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STDs (Expert Forum)
genital warts and vestibular papillae
Answered by
University of Washington
Seattle - WA
This forum does not cover AIDS/HIV issues. This forum is for questions and support regarding STD issues such as: Chlamydia, Crabs (pubic lice scabies), Gonorrhea, Hepatitis (viral), Herpes, HPV, Molluscum Contagiosum, PID, Rectal Infections, Syphilis, Trichomonas, Warts, Yeast Infection.
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This forum is limited to questions about STDs other than HIV/AIDS. For questions about HIV prevention, or if you have general questions about safe sex (e.g., condoms, how to protect yourself from HIV and STDs), please visit the HIV Prevention and Safe Sex Forum
Some of the most common types of questions concern the risk of HIV or STD after a particular sexual exposure, and about symptoms that might or might not be due to HIV. If your question is along these lines, please visit the HIV Prevention and Safe Sex Forum.
genital warts and vestibular papillae
by hpvinfosearcher, Jul 14, 2007 12:00AM
26YO F diagnosed with GW in July 06. Laser surgery in Oct 06. Last outbreak was Jan 07 (TCA got rid of it). Free of warts since then (and pap was normal). Completed gardasil injections in Apr 07. During this time I was not sexually active.
I began having sex with a new partner in May 07 (I did disclose my HPV status). There were a few times recently that I bled after sex (and it looked like a small paper cut at the opening of my vagina). I began taking birth control about 3 weeks ago.
Recently, I noticed small bumps on my labia minora, which my GYN diagnosed as vestibular papillae (he said it was normal. He attributes the bleeding after sex to not being lubricated enough, and possibly due to the yeast infection.
My questions:
1. The vestibular papillae are new growths (past month) – what causes them to grow (could it be bc I started the pill)? Is this indicative that I still have an active HPV infection? Can I expect them to grow or disappear? could they turn into or encourage warts to grow?
2. I’ve been “clear” of warts for 6 months, from what I’ve read, I have a much lower risk of transmitting HPV to my partner (we’d like to start having unprotected sex). Is the risk still low with the papillae?
4. Would you recommend having my current boyfriend get the gardasil injection (off-label)?
I began having sex with a new partner in May 07 (I did disclose my HPV status). There were a few times recently that I bled after sex (and it looked like a small paper cut at the opening of my vagina). I began taking birth control about 3 weeks ago.
Recently, I noticed small bumps on my labia minora, which my GYN diagnosed as vestibular papillae (he said it was normal. He attributes the bleeding after sex to not being lubricated enough, and possibly due to the yeast infection.
My questions:
1. The vestibular papillae are new growths (past month) – what causes them to grow (could it be bc I started the pill)? Is this indicative that I still have an active HPV infection? Can I expect them to grow or disappear? could they turn into or encourage warts to grow?
2. I’ve been “clear” of warts for 6 months, from what I’ve read, I have a much lower risk of transmitting HPV to my partner (we’d like to start having unprotected sex). Is the risk still low with the papillae?
4. Would you recommend having my current boyfriend get the gardasil injection (off-label)?
Doctor's Answer
by H. Hunter Handsfield, M.D., Jul 14, 2007 12:00AM
, Jul 14, 2007 12:00AM
Unfortunately, vestibular papillae are not an STD, which is the only focus of this forum; and I'm not a gynecologist and really don't know much about them. Although they can be confused with warts by untrained observers, that's undoubtedly not a problem for a gynecologist.
1) So I cannot answer question 1, except to confirm it's not a manifestation of HPV or warts. You should just ask your gynecologist for much more accurate information than I can offer.
2) In general, warts usually are not transmissible once the warts themselves have been resolved and there has been no visible recurrence after a few months. Six months is probably about right.
4) You don't say how long you and your boyfriend have been together. If you were sexually active during the time you had warts, you can assume he already has been infected, regardless of whether he ever had visible warts. If he is a new partner since your warts were treated, he might be susceptible--but on the other hand, you probably aren't still infected yourself. Either way, most likely there is no problem. Further, if he gets immunized with Gardasil, he won't be protected until a month or so after the second dose, i.e. not until 2 months after starting--and not fully protected until after the 3rd dose in 6 months. And as you say, since it's still off-label for men, it would cost at least $500. So bottom line is that it's up to you, but to me it doesn't seem worth the hassle. What's the worst that happens? He gets warts, gets treated, then doesn't have to worry about it--at least not if he doesn't have a new partner who he might infect.
Good luck-- HHH, MD
1) So I cannot answer question 1, except to confirm it's not a manifestation of HPV or warts. You should just ask your gynecologist for much more accurate information than I can offer.
2) In general, warts usually are not transmissible once the warts themselves have been resolved and there has been no visible recurrence after a few months. Six months is probably about right.
4) You don't say how long you and your boyfriend have been together. If you were sexually active during the time you had warts, you can assume he already has been infected, regardless of whether he ever had visible warts. If he is a new partner since your warts were treated, he might be susceptible--but on the other hand, you probably aren't still infected yourself. Either way, most likely there is no problem. Further, if he gets immunized with Gardasil, he won't be protected until a month or so after the second dose, i.e. not until 2 months after starting--and not fully protected until after the 3rd dose in 6 months. And as you say, since it's still off-label for men, it would cost at least $500. So bottom line is that it's up to you, but to me it doesn't seem worth the hassle. What's the worst that happens? He gets warts, gets treated, then doesn't have to worry about it--at least not if he doesn't have a new partner who he might infect.
Good luck-- HHH, MD
I'm concerned about transmissability because the guy that infected me never showed any visible symptoms, but after I was infected I had warts appear.
If I understand correctly, for people who do have visible GWs, once they clear up, and stay gone, the transmission risk is lowered.
But what about for the subclinical carriers of the virus? does their transmission risk taper off or stay high always?