Urinary incontinence refers to the loss of bladder control; it can range from occasional urine leakage to complete inability to hold urine. Urinary incontinence affects more women than men. More than 13 million women in the United States suffer from urinary incontinence at some point in their lives.

Types of urinary incontinence

The three main types of urinary incontinence are:

• Stress incontinence: sudden loss of urine during certain activities or motions
• Urge incontinence: a sudden need to urinate followed by involuntary loss of urine
• Overflow incontinence: occurs when the bladder does not empty completely, causing dribbling

.
Some women may also experience symptoms of both stress and urge incontinence, a condition known as mixed incontinence.

Stress incontinence

The most common type of urinary incontinence in women is stress incontinence, which is the unintentional release of urine during certain activities such as coughing, sneezing, laughing, exercising, or lifting heavy items. Stress incontinence affects women of all ages and is very treatable.

Stress incontinence occurs when your urethra, the tube that releases urine from the bladder, is unable to remain closed. Any movement that puts pressure on the bladder can cause the urethra to lose its seal, allowing urine to escape.

Urinary incontinence causes

Urinary incontinence is often thought to be a natural part of the aging process, but in reality, it affects women of all ages. Many factors can contribute to a weakening of the muscle and connective tissue of the vagina, including:

• Pregnancy and childbirth
• Menopause
• Obesity
• Chronic heavy lifting or straining

.

Urinary incontinence symptoms

Women often live with urinary incontinence for long periods of time, feeling frustrated by the way it complicates their lives and limits their activities. Talk to your doctor about urinary incontinence treatment if you experience any of the following symptoms:

• Unplanned urine loss while laughing, coughing, sneezing, getting up from a seated or lying position, or exercising
• The need to wear pads to absorb urine leakage
• Limiting or avoiding your activities to prevent urine leakage
• Planning trips or activities around the availability of restroom facilities

.

Urinary incontinence can often be diagnosed based on your symptoms and a pelvic exam. Your doctor may also want to perform special tests to evaluate the function of your bladder and urethra.

Urinary incontinence treatment

Traditional means of treating urinary incontinence include behavioral/muscle therapy and electrical stimulation, both of which aid in isolating and strengthening the pelvic floor muscles. Currently, there are no medications to treat stress incontinence in the United States.

Our office also offers Gynecare TVT, a minimally invasive outpatient procedure with proven results in treating stress incontinence.

.

For more information or to schedule an appointment, please contact the Center for Women’s Health at 913-491-6878.

Regular exercise builds bones and muscles, gives you energy, and keeps you healthy. Exercise is just as important during pregnancy. Being active and exercising at least 20 minutes on most days of the week can benefit your health in numerous ways, including:

• Reduces backaches, constipation, bloating and swelling
• Helps prevent or treat gestational diabetes
• Increases your energy
• Improves your mood
• Improves your posture
• Promotes muscle tone, strength and endurance
• Improves sleep

.

Pregnancy causes many changes in your body, some of which will affect your ability to exercise. The hormones produced during pregnancy cause your ligaments and joints to become relaxed. Remember that during pregnancy you are carrying extra pounds — as much as 25 to 40 pounds at the end of pregnancy. The extra weight in the front of your body shifts your center of gravity and places stress on joints and muscles, especially those in the pelvis and lower back. The extra weight you are carrying will make your body work harder than before you were pregnant. Exercise increases the flow of oxygen and blood to the muscles being worked and away from other parts of your body, so it’s important not to overdo it.

Before beginning your exercise program, talk with your doctor to make sure you do not have any health condition that would limit your activity. Most forms of exercise are safe during pregnancy; however, some types of exercise involve positions and movements that may be uncomfortable, tiring or harmful for pregnant women. For instance, after the first trimester of pregnancy, women should not do exercises that require them to lie flat on their backs.

Pregnancy exercises

Certain sports are safe during pregnancy, even for beginners: Walking or swimming is good exercise for anyone. Cycling provides a good aerobic workout. Aerobics is a good way to keep your heart and lungs strong. Other exercises, if done in moderation, are safe for women who have done them for a while before pregnancy:

• Running/jogging/walking
• Racquet sports
• Strength training
• Low impact aerobics
• Yoga

.
The following activities should be avoided during pregnancy:

• Water or snow skiing
• Contact sports
• Scuba diving

.

