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February 9, 2012

Genital Warts In Women (cont.)

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Precancerous changes (dysplasia) of the cervix

Women who have evidence of moderate or severe precancerous changes in the uterine cervix require treatment to ensure that these cells do not progress to cancer. In this case, treatment usually involves surgical removal or destruction of the involved tissue. Conization is a procedure that removes the precancerous area of the cervix using a knife, a laser, or by a procedure known as LEEP (loop electrosurgical excision procedure, which uses an electric current passing through a thin wire that acts as a knife). LEEP is also referred to as LLETZ (large loop excision of the transformation zone). Cryotherapy (freezing) or laser therapy may also be used to destroy tissue areas that contain potentially precancerous changes.

Can HPV infection be prevented?

A vaccine is available against four common HPV types associated with the development of genital warts and cervical and anogenital carcinomas. This vaccine (Gardasil) has received FDA approval for use in males and females between 9 and 26 years of age and confers immunity against HPV types 6, 11, 16 and 18. Another vaccine directed at HPV types 16 and 18, known as Cervarix, has been approved for use in females aged 10-15.

Abstinence from sexual activity can prevent the spread of HPVs that are transmitted via sexual contact, but a person who abstains from sex may still become infected with other HPV types, such as those that cause common skin warts. Some researchers have postulated that HPV infection might be transmitted from the mother to her infant in the birth canal, since some studies have identified genital HPV infection in populations of young children and cloistered nuns. Hand-genital and oral-genital transmission of HPV has also been documented and is another means of transmission.

HPV is transmitted by direct genital contact during sexual activity. The virus is not found in or spread by bodily fluids, and HPV is not found in blood or organs harvested for transplantation. Condom use seems to decrease the risk of transmission of HPV during sexual activity but does not completely prevent HPV infection. Spermicides and hormonal birth control methods cannot prevent the spread of HPV infection.


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