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Genital warts

Genital warts in women

 What are genital warts?

  • Genital warts are the most common sexually transmitted infection affecting men and women.
  • Warts are caused by the Human Papilloma Virus (HPV).
  • There are more than 40 types of HPV that can infect the genital area but genital warts are caused by just 2 types – HPV 6 and 11
  • Most women infected with HPV will not know they have it.
  • Most of the time the body’s immune system will clear HPV naturally within 2 years.
  • Genital warts do not cause cervical cancer.
  • If you have genital warts we recommend that you should have a full STI screen including a HIV test.  

How common are warts?

  • Genital warts are very common.
  • They mainly occur in teenage girls and in men aged 20 to 25 years. 
  • A large number of people carry genital HPV infection without ever developing warts. 
  • It is estimated that at least 50% of sexually active women will be infected with HPV at some point in their lives. 

How do you catch genital warts?

  • HPV is passed on through genital contact during:
    • vaginal sex
    • anal sex
    • sometimes oral sex or just close genital contact without penetration
    • sharing sex toys with someone who has HPV
    • HPV infection may lead to the appearance of genital warts after a time interval of 2 – 3 months, but this can be sometimes be much longer.
    • Common warts that occur on hands and fingers are caused by a different type of HPV and are very unlikely to be passed onto the genital area.

What would I notice if I had genital warts?

  • Genital warts vary in appearance:
    • Single or groups of bumps
    • Smooth flat papules or raised and cauliflower like
    • Soft or gritty hard lumps
    • In women warts are commonly found on the vulval lips, around the entrance to the vagina and sometimes around the anus (this is not related to anal sex).
    • Occasionally warts are found internally in the vagina or on the cervix (neck of the womb).
    • Warts sometimes cause itching or discomfort.

How do I get tested for genital warts?

  • Genital warts are diagnosed visually during a genital examination.
  • There is no specific test for HPV in the genital area.
  • Sometimes wart virus changes are reported on a cervical smear but this does not mean you will develop warts.

How are warts treated?

  • Warts will often clear up without any treatment.
  • Treatments are provided mainly for cosmetic reasons to remove the wart – there is no treatment for the virus itself.
  • Treatment will depend on the appearance, location and number of warts you have and may include one or more of the following:
    • Clinic treatment
      • Cryotherapy (freezing)
      • PODOPHYLOTOXIN liquid
      • Home treatment with a self-applied cream
        • PODOPHYLOTOXIN (Warticon)
        • IIMMIQUIMOD (Aldara)
        • Treatments are usually applied several times a week. It takes on average 4 weeks for the warts to go.
        • All treatments from the Wolverton are free and are given to you directly in the clinic
        • Internal warts in the vagina or cervix are not treated as they will disappear by themselves

What about my partner?

  • Warts are infectious and you can easily pass the HPV infection onto your partner.
  • About two thirds of partners are found to have warts.
  • We recommend that your partner attends the clinic for a check up and STI screen.

What problems can untreated warts lead to?

  • Warts themselves are relatively harmless. If left untreated they may go away, remain unchanged or increase in size or number.
  • Warts will not turn into cancer.
  • Women should have a cervical smear every three years as normal starting at 25 years of age.

Warts in pregnancy

  • During pregnancy a woman’s immune system is lowered and warts often appear for the first time.
  • The warts are treated with freezing – we avoid podophyllotoxin-based treatments, as they may be harmful to the baby.
  • Very occasionally a woman with a large number of genital warts may pass HPV onto her baby where it may lead to warts in the throat – this is very rare.

Will warts come back again after treatment?

  • Warts may recur in up to one quarter of individuals within the first month but this becomes less likely as time passes.
  • Warts are more likely to recur or persist if you:
    • smoke
    • are pregnant
    • your immune system (defence system) is lowered:
      • by immunosuppressive drugs
        • used after organ transplantation
        • to treat cancers
        • to treat severe arthritis, inflammatory bowel disease
        • certain medical conditions
        • HIV
        • It is unlikely that you will be re-infected again as your body will have developed immunity from your first infection.

HPV vaccines

Unfortunately, the NHS (including the Wolverton Centre) does NOT offer either HPV vaccine at this time, to men or women.   However, these vaccinations are available via private healthcare providers http://www.privatehealth.co.uk/

  • These vaccines can protect against catching HPV and are most effective if administered before a woman’s first sexual contact.
  • Cervarix
    • In the UK this vaccine is given as part of an immunisation programme to teenage girls to protect them against cervical cancer.
    • It works by stimulating immunity against certain types of HPV that are linked to cervical cancer  (HPV 16 and 18).
    • It will not provide protection against genital warts – as they are caused by a different type of HPV (HPV 6 and 11).
    • Gardasil
      • This vaccine provides protection against cervical cancer and genital warts (HPV 6,11,16 and 18).
      • It is not routinely used in the UK and can only be prescribed privately.
      • There is no benefit from it if you have already had genital warts.

More information

http://www.bashh.org/

http://www.nhs.uk/conditions/genital_warts/Pages/Introduction.aspx

http://www.hpa.org.uk/web/HPAweb&Page&HPAwebAutoListName/Page/1191942128