STIs With Flu-Like Symptoms
What Are Genital Warts? Doctor Explains Causes
Genital warts are a type of sexually transmitted infection (STI) caused by certain strains of the virus known as human papillomavirus (HPV). In this article we will understand causes, symptoms, and treatment options for genital warts is important for anyone who is sexually active.
To understand its causes and what parts it affects, OnlyMyHealth interacted with Dr Kiran Dhake Senior Physician and Sonologist, Mumbai.
Explaining genital warts, Dr Dhake said, "Typical warts manifest as flesh-coloured bumps or a group of bumps, either flat or raised, and may feel soft or firm, with variable size and texture, in the genital or rectal areas. They may be painful or itchy sometimes."
A study published by the National Institute of Health stated, "Warts are a recognized symptom of genital HPV infections. About 90% of those exposed who contract HPV will not develop genital warts. Only about 10% who are infected will transmit the virus."
Genital warts can affect the following sites:
1. Groin area
2. Penis & scrotum
3. Vulva, vagina and cervix
4. Anus and rectum
5. Lips, tongue, or throat region
Causes Of Genital Warts"The primary cause of genital warts is the human papillomavirus (HPV), specifically strains (types), HPV-6 and HPV-11," said Dr Dhake. These strains are transmitted through skin-to-skin contact during intercourse activities with an infected individual. Genital warts can also be transmitted through oral or anal coital activities. As a result, it may lead to pain or discomfort during intercourse activities.
There are several risk factors that can cause genital warts, the most common being sexual intercourse. Dr Dhake listed down a few risk factors.
1. Skin-to-skin TransmissionWarts are known to spread through direct skin-to-skin contact with an infected region, so any coital activity involving genital or anal contact is likely to transmit the virus, as per Dr Dhake.
2. Coital activitiesEngaging in coital activity with an infected person increases the risk of contracting HPV and developing genital warts.
3. Unprotected intercourse activitiesNot using barrier contraceptive methods such as condoms during intercourse activity can raise the risk of HPV transmission.
"Having engaged in unprotected intercourse activities with multiple sexual partners or with someone who has had multiple partners increases the risk of exposure to HPV," Dr Dhake said.
5. Impaired immunityIndividuals with weakened immune systems, such as those with HIV or undergoing immunosuppressive therapy, are at higher risk of developing genital warts because their body system may not be able to offer protection against HPV infection.
ConclusionConcluding, Dr Dhake said, "It is essential to note that not every individual infected with HPV will develop genital warts. Additionally, some individuals may carry the virus without exhibiting any symptoms, making them vulnerable to harbour the virus silently for a long time. Such individuals may be super-spreaders transmitting the infection unknowingly to individuals who encounter them." Regular assessment, implementing protection during intercourse activities, early intervention if symptomatic, and getting vaccinated against HPV can help minimise the risk of genital warts and other HPV-related complications.
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Genital Warts And HPV
Warts are caused by viruses and can appear anywhere on the body. Those that show up in the genital area are caused by the human papillomavirus, commonly called HPV, and are easily transmitted by sexual contact.
HPV infection is the most common sexually transmitted disease (STD) in North America. Certain forms of the virus can cause cervical, rectal, vulvar, vaginal, and penile cancer.
After a person has been infected by HPV, it may take 1 to 3 months (or longer in some cases) for warts to appear. Some people who have been infected never get warts.
Genital warts are caused by certain strains of HPV. Warts found on other parts of your body are caused by a different virus. You can't get genital warts from touching your own body or someone else with a wart on the hand or foot.
The ways that genital warts spread include:
Like many STDs, the human papillomavirus does not always have visible symptoms. But when symptoms do occur, warts may be seen around the genital area. In women, warts can develop on the outside and inside of the vagina, on the cervix (the opening to the uterus), or around the anus. In men, they may be seen on the tip of the penis, the shaft of the penis, on the scrotum, or around the anus. Genital warts also can develop in the mouth or throat of a person who has had oral sex with an infected person.
Because there is no way to predict whether the warts will grow or disappear, people who have been infected should be examined and treated, if necessary.
What do genital warts look like?
Genital warts look like small flesh-colored, pink, or red growths in or around the sex organs. The warts may look similar to the small parts of a cauliflower, or they may be very tiny and hard to see. They often appear in clusters of three or four, and may grow and spread rapidly. They usually are not painful, although they may cause mild pain, bleeding, and itching.