For more information or to schedule an appointment, please contact the Center for Women’s Health at 913-491-6878.

Diabetes is a condition that causes high levels of glucose in the blood. Glucose is a sugar that is the body’s main source of fuel. Health problems can arise when the glucose levels are too high or not well controlled. Diabetes during pregnancy, known as gestational diabetes, is high blood sugar that begins or is first diagnosed during pregnancy.

If you have diabetes, preparing for pregnancy can improve your health and that of your future child. Plan to see your doctor before you get pregnant to discuss your care.

Causes of gestational diabetes

Diabetes occurs when there is a problem with the way the body makes or uses insulin, is a hormone that converts glucose in food into energy. During pregnancy, the hormones produced by the placenta can change the way insulin works, leading to gestational diabetes. Gestational diabetes can occur even when no risk factors or symptoms are present. If symptoms are present, they are often mild, and glucose levels often return to normal after delivery.

Gestational diabetes risks

The risk of problems during pregnancy is greatest when diabetes is not well controlled. If you have diabetes or if you are at risk of developing gestational diabetes, you should be aware of the problems that may arise:

• Birth defects
• Macrosomia: delivering a very large baby, which can increase the risk of complications during delivery
• Preeclampsia: high blood pressure during pregnancy
• Hydramnios: too much amniotic fluid
• Urinary tract infections
• Respiratory distress syndrome, which can make it harder for the baby to breathe after birth

.

Diabetes control

You can measure and monitor your own glucose levels through a number of glucose monitoring devices, all of which are safe and simple to use on a daily basis. Maintaining a healthy diet, especially during pregnancy, can also help stabilize your blood sugar levels.

Home blood glucose monitoring

You can easily measure your blood sugar levels with a home glucose meter, which requires a small blood sample. A special needle called a lancet can be used to quickly prick the fingertip, and a drop of blood is then placed on a disposable testing strip. The testing strip is inserted into the glucose meter, which will read your blood sugar level.  You may need to check your glucose several times day to keep it at a normal level. For the most effective monitoring and treatment, keep accurate records of your results and report them to your doctor.

Gestational diabetes diet

Eating a balanced and nutritive diet is an important part of any pregnancy. The food you eat provides your baby with the necessary nutrients to grow and develop. Eating a healthy diet is even more important if you have gestational diabetes. Eating properly can often keep your blood sugar levels stable and may even help you avoid certain medications during your pregnancy.

Talk to your doctor about developing a proper diet plan during pregnancy. Your proper diet for gestational diabetes will depend on several factors, such as your weight, your activity level, how far along you are in your pregnancy, and how fast your baby is growing. Most women need just 300 extra calories a day during pregnancy.

.

For more information or to schedule an appointment, please contact the Center for Women’s Health at 913-491-6878.

Although many women have never heard of it, bacterial vaginosis (BV) is one of the most common vaginal infections and can lead to other problems. For many years, yeast infections have been the subject of widespread educational and advertising efforts, but little attention has been paid to a more common form of infection: bacterial vaginosis (BV).

BV is caused by an overgrowth of certain kinds of bacteria in the vagina.  Normally, the vagina contains protective bacteria called lactobacilli.  These “good” bacteria help maintain a normal pH level and hold down the growth of harmful microorganisms.  Anything that alters the normally acidic pH of the vagina can allow harmful organisms to take hold and flourish.

Bacterial vaginosis symptoms

Bacterial vaginosis is associated with a foul-smelling (“fishy”) vaginal odor, a milky vaginal discharge, and vaginal burning or itching. If you have BV, you may experience one or more symptoms, or you may not have any symptoms at all.

Bacterial vaginosis complications

Recent research has shown that BV increases the risk of some serious complications.  These include pelvic inflammatory disease (PID); infections following pelvic surgery, D & C, or abortion; and complications related to pregnancy, such as preterm labor, premature rupture of membranes, amniotic fluid infection, or post-partum infections.

How common is BV?

It is now thought that BV is even more common than yeast infections.  Studies show up to one-third of asymptomatic women will be found to be carriers of BV.

How do you get BV?

The cause of BV cannot always be traced.  It may be sexually transmitted — but not always.  Having multiple partners will increase the probability of getting BV.  Many women diagnosed with BV are experiencing no symptoms.  This can make BV a serious hidden danger, especially because it could affect fertility and cause pregnancy complications.

