Gynecologic Infectious Diseases

What is human papillomavirus (HPV)?

Human papillomavirus (HPV) is a sexually transmitted virus that is associated with 34,000 cancers annually, including cervical cancer, anal cancer, head and neck cancer, and throat cancer.

What are the symptoms of HPV?

HPV may cause genital warts, or small bumps in the genital area. In many cases, however, women will not experience any symptoms of HPV. That is why it is important to receive regular cervical cancer screening, which can detect precancerous cell changes caused by persistent HPV infection. If you are experiencing these symptoms and would like to discuss them with your healthcare provider, please reach out to your primary care physician, gynecologist or OB/GYN.

How is HPV diagnosed?

Your doctor will collect cells from your cervix, as in a Pap smear, to check for abnormalities or cancer cells.

If you receive a positive or abnormal HPV test, your doctor may recommend:

• Colposcopy exam
• Biopsy
• Removal of abnormal cells

If you have cervical cancer, Hoag Family Cancer Center, our top-ranked gynecologic oncologists, surgeons, scientists, nurse navigators, radiation oncologists, pathologists, therapists, pharmacists, social workers, rehabilitation therapists and more work shoulder to shoulder to provide you with comprehensive, coordinated care.

How is HPV treated?

There is no treatment for the virus itself, and you may have to wait until your immune system clears the virus. Treatment of genital warts caused by HPV include prescription medication and procedures to remove warts and abnormal cells. If left untreated, genital warts may grow in size or number.

Can HPV be prevented?

Yes. In addition to safe sex measures, such as condom use, there is a safe and effective vaccine that pediatricians recommend beginning at around age 11 or 12. The vaccine was originally approved by the FDA for women and girls between the ages of 9 to 26, however, people can get vaccinated up to the age of 45. A large study of vaccinated women showed a 90% reduction in the rate of cervical cancer.

What is condyloma (genital warts) and how is it diagnosed?

Condyloma are genital warts caused by the human papillomavirus (HPV). You can be infected with HPV and not have any visible warts at all. Often the only symptom of genital warts is tiny, flat or slightly raised lesions. They may form clusters that take on a cauliflower-like shape and can be found in the vagina, on the vulva, on the cervix, on the anus and in the throat. In men, genital warts can be found on the tip of the penis, on the anus, in the throat or on the scrotum.

Your physician can diagnose genital warts by a physical exam or biopsy. Tests include:

• Pelvic exam
• Anal exam

How is condyloma treated?

While there is no cure for HPV, there are treatments to get rid of genital warts, including:

• Medicated creams and solutions
• Cryotherapy or freezing the warts with liquid nitrogen
• Surgery
• Electrocautery
• Laser treatment

If you are experiencing these symptoms and would like to discuss them with your healthcare provider, please reach out to your primary care physician, gynecologist or OB/GYN.

What is chlamydia?

The sexually transmitted disease chlamydia is a common infection among both men and women. It can cause permanent damage to a woman’s reproductive system, making it difficult or impossible to get pregnant later. Chlamydia is also associated with ectopic pregnancy, a potentially fatal condition in which pregnancy occurs outside the womb.

How is chlamydia diagnosed?

The majority of people infected with chlamydia never notice symptoms. When women do have symptoms, they may include:

• White, yellow or gray discharge from your vagina that may be smelly.
• Pus in your urine (pyuria).
• Increased need to pee.
• Pain or a burning sensation when you pee.
• Bleeding in between periods.
• Painful periods.
• Painful intercourse.
• Itching or burning in and around your vagina.
• Dull pain in the lower part of your abdomen.

To diagnose you, your doctor may perform a nucleic acid amplification test (NAAT), which involves taking a sample of vaginal or cervical fluid or by collecting a urine sample. The sample is then tested for the bacteria that causes chlamydia.

Because chlamydia can pass from person to person undetected, national guidelines recommend yearly screening for those in high-risk groups, including women under 25.

How is chlamydia treated?