Although rare, other symptoms can include:
The ways your doctor will check for genital warts, related STDs, or both include:
Visual exam. An examination of visible growths to see if they look like genital warts
Vinegar solution. Application of a mild acetic acid (vinegar) solution to highlight less visible growths
Pelvic exam. A complete pelvic exam and Pap smear
HPV test. A specialized test for high-risk HPV (low-risk should not be screened for), collected in a way similar to a Pap smear. This is one way that HPV is diagnosed.
Biopsy. The doctor might take a sample of cervical tissue (if you have an abnormal Pap smear or visible abnormality) to make sure there are no abnormal cells that could develop into HPV-related cervical cancer. The tissue is examined under a microscope.
Rectal exam. Examination of the rectum to check for warts
You might be referred to a gynecologist (a doctor who specializes in female reproductive health) for further testing and biopsy.
Genital warts vs. Herpes
Both are caused by viruses that are spread through sexual contact. Genital herpes, also known as herpes simplex type 2, causes sores and blisters that are filled with fluid. Genital warts generally don't lead to sores.
Genital warts can be treated, although the virus that causes them can't be killed. With the right treatment, genital warts can disappear.
Do genital warts go away?
Your immune system might fight the infection, causing genital warts to go away on their own.
How long do genital warts last?
HPV is a lifelong infection. Your genital warts may go away with treatment, but they could always come back.
Medications
Don't try to treat genital warts with over-the-counter wart removers. They're not meant to be applied to your genitals. Topical medicines for genital warts include:
Imiquimod (Zyclara). This drug boosts your immune system's response to the infection. Avoid sexual contact while the cream is on your skin, because it can make condoms less effective or damage your partner's skin. Your skin might change color in the area where you use the cream. You also might have blisters, pain, coughing, rashes, and fatigue.
Podophyllin (Podocon-25) and podofilox (Condylox). These medicines destroy genital wart tissue. A health care professional can apply it in the office, or you might be given a version to use at home. Podofilox shouldn't go inside your body. It's also not recommended if you're pregnant. Side effects include sores, irritated skin, and pain.
Trichloroacetic acid. This chemical burns away genital warts, and it can be used inside your body. You might have sores, irritated skin, or pain when you use it.
Sinecatechins (Veregen). This topical medicine can treat genital warts in and around your anus, as well as other parts of the body. It may change your skin color where it's applied. It also can cause, burning, itching, and pain.
Procedures
If your genital warts don't improve with medicine, you may need a procedure to remove them. Larger genital warts also might have to removed. Procedures to do that include:
Cryotherapy. This involves using liquid nitrogen to freeze the wart. A blister will form, prompting your body to slough off the wart and dead skin as new skin is formed. You might need more than one session. You might have pain and swelling afterward.
Electrocautery. An electrical current burns away the wart. Side effects include pain and swelling.
Surgical excision. The wart is cut away. You'll need anesthesia to keep you from feeling pain during the procedure. You might have pain afterward.
Laser treatment. A beam of light is directed at the wart to remove it. This treatment is more expensive than others, and it's used on cases that are especially difficult. You might have pain afterward, and the area may form a scar.
Loop electrosurgical excision procedure. This is also called LEEP, and it uses an electrically charged wire loop to remove warts. It's sometimes used to remove warts on your cervix.
What happens if I don't get treated?
Having high-risk HPV can increase your risk of cervical, rectal, and penile cancer. But not all forms of the virus are linked to these cancers. If you have genital warts, it is important to get annual checkups to screen for cancer.
If you have genital warts:
Experts recommend that you abstain from sex while you're having treatment for genital warts. Condoms don't provide complete protection against HPV and genital warts. Talk to your doctor about your concerns, and then have an honest discussion with your partner.
If my partner has genital warts, will I get them?
HPV and genital warts are contagious. If your partner is infected with HPV, there's always the risk it will spread through sexual contact to you. HPV can't be cured. Even without visible warts, the virus can spread.
An HPV infection can increase your risk of cervical cancer. Infections also have been linked to cancers of the throat, mouth, anus, penis, and vulva. Not all HPV infections cause cancer. But it's important to have a Pap smear regularly to check for signs of cervical cancer. This is especially key if your HPV infection is one of the higher-risk strains.