What is the difference between BV and a yeast infection?

A vaginal yeast infection is usually caused by Candida albicans, a fungus rather than bacteria.  Its symptoms include itching, burning and a “cottage cheese-like” discharge.  Yeast infections are usually odorless, and have not been associated with an increased risk of any serious medical complications.

Can I detect BV myself?

A fishy vaginal odor, burning, and a milky discharge are indicators of BV.  However, these symptoms are not always present.  If you suspect that you have BV or some other type of vaginal infection, you should consult your gynecologist or nurse practitioner for proper diagnosis and treatment.

How will the doctor tell if I have BV?

The first thing your doctor may do is check the appearance of your vagina and cervix.  Women with BV typically have vaginal pH levels higher than 4.5, while normal levels are in the 4.0 range.  BV may cause the secretions to have a bad odor, but sometimes this is hard to detect.  A drop of potassium hydroxide placed on secretions on a microscope slide will produce a positive “whiff test” if BV is present.  An additional test is the examination of the slides under a microscope to rule out the additional presence of yeast or trichomonas.

How does BV affect my sex life?

There is no scientific evidence that BV affects sexual relations, but many women say they are bothered by the odor and vaginal burning during — and especially after — intercourse.

Is BV a sexually transmitted disease?

Although BV is more common in women visiting clinics for sexually transmitted diseases, BV has also been reported in young girls and women who are not sexually active.

What is the treatment for bacterial vaginosis?

One oral and two topical treatments exist for BV.  Vaginal medicines include metranidazole gel (MetroGel), clindamycin cream, or ovules (Cleocin) used at bedtime for 1 to 7 nights, depending on the brand chosen.

The oral method is the use of metranidazole (Flagyl) tablets given orally for 5 to 7 days.

After treatment, could I get BV again?

As with most vaginal infections, recurrences of BV are common.  Some women have flare-ups of infection when they are on birth control pills or when pregnant.

What about sex during treatment?

It is recommended that your partner wear a condom while you are being treated.  The male is often not treated.

.
For more information or to schedule an appointment, please contact the Center for Women’s Health at 913-491-6878.

Most women feel changes in their body or mood during the days before menstruation. When these changes are severe enough to affect a woman’s normal life, they are known as premenstrual syndrome (PMS).

Premenstrual syndrome can affect menstruating women of all ages and backgrounds. The cause of PMS is unclear; however, the symptoms can be managed in many women.

Symptoms of PMS

Premenstrual symptoms are a common part of the monthly cycle. In fact, at least 85 percent of women who menstruate have at least one premenstrual symptom.

Women with PMS experience a pattern of symptoms month after month. They also find that the symptoms interfere with some aspect of their family, social or work lives.

Common symptoms of PMS are:

• Irritability
• Anger
• Depression or crying
• Mood swings
• Fatigue
• Bloating
• Breast tenderness
• Acne
• Changes in sleep patterns
• Changes in appetite

.

PMS or something else?

Symptoms of other conditions can mimic PMS, so talk to your doctor to determine if you have PMS or something else. To be considered PMS, your symptoms must:

• Be present in the five days before your period for
  at least three menstrual cycles in a row
• End within four days after your period starts
• Interfere with some of your normal activities

.

Premenstrual dysphoric disorder (PMDD)

Premenstrual dysphoric disorder (PMDD) is a severe type of PMS that affects a small percentage of women with PMS. PMDD symptoms are often similar to those listed above but are more intense and debilitating.

Depressive and anxiety disorders

These disorders are the conditions most commonly confused with PMS. The symptoms of depression and anxiety are much like the emotional symptoms of PMS. These symptoms may worsen before or during a woman’s period, which makes some women think they have PMS.

Menopause

Women entering menopause may have PMS-like symptoms, including mood changes and fatigue.

Other conditions

Your doctor will want to rule out other conditions that share symptoms with PMS. These conditions include chronic fatigue syndrome, irritable bowel syndrome, and endocrine problems.

What you can do

If you have PMS, talk with your doctor about your symptoms and treatment options. Simple changes may help improve your well-being, during your PMS and all month long. Lifestyle and dietary changes often can relieve some PMS symptoms.

