HPV- Vain1

[Callie1]

Hi Doc,

Thanks so much for this service!  My question is: I like everyone else, found a "bump" and went to the doctor to see what it was. Turns out I have GW. I went to the Gynocologist and she found other areas that she was concerned about and biopsied them. The pathology came back as VAIN1 and the HPV type as low risk. How serious is the intraepithelial neoplasia? I cannot seem to find much information on it and I'm a little scared. How difficult is it to treat? I'm sure you can imagine my questions are endless so if you have a source to direct me to that would be great as well. If I may also ask another question: I've been in a monogamous relationship for the past 2.5 years (I only had 2 partners before this and the GW's came up this March). My fiance does not have any visible GW's and we've had unprotected sex b/c we are exclusive and plan on being married. Is it normal for him to not have them? Could he have given them to me even though he does not have visible warts? I'm still scared to have oral sex with him too. Please help!

Thanks so much!

[H. Hunter Handsfield, M.D.]

I'm not a particular expert on the natural course of vaginal intraepithelial neoplasia (VAIN), but I'm quite certain that stage 1 is commonly present in people with genital warts and that the risk of progression to malignancy is extremely low.  But a dermatologist or your own gynecologist probably know more than I do.  In any case, vulvar cancer is an extremely rare disease.  But for more expert information, consider posting your question on the med help dermatology forum.



Yes, it is entirely normal for one person in a sexual relationship to have genital warts and the other have no symptoms, and no warts even on careful examination by a professional.  He undoubtedly is infected with the same HPV type causing your warts, but it is impossible to know which of you was infected first; you'll never know, and in any case it probably isn'tt important.



Oral warts are exceedingly rare, even when there is known oral contact with people with known HPV infection.  In any case, your oral cavity undoubtedly has already been exposed to the virus.  The two of you need take no precautions whatsoever at this stage--no condoms, no changes in sexual practices, etc.



Good luck--  HHH, MD