HPV also can cause pregnancy complications. Sometimes the warts become larger during pregnancy, which can make it hard to urinate. If your vaginal wall has warts, it might be hard for it to stretch the way it needs to during childbirth. Warts in your vagina or on your vulva can stretch during delivery, causing bleeding.
Your doctor might recommend you have warts removed so that your baby doesn't come in contact with them during delivery. Although it's rare, babies exposed to genital warts and HPV are sometimes born with genital warts in their throats. They might need surgery to clear their airways.
Genital warts recurrence
An HPV infection never goes away. You can get genital warts again, even after treatment.
Anyone who's sexually active can get or spread HPV. Things that can make you more likely to get genital warts include:
Condoms aren't 100% effective, because they do not cover the entire penis or surrounding areas. Abstaining from sex is the only 100% effective way to avoid HPV infection. If you have sex, limiting your number of partners can decrease your risk.
Vaccination
HPV vaccines – given as a series of shots – can protect you from some types of HPV, which has multiple strains. If you've already been exposed, though, the vaccine doesn't make the virus go away. There are three types of HPV vaccines, but two of them are no longer used in the U.S.
Gardasil 9. This is the only vaccine you can get in the U.S. Since 2017. It protects against the HPV-16 and HPV-18 strains, which are the most high-risk. It also protects against the strains 31, 33, 45, 52, and 58, which are linked to cervical cancer. And it protects against strains 6 and 11, which cause genital warts.
Gardasil. This was the first HPV vaccine that the FDA approved. It became available in 2006. It protects against strains 16, 18, 6, and 11. It doesn't provide as much protection against cervical cancer as Gardasil 9.
Cervarix. This vaccine became available in 2009. It protects against the strains 16 and 18, which cause most cervical cancers. But it doesn't protect against the strains that cause genital warts, and it offers less protection against cervical cancer than Gardasil 9.
It's recommended that everyone get the vaccination before they can be exposed to HPV through sexual contact. The vaccine only protects you against strains of HPV that you don't have already. The CDC offers these guidelines, based on age:
If you're older, you still might benefit from the vaccine if you haven't been exposed to certain strains of HPV already. But insurance coverage can be limited by age. Talk with your doctor about your sexual history and whether the vaccine might help you.
Other prevention methods
If you're sexually active, these steps can provide some protection against HPV:
The human papillomavirus, or HPV, is one of the most common sexually transmitted infections. Certain strains of HPV are linked to cancers of the cervix, vulva, vagina, penis, and rectum. Other strains cause genital warts. Genital warts are usually not a major health risk, and there are several ways to treat them. Your doctor may suggest a topical medication or a procedure to remove genital warts. Getting treatment right away can reduce the symptoms of genital warts, which can include itching and discomfort. Once you have HPV, the infection itself can't be treated. But a vaccine can prevent HPV in those who haven't been infected yet. The CDC recommends vaccination for people through age 26. Children's vaccines are generally scheduled at age 11 or 12, but the vaccine is safe for those as young as 9.
What is mistaken for genital warts?
If you have a condition called vestibular papillomatosis, (VP) you might be worried that you have genital warts. A doctor can tell if you have VP rather than genital warts. You also can get skin tags (acrochordons) in your genital area. These harmless growths are often attached to your skin by a fleshy stalk. They don't hurt, but they can cause irritation if your clothes rub against them.
How do I know if my warts are HPV?
Genital warts and warts on other parts of your body – such as your hands or feet – are caused by different viruses. Your doctor can perform tests to determine whether you have genital warts.
Is HPV an STD?
Yes, HPV is a sexually transmitted disease or infection. There are many strains of HPV. It's so common that 80% of people who are sexually active will have an HPV infection at some point. Vaccination can protect you against some HPV strains.
Do HPV warts turn into cancer?
The strains of HPV that cause genital warts are not the same strains linked to cancer. Genital warts are not cancer.
What Is A Vaginal Self-Exam?
As long as you're getting routine vaginal exams with Pap smears, you don't need to do vaginal self-exams. But you may want to check for any unusual changes if you miss your regular checkup. If you do find a problem, you can start treatment sooner, and you'll probably have a better outcome.
A self-exam can also give you a better understanding of the vagina anatomy and how this part of your body works. Everyone's body is different, and a self-exam can help you learn what's normal for you.
