What to know about genital warts in women

By Beth Sissons 

Reviewed by Stacy Sampson, DO

Symptoms | Causes | Risk factors | Seeing a doctor | Diagnosis | Treatment | Complications | Prevention | Summary

Genital warts are a very common sexually transmitted infection. They can develop on or around the genitals and may appear as small bumps or fleshy growths.

These warts result from infection with the human papillomavirus (HPV). People who have the virus can pass it on through vaginal, anal, or oral sex.

Genital warts can cause discomfort, but they do not lead to other health problems and are not cancerous.

A doctor can prescribe treatments for relieving symptoms, and they can also remove the warts.

In this article, we investigate the symptoms, causes, and risk factors of genital warts in the female body.

We also describe diagnosis, treatment, complications, and prevention.

Symptoms

Anyone can get genital warts. In females, genital warts can develop in or around the:

• vagina
• vulva
• cervix
• anus
• groin region and upper thighs

Because the virus can spread through oral sex, warts can also appear on the lips, mouth, and throat.

Genital warts tend to look like small, fleshy bumps or growths. The number of warts can vary, and clusters may develop in a formation that resembles a cauliflower.

Genital warts are usually the same color as the person's skin or slightly darker. The bumps may be smooth or rough. Also, they can be too small to notice.

Often, genital warts do not cause symptoms. However, they can occur with:

• itching
• burning
• tenderness or pain
• bleeding

Causes

Genital warts result from infection with HPV. This is a type of sexually transmitted infection (STI).

According to the Centers for Disease Control and Prevention (CDC), HPV is the most common STI in the United States.

It affects around 79 million people in the country, mostly adults under the age of 30. There are around 14 million new HPV infections each year in the U.S.

A person with an HPV infection can pass on the virus through:

• vaginal, anal, and oral sex
• skin-to-skin genital contact
• childbirth

Genital warts do not always appear immediately after a person becomes infected — they can take months or even years to develop.

The CDC note that most people fight off the virus without treatment and that, in this case, it does not cause any health problems. Once the virus goes, a person can no longer pass it on.

There are many different types of HPV. The type of HPV that causes genital warts does not cause cancer.

Risk factors

Anyone who is sexually active is at risk of an HPV infection.

Other risk factors include:

• smoking
• having a weakened immune system
• being under the age of 30

When to see a doctor

When a person notices that they have genital warts, they should see a healthcare professional, for example at a sexual health clinic.

Sometimes genital warts clear up on their own over time. However, getting treatment can reduce the risk of transmission and help ease uncomfortable symptoms, such as itching and pain.

Diagnosis

Healthcare professionals usually diagnose genital warts with a physical examination. To see the warts better, they may use a colposcope or apply a vinegar solution to the genital area, if the warts are not visible to the naked eye.

A healthcare professional may also take a small sample of a visible wart and send it for analysis. This testing can help confirm the diagnosis.

Treatment

There is currently no treatment for HPV. A person's immune system often fights off the virus over time.

If genital warts are causing discomfort or distress, a doctor can prescribe treatments to relieve symptoms or remove the warts. This treatment can also help reduce the risk of passing on the infection to other people.

Topical treatments for genital warts include:

• podofilox
• imiquimod
• podophyllin
• trichloroacetic acid

For people with larger or more difficult-to-treat warts, the doctor may recommend removing them. The following are some removal methods:

• Cryotherapy. This involves freezing off the warts with liquid nitrogen. Cryotherapy may cause a burning sensation, as well as pain and blistering.
• Surgical excision. This involves a doctor cutting away the warts. Before the procedure, they will give the person a local anesthetic to numb the area.
• Electrocautery. This involves a doctor burning the warts off the skin with an electrical device. A person may require a local or general anesthetic.
• Laser therapy. In this procedure, a surgeon uses a powerful beam of light to destroy the warts. It can cause pain and irritation afterward.

It is important not to use treatments for other types of warts on genital warts. Doing so can make symptoms worse.

Removing genital warts does not get rid of the HPV infection. They may return after treatment and a person can still pass on the virus.

Also, wearing a condom during sex can help lower the risk of transmission but does not completely prevent it.

Complications

There are over 100 different types of HPV. The types that cause genital warts do not cause cancer. Even if a person does not receive treatment for their genital warts, the warts will not become cancerous.

However, a person can have more than one type of HPV infection at a time, and at least 14 types can cause cancer, including cervical cancer.

When a female has genital warts, a doctor may suggest screening for signs of cervical cancer or high-risk types of HPV.

The U.S. Preventive Services Task Force recommend that all females:

• aged 21–29 years have a cervical screening, also known as a Pap smear or smear test, every 3 years
• aged 30–65 years have a Pap smear every 3 years, or a Pap smear plus an HPV test every 5 years

Females aged 30-65 years also have the option of just having an HPV test every 5 years.

If a Pap smear gives an unclear or abnormal result, it does not mean that a person has cancer. The doctor will carry out additional tests to look for any changes in the cells of the cervix.

Pregnant women with a past history of genital warts should inform their healthcare providers. This is unlikely to cause any pregnancy complications or affect the baby.

Also, having genital warts during pregnancy can make the delivery more difficult.

Prevention

Wearing a condom during sex lowers the risk of getting genital warts. However, a condom does not cover the whole genital area and so may not completely protect against HPV transmission.

Other methods of birth control do not protect against genital warts. It is important for people to tell their sexual partners if they have these warts.

Getting an HPV vaccination can also help protect against the types of the virus that can cause genital warts or cervical cancer.

The CDC recommend HPV vaccination for all children at 11 or 12 years of age and for all females aged 13–26 years.

According to the Office on Women's Health, the Food and Drug Administration (FDA) have approved the HPV vaccine for people aged 9–45 years.

Anyone with any severe allergies or an allergy to yeast should consult their doctor before getting the vaccine.

The CDC do not recommend the HPV vaccine for women who are pregnant.

Stopping smoking can also lower the risk of getting genital warts.

Summary

Infection with some types of HPV can cause genital warts. These can form in or around the vulva, vagina, or cervix.

The warts may appear on their own or in cauliflower-like clusters. They can cause itching, tenderness, or a burning sensation.

Genital warts are generally harmless and are not cancerous. The types of HPV that cause genital warts do not cause cervical cancer.

Although there is no treatment for the virus, a doctor can prescribe medications to relieve symptoms. They can also remove the warts. For large or difficult-to-treat warts, a doctor may recommend surgical removal.

A person can pass on HPV through vaginal, anal, or oral sex. Wearing a condom during sex can help reduce the risk of getting and spreading genital warts. HPV vaccination can also protect against genital warts and cervical cancer.

SOURCE: MEDICAL NEWS TODAY