Genital warts and HPV (human papillomavirus)

Warts are caused by viruses and can appear anywhere on the body. Those that show up in the genital area caused by the human papillomavirus, commonly called HPV, are easily transmitted by sexual contact.

HPV infection is one of the most common sexually transmitted infections (STIs) in Western Europe and certain forms of the virus can cause cervical and penile cancer. According to the Health Protection Agency, between 2008-2009 over 90,000 new cases of genital warts were diagnosed in the UK.

After a person has been infected, it may take one to three months (or longer in some cases) for warts to appear. Some people who have been infected never get warts. If you think you have been infected, seek medical advice, even if you cannot see warts.

What do genital warts look like?

Genital warts look like small flesh-coloured, pink, or red growths in or around the sex organs. The warts may look similar to the small parts of a cauliflower or they may be very tiny and difficult to see. They often appear in clusters of three or four, and may grow and spread rapidly. They usually are not painful, although they may cause mild pain, bleeding, and itching.

How do I know if I have genital warts?

Like many STIs, HPV does not always have visible symptoms. However, when symptoms do occur, warts may be seen around the genital area. In women, warts can develop on the outside and inside of the vagina, on the cervix (the opening to the uterus), or around the anus. In men, they may be seen on the tip of the penis, the shaft of the penis, on the scrotum, or around the anus. Warts also can develop in the mouth or throat of a person who has had oral sex with an infected person.

Because there is no way to predict whether the warts will grow or disappear, people who suspect that they have been infected should be examined and treated, if necessary.

What tests are used to detect genital warts?

Your doctor may perform the following tests to check for genital warts:

• An examination of visible growths to see if they look like genital warts
• Application of a mild acetic acid (vinegar) solution to highlight less visible growths.
• A complete pelvic examination and smear test (for women).
• A specialised test for HPV, collected in a way similar to a cervical smear.
• Biopsy of cervical tissue to make sure there are no abnormal cells that could develop into HPV-related cervical cancer. A biopsy involves taking a small sample of tissue from the cervix and examining it under a microscope.
• Examination of the rectum.
• A fluid sample test for gonorrhoea and chlamydia
• A blood sample test for syphilis

Tests for gonorrhoea, chlamydia and syphilis are taken because STIs often occur together and share similar symptoms. Sometimes female patients are referred to a gynaecologist (a doctor who specialises in female reproductive health) for further testing and biopsy.