Your vagina is the canal between your uterus and the outside of your body. The vulva and labia form its entrance, and the cervix connects it to the uterus
The vulva is the name for the external parts of your genitals. It includes the pubic mound (mons pubis) and the outer and inner lips of the vagina, called the labia majora and labia minora.
It also includes:
The vagina is an elastic, muscular canal with a soft, flexible lining that provides lubrication and sensation. The vagina connects the uterus to the outside of your body. The vulva and labia form its entrance. The cervix, or neck, of the uterus protrudes into the vagina to form the interior end.
The vagina receives the penis during sexual intercourse. It also allows menstrual blood to flow out of the uterus. During childbirth, the baby passes through the vagina, which is sometimes called the birth canal.
The hymen is a thin membrane of tissue that surrounds and narrows the vaginal opening. It may be torn or ruptured by sexual activity or by exercise.
This vagina diagram shows the parts of the vulva, including the clitoris, urethra, and outer and inner labia.
You can do a vaginal self-exam any time, but it's best when you're between periods. Don't use any vaginal creams or douches for at least 24 hours before doing the exam.
Helpful tools for a vaginal self-exam
Here are some things that will help:
How to prepare for a vaginal self-exam
Make sure your hands are clean or that you're wearing sterile gloves. Be mindful of your fingernails.
Remove your clothes from the waist down. Sit on your bed or on a towel on the floor against a wall with your back propped up by pillows. Pull your feet toward your butt and spread your legs. Try to relax your pelvic muscles.
What to look at during a vaginal self-exam
Examine the parts of the vulva: the clitoris and the outer and inner labia. Take note of the color and size of each part, so if anything changes you'll notice it easily. You may need to pull back slightly on the hood of the clitoris. You might also have to spread apart your pubic hair to get a clear view of the area.
To do a more complete self-exam, gently spread the labia apart and angle the mirror and light so you can see into the vagina. The walls should be pinkish. If you're comfortable doing so, place your finger inside your vagina and feel along the vaginal wall. You may notice it feels a little like the roof of your mouth. If you push deeply enough, you may feel your cervix. It feels like the tip of your nose.
What should my vagina look like?
Vaginas are as individual as the people who have them. Healthy labia come in many different shades, from pink to brown to purple to black. The two sides of your labia may or may not be symmetrical. The inner lips can be longer than the outer ones or vice versa. Your clitoris, labia, and vulva may be large, small, or in between. A normal vaginal opening can also vary in size.
Doing vaginal self-exams can let you see you what's normal for you and may help you notice when something looks or feels different.
What should my vagina feel like?
You should feel pressure, but not pain, when you insert a finger. You'll feel soft folds along the vaginal walls. The walls will likely feel more sensitive to touch in some areas than others.
The vaginal walls can be nearly dry, very moist, or somewhere in between. The moisture level of your vagina is affected by your menstrual cycle and pregnancy as well as sexual arousal.
Alternatives to vaginal self-exam
If you're not comfortable with this much probing, it's OK. You can do a simple visual inspection. Just be sure you see your gynecologist for regular pelvic exams. How often you have pelvic exams may depend on your age, health history, and other factors. Ask your doctor about what's right for you. Your doctor can also show you how to do a genital self-exam.
A self-exam isn't as in-depth as a pelvic exam done by your gynecologist. You should still get routine pelvic exams to check for ovarian cysts, sexually transmitted diseases (STDs), uterine fibroids, early-stage cancer, and other signs of health problems. But a self-exam may help you find signs of an STD or changes to your vulva (the outer part of your genitals) that could signal other health problems
Look for any changes to the skin of your vulva, including lumps, sores, and differences in texture or color. Pay special attention to any issues that don't heal or keep coming back. If you use an IUD for birth control, you should be able to see the string that indicates it's still in place.
Bumps on vulva
Most bumps on your vulva are harmless. The hair follicles on your pubic mound may feel or look like bumps. You can also get skin tags, pimples, ingrown hairs, or cysts in this area. Another common issue is atopic dermatitis, a rash you can get due to irritation from soaps, detergents, or feminine products.
But bumps could also be a sign of conditions such genital warts, a viral skin infection, or, in rare cases, cancer of the vulva.
Spots on vulva
You can get darker areas on your vulva because of hormone changes due to pregnancy, menopause, or hormonal birth control. Skin changes that come with age may also cause your vulva to look darker.