The following methods can sometimes help lessen PMS symptoms:

• Aerobic exercise
• Finding ways to relax and reduce stress
• Simple changes in your diet
• Dietary supplements

.

Women with severe PMS may not feel relief with lifestyle or dietary changes alone. If these methods don’t reduce symptoms, your doctor may suggest certain medications. Talking with others about what you are going through may also help and may encourage your friendly and family to offer more support.

.

For more information or to schedule an appointment, please contact the Center for Women’s Health at 913-491-6878.

A Pap test, often called a Pap smear, checks for changes in the cells of your cervix, the opening to the uterus. The Pap test can tell if you have an infection or abnormal cells that could lead to cervical cancer.

During a Pap test, your doctor will collect a small sample of cells from the surface of the cervix. The sample is then spread or smeared on a slide or mixed in a liquid fixative and sent to a lab to be examined under a microscope. A Pap test is usually conducted as part of a woman’s regular pelvic exam.

Why do I need a Pap test?

A Pap test can save your life. It can detect the earliest signs of cervical cancer — a common cancer in women. If abnormal cells are caught early, the chances of curing cervical cancer are very high. Treatment can prevent most abnormal cells from developing into cervical cancer.

How is a Pap test done?

The Pap test is a simple and quick test that your doctor can perform as part of a routine pelvic exam. While you lie on the exam table, your doctor will use an instrument called a speculum to open your vagina and view your cervix. She will then use a special stick or brush to take a sampling of cells from inside and around the cervix. While usually painless, a Pap test may be slightly uncomfortable for some women.

How do I prepare for a Pap test?

Several factors can cause false test results by washing away or hiding abnormal cells. For two days before your test, you should avoid disrupting the cervical cells in any way, including:

• Douching
• Using tampons
• Using vaginal creams, suppositories, or medicine
• Using vaginal deodorant sprays or powders
• Having sex

.

Can I have a Pap test when I have my period?

No. Doctors suggest you schedule your Pap test when you do not have your period. The best time to be tested is 10 to 20 days after the first day of your last period.

What do abnormal Pap test results mean?

It is scary to hear that your Pap test results are “abnormal.” But abnormal Pap test results usually do not mean you have cancer. Most often there is a small problem with the cervix.

Your doctor may tell you that your Pap test indicates a condition known as Atypical Squamous Cells of Undetermined Significance, or ASCUS.  This means that you have thin, flat cells growing on the surface of your cervix, but these changes don’t necessarily indicate the presence of pre-cancerous cells. Your doctor may recommend that you have a test for human papillomavirus (HPV). HPV is a virus that can sometimes lead to cervical cancer. If no virus is found, your doctor may recommend that you have another Pap test in 6 months.

Some abnormal cells will turn into cervical cancer. But most of the time, your immune system can fight off these cells and they will go away on their own. Almost all cases of cervical cancer can be prevented with proper monitoring and treatment of abnormal cells.

How are abnormal cells treated?

If you have abnormal cells, your doctor may simply recommend that you have another Pap test in 6 months to see if the abnormal cells are still present. In some cases, your doctor may want to perform a more detailed examination called a colposcopy.

.
For more information or to schedule an appointment, please contact the Center for Women’s Health at 913-491-6878.

Human papillomavirus (HPV) is one of the most common causes of sexually transmitted infection (STI) in the world. Health experts estimate there are more cases of genital HPV infection than any other STI in the United States. According to the Centers for Disease Control and Prevention, approximately 6.2 million new cases of sexually transmitted HPV infections are reported every year. At least 20 million people in this country are already infected.  If left untreated for many years, HPV has the potential to develop into cervical cancer.

HPV symptoms

Like many STIs, genital HPV infections often do not have signs and symptoms that can be seen or felt. One study sponsored by the National Institute of Allergy and Infectious Diseases reported that almost half of women infected with HPV had no obvious symptoms. If you are infected but have no symptoms, you can still spread HPV to your sexual partner and/or develop complications from the virus.

When symptoms are present, they may include:

• Burning after intercourse
• Chronic vaginal discharge
• Warts on the vaginal opening or anus

.

Often, it is up to the primary care physician or gynecologist to rule out the possibility of HPV. Warning signs for doctors to look for include abnormal Pap smears and frequent vaginal infections.

