirm the diagnosis and treatment plan.
Please seek care from a gynecologist nearby.

Reply Date: 2014/01/23

More Info

Genital warts, also known as condylomata acuminata, are caused by certain strains of the human papillomavirus (HPV), a sexually transmitted infection (STI). Understanding the causes, risks, and treatment options for genital warts is crucial for effective management and prevention of further complications.

Causes of Genital Warts
Genital warts are primarily caused by HPV types 6 and 11, which are considered low-risk strains. These strains do not typically lead to cancer but can cause warts in the genital area. HPV is transmitted through direct skin-to-skin contact, which can occur during sexual activity, including vaginal, anal, and oral sex. It's important to note that HPV can be transmitted even when an infected person does not have visible warts or other symptoms.

In your case, the limited sexual encounters you described, combined with the lack of condom use, could have contributed to your infection. While it is less common for genital warts to be transmitted through non-sexual activities like masturbation, it is still possible if there are micro-abrasions or if the virus is present on the hands and then transferred to the genital area.

Risks Associated with Genital Warts
The primary risk associated with genital warts is the potential for emotional distress and anxiety regarding the diagnosis. Additionally, while the strains of HPV that cause genital warts are low-risk for cancer, other high-risk strains (such as HPV types 16 and 18) can lead to cervical and other genital cancers. Regular screenings, such as Pap smears for women, are essential for early detection of any changes in cervical cells that could indicate cancer.

Treatment Options
Treatment for genital warts can vary based on the size, number, and location of the warts, as well as patient preference. Here are some common treatment options:
1. Topical Treatments: These include medications like imiquimod (Aldara), podofilox (Condylox), and sinecatechins (Veregen). These treatments can be applied directly to the warts and work by stimulating the immune system or causing the wart tissue to die.

2. Cryotherapy: This involves freezing the warts with liquid nitrogen, which can effectively remove them.

3. Electrosurgery: This method uses electrical currents to burn off the warts.

4. Surgical Removal: In some cases, warts may need to be surgically excised, especially if they are large or resistant to other treatments.

5. Laser Treatment: This is typically reserved for extensive warts or those that do not respond to other treatments.

Prevention and Follow-Up
To prevent the recurrence of genital warts and the transmission of HPV, vaccination is highly recommended. The HPV vaccine can protect against the most common cancer-causing strains as well as those that cause genital warts. It's also advisable to use condoms consistently and correctly during sexual activity, as they can reduce the risk of transmission, although they do not provide complete protection since HPV can infect areas not covered by a condom.

Since you mentioned that your sexual partner has had other encounters, it would be prudent for him to get tested for HPV and other STIs. Open communication about sexual health is vital for both partners.

In conclusion, while the diagnosis of genital warts can be distressing, effective treatment options are available. It is essential to follow up with your healthcare provider for appropriate management and to discuss vaccination options for future prevention. Regular check-ups and open discussions about sexual health with partners can help mitigate risks and promote overall well-being.

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