Human Papillomavirus (HPV) is the most common sexually transmitted infection in the United States. Nearly 90% of sexually active men and women are exposed to HPV at some point in their lifetime. HPV encompasses a group of over 200 related viruses. They are categorized into high risk HPV and low risk HPV. While there is no treatment for the virus, most HPV infections will resolve within 1-2 years. If left untreated, persistent high risk HPV infection can lead to cervical cancer. Low risk HPV can cause genital warts which are benign cauliflower-like lesions on the skin.
HPV is sexually transmitted by skin-to-skin contact. The virus can be transmitted even when there are no signs or symptoms. In some cases symptoms do not appear for years after exposure to HPV. This can make it difficult to pinpoint the source for infection.
High risk HPV can cause cancer of the vulva, vagina, cervix, penis, anus, and throat. The highest HPV related cancer risk for women is cervical cancer. There are approximately 11,000 new cases of cervical cancer each year. HPV strains type 16 and 18 are most aggressive and cause up to 75% of all cervical cancers.
There are a few ways to decrease your risk of HPV infection. These include proper use of condoms (although this does not provide full protection), getting vaccinated, and engaging in a monogamous relationship. There are 3 FDA approved vaccines for HPV. In a person who has never been sexually active or exposed to HPV, the vaccine can decrease your risk of getting the most common HPV strains that cause cervical cancer and genital warts. HPV types that cause cervical cancer are not the same as those that cause genital warts. Most women with HPV do not have visible lesions and don’t realize they have been infected.
To screen for cervical cancer, a PAP smear is performed. Current recommendations state that women 30 years of age and older should routinely be tested for HPV with a PAP smear. If a PAP test shows abnormal cervical cells or high risk HPV, then additional testing is needed. This test is called a colposcopy. During colposcopy, a microscope is used to view the cervix after the application of vinegar. Any abnormal areas are biopsied and sent to a lab. If the changes are mild, then the abnormalities may resolve on their own and follow-up PAP smears are recommended. If moderate to severe changes are noted, then further treatment with cryotherapy (freezing of the cervix), loop electrical excision procedure (LEEP), conization of the cervix, or laser is recommended. With appropriate follow-up, the risk of progression to cervical cancer is low. This is why it is very important to follow up with your gynecologist.
Low risk HPV can cause genital warts which are seen visually on exam. They are generally described as cauliflower-like skin lesions. Genital warts (condyloma) are most often found on the vulva, vagina, cervix and anus. Treatment for genital warts consists of topical medication/creams, cryotherapy, excision of the lesions, and laser removal.
At McDowell Mountain Gynecology you will receive up-to-date screening and most current treatment options for HPV and HPV related lesions. Call our office today and schedule your appointment with one of our excellent providers!
Kimberly Hartzfeld, D.O., FACOG