Gynecology

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Human Papillomavirus (HPV)

Genital human papillomavirus, also known as HPV, is a sexually transmitted viral infection. There are more than 40 different kinds of HPV that can infect the genitalia, mouth and throats of men and women. For some people, the immune system will remove the infection over the course of two years, but, for others, HPV may lead to genital warts or cancers of the cervix, vulva, vagina and anus.

More than 20 million people in the United States are infected with HPV, with an estimated six million people becoming infected each year. It is estimated that at least half of all sexually active people will contract HPV at some point in their lives.

Causes of HPV

The HPV virus is contracted through the following forms of contact:

  • Vaginal sex
  • Anal sex
  • Oral sex
  • Genital-to-genital contact
  • Childbirth

Fortunately, many types of HPV can be successfully treated, while others can be managed to prevent complications such as cervical cancer.

Symptoms of HPV

Symptoms of HPV infection vary depending on the type of HPV and the severity of the infection. Many patients do not experience symptoms at all. In some cases, symptoms may include:

  • Genital warts
  • Cervical cancer
  • Cancer of the vulva, vagina, penis or anus
  • Cancer of the back of the throat

Diagnosis of HPV

Because many types of HPV do not present any symptoms, regular testing is recommended to screen for cervical cancer and other complications of HPV. There is no standard test to detect HPV viruses. It is important for women to undergo regular Pap tests to detect certain abnormalities that may indicate an HPV infection. If abnormalities are found, a DNA test, which can test for 13 high-risk types of HPV, may be performed.

If warts or lesions appear in the genital area, medical attention and testing for HPV.

Complications of HPV

Although most cases of HPV will clear up on their own, with no side effects or complications, certain types of HPV can develop into cervical, penile or anal cancer. These diseases are most treatable when detected early, making regular screening important.

Treatment of HPV

While there is no cure for HPV, treatment for symptoms such as genital warts, cervical changes and cervical cancer is available. HPV treatment will depend on the diagnosis and the severity of the infection.

Genital warts may be treated with:

  • Medications
  • Creams
  • Cryotherapy
  • Electrocautery
  • Laser treatment or surgery to remove the warts

Treatment will remove the genital warts but it does not cure the infection. Patients can still transmit the HPV infection to a sexual partner.

Other types of lesions may be treated with surgery, laser treatments or cryotherapy to prevent them from developing into cervical cancer.

Prevention of HPV

There are currently two vaccines, Gardasil and Cervarix, available to protect against high-risk types of HPV. Gardasil, the first HPV vaccine, targets the types of HPV that cause genital warts. Cervarix helps protect women from cervical cancer. These vaccines are not effective for all types of HPV, so the following recommendations should be followed to reduce the risk of contracting HPV:

  • Abstain from sexual activity
  • Be in a monogamous relationship
  • Use condoms, but note that HPV can infect areas surrounding condom

Sexually Transmitted Diseases

A sexually transmitted disease, or STD, is a disease or infection that is spread from one person to another through sexual contact. Most STDs are caused by bacteria, parasites or viruses, that are transmitted through contact with the genitals, skin, mouth, rectum, or bodily fluids. There are many different types of viruses that are characterized as STDs, some of which include:

  • Genital Herpes
  • Gonorrhea
  • Chlamydia
  • HIV
  • HPV
  • Condyloma
  • Syphilis
  • Hepatitis

STDs can cause problems ranging from mild irritation to severe pain. Left untreated, some STDs can cause illness, cancer, infertility or harm to a fetus during pregnancy.

Causes of Sexually Transmitted Diseases

STDs are caused by a bacterial or viral infection that is spread through sexual contact. People who may be more at risk for contacting an STD may include those who:

  • Engage in unprotected sex
  • Have multiple sexual partners
  • Are already infected with an STD
  • Abuse drugs or alcohol
  • Share needles for drug use or tattoos
  • Symptoms of Sexually Transmitted Diseases

Most sexually transmitted diseases have no symptoms at all, especially in women, so some people may not even know they have been infected with an STD. Other symptoms may vary depending on the specific type of STD and may include:

  • Vaginal or penile discharge
  • Pain during intercourse
  • Painful urination
  • Sores or blisters on the genitals
  • Warts or growths on the genitals
  • Abdominal pain

Diagnosis of Sexually Transmitted Diseases

A sexually transmitted disease can be diagnosed by a doctor after a physical examination and review of symptoms. Additional tests may include taking a sample of genital fluids or a culture of swabbed specimens to detect the presence of an STD. Additional tests may include a urinalysis and blood tests. Periodic STD testing is recommended for anyone with multiple sexual partners, even if they are having protected sex.

Treatment of Sexually Transmitted Diseases

Treatment for STDS may vary depending on the specific diagnosis. Although many STDs cannot be cured, there is medication available to treat and manage symptoms. Some STDs can be treated with antibiotics to clear the infection or medication to prevent flare-ups of symptoms. The HIV virus is commonly treated with a combination of antiretroviral drugs. In some cases, as with condyloma, genital warts may be removed through surgical methods.

Prevention of Sexually Transmitted Diseases

Sexually transmitted diseases may be prevented by avoiding risky sexual behavior. STDs may be avoided by:

  • Abstaining from sexual activity
  • Using condoms for all sexual activity
  • Remaining in a monogamous relationship
  • Not sharing needles

There is currently a vaccination available for certain strains of the HPV virus. Two HPV vaccines, Gardasil and Cervarix, are approved by the Food and Drug Administration. Both vaccines are highly effective in preventing persistent infection with HPV types 16 and 18, which cause most cases of condyloma or genital warts. Both vaccines are effective for females between the ages of 9 and 26 and the Gardasil vaccine is effective for males between the ages of 9 and 26. These vaccinations are administered as three separate injections over the course of six months.

STDs are serious infections that can cause lifelong or recurring symptoms and side effects. It is important for all patients to practice safe sex and get tested often.

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