Antibiotics can clear up chlamydia in about a week or two. Do not wait until the body clears up chlamydia on its own, as the bacteria can do lasting harm to a woman’s reproductive system if left untreated.

What are genital herpes and how are they diagnosed?

Genital herpes is a common sexually transmitted infection (STI) caused by the herpes simplex virus (HSV). Your doctor may be able to diagnose genital herpes just by looking at the sores on your genitals, anus or mouth. A swab from a blister or sore can also be tested for HSV. In addition to sores or ulcers, symptoms of genital herpes may include:

• Painful urination
• Discharge from the urethra
• Discharge from the vagina
• Fever
• Headache
• Body aches
• Swollen lymph nodes in the groin

How are genital herpes treated?

Genital herpes cannot be cured, but antiviral pills can treat sores and reduce the frequency and severity of outbreaks. Speak with your doctor about treatment options.

What is gonorrhea?

Gonorrhea is a common STI caused by a bacteria and spread through sexual fluids, including vaginal fluid and semen. You can get gonorrhea from intercourse, anal sex, oral sex, or sharing sex toys with an infected person.

If you suspect you have been exposed to gonorrhea get tested and treated right away. Left untreated, gonorrhea can cause several long-term health problems and can even be life-threatening.

How is gonorrhea diagnosed?

Your doctor can test your urine or body fluid for the bacteria that causes gonorrhea. National guidelines recommend yearly screening for gonorrhea, for those in high-risk groups, including women under 25.

Often gonorrhea does not cause noticeable symptoms, but women who do experience symptoms may notice the following:

• Unusual vaginal discharge
• Pain in your lower abdomen
• Pain during sex
• Pain on burning when you pee
• Bleeding between periods

How is gonorrhea treated?

Prompt treatment with antibiotics can cure gonorrhea, however, some forms of gonorrhea have developed a high level of antibiotic resistance. Talk with your doctor about the treatment that is right for you, and don’t take anyone else’s medication to treat your infection.

What is syphilis?

Syphilis is an STI that can cause serious health problems if left untreated. It can permanently damage your heart, brain, muscles, bones and eyes.

How is syphilis diagnosed?

If you suspect you have been exposed to syphilis, your doctor can test your blood for signs of the infection. If you have sores, your doctor can remove fluid or a small piece of skin to examine under a microscope for signs of syphilis. Getting seen by your doctor is important if you suspect you have been exposed to syphilis because the STI can progress through four stages, with different symptoms in each stage:

1. Primary syphilis: Two to 12 weeks after exposure, a smooth, hard sore called a chancre develops on your genitals or mouth. If you do not get treatment with medication, your infection may move to the second stage. You are highly infectious during this stage.
2. Secondary syphilis: About one to six months after the syphilis sore goes away, a rough, bumpy syphilis rash appears. The rash can cover your entire body, including your palms and soles (bottoms) of your feet.
3. Latent syphilis: If you don’t receive treatment during the first two stages, the infection moves into the latent stage and can damage your heart, bones, nerves and organs. This stage can last up to 20 years.
4. Late (tertiary) syphilis: Only about 20% of people progress to this phase, which causes a range of serious health problems. These problems occur slowly and include:

• • Brain damage, dementia and cognitive health problems
  • Heart disease
  • Movement disorders and muscle problems
  • Nerve damage
  • Seizures
  • Vision problems, including blindness

How is syphilis treated?

Your doctor can treat your syphilis infection with antibiotics.

What is trichomoniasis?

Trichomoniasis is a common STI caused by a one-celled protozoan parasite. In women, trichomoniasis can cause a foul-smelling vaginal discharge, genital itching and painful urination.

How is trichomoniasis diagnosed and treated?

A physical exam and lab tests can be used to diagnose trichomoniasis. Your doctor may look at a sample of your vaginal fluid under a microscope to look for evidence of the parasite. Trichomoniasis is treatable with antibiotics. Speak with your doctor about treatment options.