Types of HPV

More than 100 different types of HPV exist, most of which are harmless. About 30 types are spread through sexual contact and are classified as either low risk or high risk. Some types of HPV that cause genital warts are considered low risk. High-risk types of HPV may cause abnormal Pap smear results and could lead to cancers of the cervix, vulva, vagina, anus, or penis. Many people infected with HPV have no symptoms.

Some types of HPV cause common skin warts, such as those found on the hands and soles of the feet. These types of HPV do not cause genital warts.

Is HPV a threat to you?

Experts estimate that over 85 percent of all women with cervical cancer at one time were infected with HPV. Age is no barrier to HPV.  Women of all ages have been found to have HPV. All sexually active women are at risk, even those in a monogamous relationship.

Studies have shown that with proper detection and definitive treatment, the human papillomavirus should not progress to a cancerous stage. One reason why HPV is often not detected is the widespread reliance on only the Pap smear — often thought to be a fail-safe test for cervical disease.  Historically, if a woman’s Pap smear came back “negative,” she was told that she was free of cervical disorders. Recent studies have shown that Pap smears often fail to diagnose HPV.

What are the causes of HPV?

Although HPV is primarily spread by sexual contact, this is not always the case.  Reports exist of infection from gym equipment, tanning beds, and shared towels.

Another cause is thought to be a depressed immune system — such as that caused by smoking.  Some women may have also been born with the infection.

With proper detection and treatment, HPV rarely progresses to cervical cancer

To halt the progress of the HPV epidemic, some healthcare providers recommend that every sexually active woman receive some sort of diagnostic test for human papillomavirus along with her Pap smear.  An aggressive approach to chronic infections or a Pap smear showing inflammatory changes often discovers unsuspected HPV. If you have abnormal cervical cells, it is particularly important for you to have regular pelvic exams and Pap smears so you can be treated early if necessary.

Because of modern medical advances, procedures are available to help discover and treat diseases that were once responsible for disability and even death.  The Thin Prep is a specialized Pap smear designed to eliminate errors by human technologists. This test adds to the cost of a Pap smear and may not be covered by insurance. Another test to diagnose HPV infection detects the HPV DNA, which may indicate possible infection.

What is the treatment for HPV?

If diagnostic tests indicate you could be infected with HPV, your doctor may recommend one of the following procedures:

Colposcopy

A colposcopy is a simple procedure that allows your doctor to examine your cervix more closely. It is performed in our office and takes 10 to 15 minutes. During a colposcopy, acetic acid (vinegar) is applied to your cervix and a doctor examines your cervix with a large microscope called a colposcope. The acetic acid causes any abnormal areas to turn white. Your doctor may choose to biopsy these areas, or take a small sample of cells for further testing. Some women may experience pain or discomfort as a result of a cervical biopsy.

LEEP procedure

LEEP (loop electrosurgical excision procedure) involves the use of an electrically energized wire loop to remove the abnormal tissue. The LEEP recovery time depends upon how much tissue was removed. After a LEEP procedure, most women are able to return to their regular activities within 1 to 3 days. Some women may experience mild cramping.

Laser surgery

Laser surgery uses a microscope to deliver a tiny beam of laser energy to destroy abnormal tissue.  It may be performed in our office or in a hospital setting.

Cyrosurgery

Cyrosurgery involves freezing off the diseased tissue and warts.

Creams

Prescription creams such as Efudex or Aldara can sometimes be used on the cervix or on individual warts on the perineum.

Effective diagnosis and treatment of HPV

The Center for Women’s Health is known in the Kansas City metro area for innovative treatment methods. Because of clinical research affiliations with major pharmaceutical companies, Dr. Hodes and Dr. Nauser have access to new developments that are not yet widely available.  They have been involved in the study of human papillomavirus and are dedicated to alerting women to its danger.

The office is equipped with the latest colposcopy equipment, as well as in-office laser and LEEP surgery.  The staff is especially sensitive to the needs of women with HPV and provides the compassionate care our patients need to fully recover.

.

For more information or to schedule an appointment, please contact the Center for Women’s Health at 913-491-6878.

