HPV- the Human Papilloma Virus- Dr. Acky Fridman

Let’s start with statistics
1. HPV – Human Papilloma Virus – there are over 100 types of HPV.
2. This is the most common virus transferred during sexual intercourse.
3. The chances of catching this virus, at least once in your life are 80%. The prevalence of infection increases as the age of sexual activity is younger and number of partners is larger.
4. 50-80% of women become infected during their lifetime. The virus is found in about half a million Israelis.
5. The virus may be transferred during sexual contact of all types: “regular” sexual intercourse, anal, oral, and mutual masturbation (the virus may reside under the nails, under the tongue, in the saliva, etc.).
6. As opposed to common belief, there doesn’t have to be penetration in order to get infection.
7. It is important to note that 40% of the warts go away sporadically without treatment.
8. Cervical cancer is the second most common cancer type for women, after breast cancer.
9. In Israel, about 150 women die from cervical cancer (caused in part by some types of this virus) every year.
In light of the statistics, it is clear that prevention and checkups are the primary methods to minimize, as much as possible, the disease and lethality of this virus.

Prevention
The assumption that underlies prevention is that as long as we don’t see visible warts, everything is normal. But as soon as these warts become visible, it is best to avoid sexual intercourse and seek treatment. Please note that the warts are sometimes small, may hide under skinfolds or near hair roots, the anus, on buttocks and other nearby areas. Therefore, for proper monitoring of the situation it is best to shave the hair in the suspected area and check in optimal light.

Vaccination: In recent years, HPV vaccines have been introduced to the market. They are known to shorten the length of the infections, and by that, minimize the development of abnormal cells and pre-cancerous cells.
The vaccinations prevent the spread of the virus, which is why it is recommended to vaccinate at a young age (beginning in the second decade of life).

Diagnosis

Scientific diagnosis of genital warts may be done on a few levels:
1. Clinical checkup: usually an experienced professional doctor (Dermatologist or Gynecologist) can identify viral warts at a checkup.
2. Biopsy: excision of the lesion and transfer to the lab.
3. PCR test: checking the genetic makeup of the virus.

Emotional implications
In recent research, emotional implications of contamination from genital warts were studied, and it was found that there are widespread emotional implications that follow a diagnosis of genital warts; sexual function disorders, pain during sexual intercourse, anger, depression, repulsiveness, detachment, isolation, and guilt. These feelings cause disorders in sexual functioning because of fear of exposure, functionality, performance, self- flagellation and more.
Sometimes those who suffer from heavy emotional implications because of warts may get tattoos or haircuts to hide the warts and scars that may appear due to these actions may worsen the problems in sexual performance. A large percentage of those whose warts were removed remain stressed long after the warts are gone. Other emotional implications of having genital viral warts include a drastic decrease of sexual intercourse frequency, anxiety in having new partners, and anxiety of the will/need to share with partners their private problems when they intend on having a long, serious relationship. There is a drastic decrease in occurrences of sex and the enjoyment of it.

Treatment

Excision of the lesions. There are a number of methods:
1. Local treatment: ointments that cause deterioration of the lesion and their destruction (Condylox, Aldara)
2. Physical demolition: burning with fluid nitrogen, laser resurfacing, surgical removal.
In conclusion, viral genital warts are a common infection that may be diagnosed and treated easily but requires regular checkups to identify it early.
Note that not every woman is easily infected by warts and that most of the women who are infected by viral warts did not develop cervical cancer. That being said, there are women who were never infected by the Papilloma virus and did not suffer from Condyloma but did have cervical cancer later on. Therefore, there is great importance in getting vaccinated at an early age and getting regular checkups, both for those who have and those who haven’t had genital warts.
There is a need to acknowledge the emotional implications on those who suffer from genital warts, since in many cases (also in those who went through successful treatment of the warts), the emotional implications may still have serious ramifications when the warts exist and in their aftermath.
These emotional aspects are pushed aside and do not receive the right attention by doctors, and with no other options, the patients are left without treatment for the emotional difficulties.
Those who suffer from viral warts should remember that in most cases, this is a phenomenon that is unpleasant but may very well be treated with no complications, given that the diagnosis and treatment are appropriate and timely.

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