Genital warts

Diagnosis of genital warts

In most cases, genital warts can be diagnosed by their appearance in the genital area or inside the vagina. You might find them and go to your doctor for a diagnosis, or your doctor might find them during a pelvic examination.

Since some strains of HPV can also affect your cervix, your doctor will use Pap tests to monitor your cervical cells for changes. By having a Pap test done every three years, you will be able to catch any early changes in cervical cells that can lead to pre-cancerous or cancerous cells.

If HPV is suspected, or if you are over 30 and sexually active, your doctor might also perform an HPV DNA test to determine which strain of HPV you have. This will tell you whether you have a strain that is known to cause cancer.

Treatment

If you develop genital warts and they do not cause any uncomfortable symptoms, you may not need medical treatment. Often, genital warts go away without treatment.

But if they are causing embarrassment or uncomfortable symptoms, you will want treatment. There are a number of options, including the use of certain medications and procedures. To begin with, your doctor will try topical medications. These include:

  • Imiquimod – Boosts the immune system to help fight the infection causing the genital warts.
  • Podofilox and podophyllin – Podofilox is a plant-based medication that destroys genital warts. You can apply it yourself at home. Podophyllin is a stronger version that must be applied by your doctor.
  • Trichloroacetic acid – This chemical effectively burns away warts and can be used on external or vaginal warts.
  • Sinecatechins – A cream that can be used on genital warts presenting externally or internally.

Some of these prescription medications are applied at home, while others are applied by your doctor in a medical office. If the topical medication doesn’t work, your doctor will consider other options. These include:

  • Cryotherapy (the use of extreme cold to destroy warts)
  • Electrocautery (the use of electricity to remove warts)
  • Laser therapy (the use of light to eliminate warts)
  • Surgery (the use of a scalpel to remove warts)

Cryotherapy, electrocautery, and laser therapy are in-office procedures.

Ultimately, the removal option chosen for genital warts will depend on the size, shape, location, and extent of the warts.

Preparation

To prepare for your initial appointment with your doctor, it is recommended that you go prepared to

  • Discuss your symptoms
  • Discuss your sexual history
  • Provide a list of medications you are taking
  • Have a pelvic exam (schedule this when you are not menstruating)

When being treated for genital warts, you may have the treatment done right in your doctor’s office, or in a clinic or hospital. Do not schedule appointments during your period.

To prepare for any appointments to treat your genital warts, it is essential to do the following:

  • Schedule appointments when you are not menstruating.
  • Be prepared to have a local or general anesthetic, which will depend on the number of warts to be removed and the procedure used.
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Recovery

Removal of genital warts using a topical cream or cryotherapy will require multiple treatments to get rid of the warts completely. The area may feel tender and irritated for a day or two after each treatment. If removal is done using electric, laser, or surgical removal, recovery can take up to two weeks.

In most cases, HPV will be resolved by the immune system within a year or two. Treatment to remove genital warts may not eliminate the HPV infection. It is possible for warts to recur after treatment, but they rarely cause long-term problems. Talk with your gynecologist about your treatment and prevention options.

Complications

Some strains of HPV can cause pre-cancerous changes to cervical cells, called dysplasia, and cervical cancer. There are also strains that can cause cancer of the vulva.

Since it is difficult to know whether you have contracted a strain of HPV that can cause cell changes or cancer, it is important to get a Pap test done every three years. This will screen for cell changes and catch any issues early enough for effective treatment.

The information contained in this article is meant for educational purposes only and should not replace advice from your healthcare provider.