A few questions to ask

Hi Doctor

I have a few questions to ask but before I start I thought Id tell you the results of my tests. After six weeks since my possible exposure I tested for Herpes, HIV and Syphilis. All results came back negative.

The doctor says its possible that the Herpes was a bit early as you said before. So I'm getting another test done on October 6th (This would make it the 10th week since the exposure)

Ive asked my Doctor about why I'm experiencing pain, DISCOMFORT rather when Im having sex. Vaginal dryness was one suggestion - I was quite skeptical since Im always aroused and Im in my early 20s. They made it sound like I was experiencing dryness due to menopause.

I don't think I have Herpes - Im not definite - I just dont think I have it. Anyways, my doctor performed a pap.

My question is...
1) Will pap smears detect low risk HPV? I mean will pap smears detect if I have Genital Warts? I know it detects abnormal changes - does this apply to low risk HPVs/ genital warts (visible or not visible)

There are LOW RISK HPV tests available. I told my doctor that Im concerned with Genital warts. She says she doesnt see anything. I suggested if we should do a LOW RISK test for HPV. She said no. She said further tests should be done if the pap smear comes back abnormal -hence my question. Can pap smears detect low risk HPV or HPV responsible for Genital Warts.

During the pelvic exam, I showed my doctor that my right inner labia looks and feels alright while the left labia has tears. Maybe chaffing that widen after sex - it doesnt HURT but i feel discomfort. Im really confused - I was thinking maybe its warts since Genital Warts can cause breaks or irregularities in the skin.

Could you please offer me some information?

Thank you

[H. Hunter Handsfield, M.D.]

The symptoms you describe do not suggest HPV or any other STD, and I have no particular opinion about likely causes; your own provider remains the best source.

No routine tests are available to detect HPV types 6, 11, and other "low risk" types.  ("Low risk" refers to association with cancer and pre-cancerous lesions--for those readers who don't know the terminology.  The low-risk types are the ones that primaily cause genital warts.)  The HPV tests done increasingly often along with pap smears are designed to detect several types, including both high and low risk, but they do not distinguish the types themselves.  And the test is not designed for non-pap specimens (e.g., a swab from the labia) and would not be reliable.

Everybody gets genital HPV somewhere along the line; it really is inevitable, except in those few people who never have sex except with a partner who also has never had other partners.  This likely will change in the future; promising anti-HPV vaccines are in development and likely will be on the market in the next 1-2 years.  But in the meantime, no treatment is available for asymptomatic low-risk HPV infection, nor is there any need to change sexual practices, notify partners, etc.

Bottom line:  Follow through with your provider about your symptoms.  Based on your description, I see no reason to be particularly concerned about HPV.

Good luck-- HHH, MD

[so_scared]

Im not asking for a diagnosis - I'm just asking for information on LOW RISK HPV and if Pap smears can detect them.

I would just like information on the things mentioned above.

Thank you

[H. Hunter Handsfield, M.D.]

I meant to add a couple of resources for more information.  You can start with the article on HPV and warts in the link "STD Quick Facts and Articles" on the STD forum home page.  Other excellent sources of HPV/warts information are the American Social Health Association (www.ashastd.org) and CDC (www.cdc.gov/std).

HHH, MD

[iknowhowyoufeel]

Hi there.  I have recently been in a similar situation (with vaginal/labial tearing after sex).  After 10 weeks of symptoms, two lots of blood tests (for HSV1 & 2 all negative), swabs (negative), use of a yeast cream (which helped only a little) I have finally found something that helps - Bepanthen.  

I'm not sure if it's called that where you live - it's basically just a nappy rash ointment that's really soothing and lubricating.  It's the only thing that has worked for me (and my doctor didn't even suggest it - one of my friends did).  If you are still suffering from these tears, give it a try.

[so_scared]

Like I said earlier, I do not know if Im experiencing vaginal cuts or tears - I have been using Vaseline - I've read that Vaseline should protect the tissue from Yeast infections etc and promote healing. On another site, Ive read that Vaseline may irritate the tissues. My question is, is there any point using it? Or should I just stop and leave it alone?

[H. Hunter Handsfield, M.D.]

You should follow your own health care provider's advice.

HHH, MD