Genital Warts

What’s the Problem?

Genital warts are caused by the genital human papillomavirus (HPV). HPV is the most common sexually transmitted disease in the U.S. Certain types of HPV cause genital warts while other types of the virus are associated with cervical, vulvar, anal, and penile cancers.

Warts on the external genitalia are easy to identify while warts in the vagina or on the cervix are not. Since HPV can lead to premalignant cellular abnormalities in the cervix, it’s very important that these changes be diagnosed and treated. Regular Pap smears are essential for diagnosing HPV on the cervix.

Infection with HPV is very common and most people do not have any symptoms. In a series of studies done on women in college, nearly 50% tested positive for HPV but only 1% – 2% had visible warts and fewer than 10% had ever had visible warts.

Who’s at Risk?

Anyone who is sexually active can develop genital warts. Factors that increase the risk of getting genital warts include:

• Multiple sex partners
• Early onset of sexual activity
• Smoking
• Poor nutrition
• Stress
• Concurrent viral infections like the flu, HIV, and herpes.

Can It Be Prevented?

Abstinence is the only completely effective way of avoiding genital warts. A monogamous relationship between two disease-free partners is “relatively” safe. The absence of warts cannot be used as an indicator for the presence of an infection. And latex condoms do not offer protection against the spread of a virus since it can be transmitted via skin-to-skin contact alone, without the presence of a lesion.

The Bottom Line

• Genital warts can be found on male genitalia, female genitalia, or around the anus of either sex.
• Genital warts in children may be indicative of sexual abuse.
• Treatment for genital warts may be topical or surgical.
• Women with genital warts should have more frequent Pap smears since their presence is associated with cervical dysplasia and cervical cancer.

Case Example

Aileen recently divorced her husband Kurt after finding child pornography in his closet. She is now in the midst of a custody battle over their 2-year-old daughter Megan. Aileen brings Megan to the doctor when the child complains of a stomach ache. After doing a comprehensive exam, the doctor leaves the room and returns with a social worker. The doctor explains that Megan has genital warts – at her age the likelihood is that she has gotten them through sexual abuse. Megan is put into protective custody while Aileen and Kurt are questioned. Kurt is convicted of sexual abuse of a minor. Aileen is given full custody of Megan.