STDs: Talk STDs with Sue (cont.)
What do you think of the attention HPV has received lately and how
prevalent it seems to have become suddenly with new testing and such?
Human papillomavirus has reached almost epidemic proportions and is
insidious. Males, because their genitals are external, would in all
probability, be aware of the presence of genital warts. They check their
penis on a regular basis and if anything is amiss, they seek medical
Females, on the other hand, may be totally unaware of the presence of
warts because much of our genitals are internal, not visible. Many
females would have warts on their external genitals (labia, clitoris,
vaginal opening) but most females do not look at their genitals on a
Most females will feel this unusual painless bump on their genitals
when inserting a tampon during their menstrual period. Internal genital
warts in females will be diagnosed when she has an annual pelvic
examination including Pap smear.
Many doctors are unaware of the prevalence of anal sexual activity
amongst their patients so they may neglect to check the rectum during a
physical examination. For this reason, patients should be honest with
their family physician and ask the doctor to check for anal warts.
Isn't it the case that most men who are carrying HPV are unaware ...
especially the types that cause cervical abnormalities? Women really
have no way of knowing if their male partners have these types or not?
Most males are aware if they have genital warts, unless the warts are up
in their urethra. In which case, he might experience difficulty
urinating or discomfort urinating and would go to a physician quickly.
Females, on the other hand, may not know they are infected and
because human papillomavirus in females is a precursor to cancer of the
cervix, diagnosis and treatment is essential.
Research is underway because there is some indication that genital
warts, in a male urethra, MAY BE precursor to prostate cancer. That has
not been verified by the American Medical Association (AMA).
I'm not talking about the types that cause warts. I'm talking about
high-risk strains that lead to cervical dysplasia and cervical cancer.
There are 57 different varieties of the human papillomavirus, of which
two are known to be high risk for cancer.
Are some sex practices more likely to spread STDs than others? Or does
the use of condoms and medications make them all pretty much the same
Condoms and practicing safer sex provide excellent protection against
Chlamydia and gonorrhea, but because warts may be located anywhere on
the genitals, areas not covered by the condom, the partner could be
exposed to a herpes lesion during an outbreak.
We have a problem. How do you keep a condom from tearing during anal
Used properly, condoms very seldom tear. When they tear, it is generally
because the male did not leave a space at the tip of the condom when he
was rolling it down to the base of his penis; so that with pressure of
anal intercourse, the condom may tear. Always leave a space at the tip
of the condom to allow room for ejaculate to be stored and for
Can I take meds for herpes while pregnant? What about delivery?
When a female is pregnant, she should tell her doctor immediately that
she has genital herpes. If she has been taking suppressive therapy, the
doctor will take her off the medication because insufficient research
has been done to prove prenatal safety.
If a patient is near her due date, she must tell her doctor
immediately if she becomes aware of the prodromal symptoms, so that the
baby may safely be delivered by cesarean section. This will protect the
baby from possible exposure to the herpes virus.
We are almost out of time. Do you have any final words for us?
I've had this wonderful opportunity to help increase awareness of
genital herpes on an STD awareness campaign. If you want more
information about herpes, visit genitalherpes.com, or alksexwithsue.com,
and watch Talk Sex With Sue Johanson on Oxygen every Sunday and I'll be
there talking about sex.
We are out of time. Thanks to Sue Johanson, RN, for sharing her
expertise with us today. For more information, please be sure to visit
the WebMD message boards , where you can post your questions and
comments for our in-house experts and your fellow WebMD members. It's a
great community and you will be welcomed warmly!
WebMD Inc. All rights