Is it safe to treat genital warts in pregnant women?
Genital warts can be treated in pregnant women. You must tell your doctor that you’re pregnant or think that you could be because the treatment you’re offered needs to be safe for your developing baby. Some of the usual medicines used to treat genital warts aren’t suitable if you’re pregnant.
Genital warts are fleshy growths found in the genital and anal area. They are caused by the human papilloma virus (HPV). The infection can be passed from person to person by skin-to-skin contact and in genital secretions, such as during sex.
Genital warts are the most common sexually transmitted viral infection in the UK, particularly in men and women aged 18-25.
Certain types of HPV can infect the skin around the genitals and anus. This can cause the cells to multiply faster than usual, which leads to warts. Genital warts on dry, hairy skin are often hard and on moist, hairless skin they tend to be soft. You may have only one wart or there may be many in groups.
Genital warts can be successfully treated, but no treatment can completely remove the virus from your body.
Many people have no symptoms of being infected with HPV and don’t have any genital warts. You can still pass on the virus even if you have no visible genital warts. Genital warts can begin to grow weeks or months after you become infected.
In women, genital warts may appear:
In men, genital warts may appear:
It’s also possible to get warts caused by the same virus on your lips and in your mouth, nose or throat.
Although genital warts are usually painless, they can become inflamed or itchy and may bleed. You may notice blood in your urine if genital warts in your urethra begin to bleed. Blood may appear on toilet paper or in the toilet if there is bleeding from anal warts.
Genital warts are caused by HPV. There are many different types of HPV. About 40 of the 100 types of HPV can cause genital warts, but most are caused by type 6 or type 11.
Genital warts are passed on by skin-to-skin contact, such as during vaginal, anal and oral sex, or when sharing sex toys. You can still pass on the infection if you have no visible genital warts and by having close skin contact even without having sex. The virus is usually passed by sexual contact, but can also be passed on from warts on the hands.
People who change sexual partners frequently are more at risk of getting genital warts.
If you’re pregnant and have genital warts, these can be passed on to your baby during a vaginal birth, but this is rare.
If you think you have genital warts, go to a sexual health clinic or see your GP for advice on treatment and prevention. If your GP diagnoses you with genital warts, he or she may refer you to a sexual health clinic for treatment.
You don’t need to be referred by your GP to go to a sexual health clinic; you can make your own appointment. All visits are confidential and you don't have to give your real name. The clinic will not send details to your GP without your consent.
At your sexual health clinic or GP surgery, a doctor or nurse will examine you and ask about your medical history. Genital warts are usually diagnosed by a doctor or nurse looking at them. He or she may also carry out an internal examination of your vagina or anus to look for internal genital warts. Sometimes a biopsy (a small sample of tissue) is taken of the genital warts to confirm the diagnosis, but this is uncommon.
If you have genital warts, you may also have another STI. You may be advised to have tests for other STIs at the same time.
There are a number of ways to treat genital warts, but you may decide you don’t want treatment. If left untreated, genital warts may clear up on their own. This can take a long time – years in some people.
Genital wart treatment varies depending on the size, location and number of genital warts.
You may be prescribed medicines, such as imiquimod and podophyllotoxin, in the form of creams or liquids to apply to the genital warts. You may be able to do this for yourself at home. You may want to ask a partner to help if the location of the genital warts makes this difficult. Alternatively, you may need to go to a sexual health clinic to have treatments applied.
Cryotherapy uses liquid nitrogen to freeze your genital warts. You will usually be advised to have a course of cryotherapy, for example, every week or two for six to 12 weeks. Your nurse or doctor will advise you if you require more treatment.
Laser therapy can be used to break down your genital warts. You will be given a local anaesthetic. This completely blocks pain from the area and you will stay awake during the procedure.
You may be offered heat treatment (electrocautery or loop electrosurgical excision procedure) to get rid of your genital warts. You will be given a local anaesthetic for this procedure.
You may have surgery to remove your genital warts under local anaesthesia.
You may need to have repeat treatments to get rid of your genital warts as they can be difficult to remove or they may come back after treatment. If you smoke, you will probably not respond as well to treatment as a non-smoker.
Don’t use treatments designed for removing warts from other areas of the body (such as the hands and feet) because these aren’t suitable for treating genital warts, and could cause damage to the sensitive tissues in the genital area.
Some creams can interfere with certain forms of contraception, such as condoms, diaphragms and caps, so you may need to use an alternative contraceptive. Avoid unprotected sex soon after applying the creams because these can cause skin irritation in your partner. Ask your doctor or nurse for advice.
If you're pregnant
Tell your doctor, midwife, or obstetrician (a doctor who specialises in pregnancy and childbirth) if you get genital warts while you’re pregnant. Your doctor will prescribe a treatment for you that is safe for your developing baby.
Genital warts can grow larger in size or number during pregnancy or may reappear after years of having no warts. If you have genital warts in your vagina that grow very large, they may need to be removed to make sure that they don’t cause a problem during childbirth. Rarely, if you’re unable to have your genital warts removed and there is a possibility that they could cause a complication, you may be offered a caesarean.
It’s rare, but the HPV infection could pass to your baby during a vaginal birth. This could affect his or her throat or genitals. Your baby may need treatment for this infection once he or she is born.
If you have a weakened immune system
Genital warts are likely to be more severe and treatment is less likely to be successful if you have a weakened immune system, for example, if you have HIV/AIDS or are being treated for cancer. This means that you have a higher risk of the genital warts coming back. It’s important to go to follow-up appointments to make sure your treatment is tailored to your needs.
Using a condom every time you have vaginal, anal or oral sex will reduce your risk of infection with HPV. Condoms can’t completely prevent you getting the infection because the areas of skin where there are genital warts aren’t always covered by a condom.
Before having sex with a new partner, you could both consider having a test for STIs.
There are two vaccines that can protect against some HPV types. One vaccine, called Gardasil, protects against HPV types 6, 11, 16 and 18. The other vaccine, called Cervarix, protects against HPV types 16 and 18 only.
Cervarix and Gardasil are available in the UK. Cervarix used to be offered as part of the national immunisation programme, but from 2012 this was switched to Gardasil. Gardasil is offered to all girls aged 12 to 13 to protect them against HPV types 16 and 18 that cause cervical cancer and types 6, 11, that cause genital warts.
Reviewed by Jane McQueen, Bupa Health Information Team, April 2014.
For answers to frequently asked questions on this topic, see FAQs.
For sources and links to further information, see Resources.
This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.
Publication date: November 2011
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