Darker spots could also be a sign of inflammation from an infection or irritation. Or they could mean you have a skin condition called acanthosis nigricans (AN), which is usually harmless but can be a sign of other health conditions.
A small red or purplish spot on your vulva or in the vagina could be an angioma or hemangioma. These are generally harmless growths made up of small blood vessels.
It's not common, but white, red, or brown patches can be symptoms of vulvar cancer or changes that could lead to it.
Sores on vulva
Sores, ulcers, or blisters on your vulva or vagina could be a sign of a few different sexually transmitted diseases:
Changes to vaginal wall or cervix
If you can see or feel tissue hanging out of your vaginal opening, you could have a prolapsed vagina. This can happen when the top part of your vagina slips out of position due to weak tissues or muscles in your pelvic area.
A bulge in your vaginal wall next to your bladder or rectum could be a cystocele or rectocele. You can get these conditions when the muscles around your vagina weaken, usually due to childbirth.
A lump or bump on the wall of the vagina could be a cyst or, more rarely, a sign of endometriosis.
You might feel your cervix in a slightly different place from time to time. That's because your menstrual cycle, as well as hormones due to puberty or menopause, can cause changes to the position of your uterus.
Other symptoms
Be aware of any other symptoms, like itching, pain, soreness, or redness, especially if they last for a while. Some discharge from the vagina is normal, but look for unusual changes in its appearance, texture, or smell.
Your doctor should check any new or unusual bumps, sores, spots or other skin changes on your vulva or in your vagina, especially if you also have other symptoms such as pain. The same is true if you notice a smelly discharge.
If you do find a problem during your vaginal self-exam, remember: The earlier it's diagnosed and treated, the sooner you'll feel better and find peace of mind.
Genital warts
These look like pale, reddish, dark, or flesh-colored bumps around your vulva or anus. You might have a single wart or a group of them, which can look like the texture of a cauliflower.
Genital warts are caused by the human papillomavirus (HPV). While this virus can lead to some types of cancer, the types that cause genital warts don't usually cause cancer.
They don't usually hurt, but they can be itchy, painful, or bleed during sex. You can also spread them to your sex partners. Genital warts often go away on their own after a while. If they bother you, a doctor can remove them. But even if get them removed, you'll likely still carry the virus that caused them for a while.
Vaginal discoloration
it's normal for your vulva and the opening of your vagina to get gradually darker as you age or during pregnancy. But if discoloration happens suddenly or if you also have other symptoms like pain or itching, see your doctor.
Skin on the vulva that looks lighter or darker than in the past, or patches of lighter skin, can be signs of vulvar cancer. Other symptoms include:
See your doctor if you have any of these symptoms.
Vulvar psoriasis can also cause discoloration that may look reddish, purple, gray, or dark brown, depending on your skin tone. You'll likely also see scaly or flaky-looking skin, and the area may itch or hurt. Your doctor can recommend treatments for psoriasis.
Smelly vaginal discharge
A small amount of non-smelly discharge is normal. It might be lighter or heavier, depending on where you are in your cycle. But see a doctor if your discharge has a strong odor you haven't noticed before. Bad-smelling discharge is often a sign of an infection.
Also tell your doctor if you see:
Vaginal self-exams can't take the place of regular pelvic exams done by a doctor. But they can help you better understand your vagina anatomy, and learn what's normal for you. If you do spot a problem, you may be able to get a diagnosis and treatment sooner.
How do you self examine your cervix?
To see your cervix, you'll need a vaginal exam tool called a speculum. This device opens the vaginal walls to allow you to see further inside. You'll also need a flashlight and handheld mirror. Apply lubricant to the speculum or to your vagina, then position yourself as you would for a vaginal exam. Using clean hands, then:
Your cervix is shaped like a flat knob. It's about the size of a quarter. You may see a dark spot in the middle, which is the opening to your uterus.
Once you're familiar with how your cervix usually looks, you can be aware of any changes. Your cervix may shift position somewhat at different phases of your menstrual cycle.
How do you know if something is wrong down there?
See a doctor when you have:
Is it normal to have small bumps inside your vagina?
The ridges inside your vagina are normal and help it expand during sex and childbirth. You can also get cysts in your vagina, which are often harmless. But it's always a good idea to see a doctor if you notice any changes to your vaginal area, especially if you also have other symptoms.
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