Interstitial Cystitis (IC), also known as painful bladder syndrome, is a condition that results in recurring discomfort or pain in the bladder and the surrounding pelvic region. The symptoms vary from case to case and even in the same individual. People may experience mild discomfort, pressure, tenderness, or intense pain in the bladder and pelvic area. Symptoms may include an urgent need to urinate (urgency), a frequent need to urinate (frequency), or a combination of these symptoms. Pain may change in intensity as the bladder fills with urine or as it empties. Women’s symptoms often get worse during menstruation. They may sometimes experience pain with vaginal intercourse.

Because IC varies so much in symptoms and severity, most researchers believe that it is not one, but several diseases. In recent years, scientists have started to use the term painful bladder syndrome (PBS) to describe cases with painful urinary symptoms that may not meet the strictest definition of IC.

IC can affect people of any age, race or sex. It is, however, most commonly found in women.

Interstitial cystitis symptoms

Some or all of the following symptoms may be present with IC:

• Frequency: Day and/or night frequency of urination (up to 60 times a day in severe cases). In early or very mild cases, frequency is sometimes the only symptom.
• Urgency: The sensation of having to urinate immediately, which may also be accompanied by pain, pressure or spasms.
• Pain: Can be in the lower abdominal, urethral or vaginal area. Pain is also frequently associated with sexual intercourse. Men with IC may experience testicular, scrotal and/or perineal pain, and painful ejaculation.
• Other disorders: Some patients also report muscle and joint pain, migraines, allergic reactions and gastrointestinal problems. It appears that IC has an as yet unexplained association with certain other chronic diseases and pain syndromes such as vulvar vestibulitis, fibromyalgia, and irritable bowel syndrome. Many IC patients, however, have only bladder symptoms.

.

How is interstitial cystitis diagnosed?

Most IC patients have difficulty obtaining a diagnosis. To make a proper diagnosis of interstitial cystitis, a doctor must follow these steps:

• Take urine cultures to determine if there is a bacterial infection present.
• Rule out other diseases and/or conditions that have symptoms resembling IC. These diseases may include bladder cancer, kidney problems, tuberculosis, vaginal infections, sexually transmitted diseases, endometriosis, radiation cystitis and neurological disorders.
• Perform a cystoscopy with hydrodistention under general anesthesia if no infection is present and no other disorder is discovered. If distention under anesthesia is not performed, the diagnosis of IC may be missed. Cystoscopy during a routine office visit may not reveal the characteristic abnormalities of IC and can be painful for those who have IC. It is necessary to distend the bladder under general or regional anesthesia in order to see the pinpoint hemorrhages on the bladder wall that are the hallmark of this disease. A biopsy of the bladder wall may be necessary at this time to rule out other diseases such as bladder cancer and to assist in the diagnosis of IC. Interstitial cystitis is not associated with bladder cancer.

.

Interstitial cystitis treatment

At this time there is no cure for interstitial cystitis, nor is there an effective treatment that works for everyone. However, a vast majority of IC patients are helped by one or more of the following treatments:

• Oral Medications: There are several drugs used to treat the causes and symptoms of IC.
• Bladder Instillation: During a bladder instillation, also called a bladder wash or bath, the bladder is filled with a solution that is held for varying periods of time, averaging 10 to 15 minutes, before being emptied.
• Bladder Distention: During this procedure, the bladder is distended or stretched by filling it with liquid. This not only helps diagnose IC but also, for reasons that aren’t completely clear, brings relief to a significant number of patients.
• Other Treatments: These include changes in diet, stress reduction, visualization, bio-feedback, bladder retraining, and exercise.  Additionally, surgery or electronic nerve stimulation might be required to treat IC.

.
.
For more information or to schedule an appointment, please contact the Center for Women’s Health at 913-491-6878.

The most easily recognized sign of genital HPV infection is genital warts (sometimes called condylomata acuminata or venereal warts). Many people, however, have a genital HPV infection without genital warts.

Genital warts are soft, moist, or flesh colored, and appear in the genital area within weeks or months of infection. They sometimes appear in clusters that resemble cauliflower-like bumps, and are can be raised or flat, small or large. Genital warts can show up in women on the vulva and cervix, and inside and surrounding the vagina and anus. In men, genital warts can appear on the scrotum or penis. Genital warts have also been found on the thigh and groin. Rarely, genital warts also can develop in your mouth or throat if you have oral sex with an infected person.

Transmission of genital warts

Genital warts are very contagious. You can get them during oral, vaginal, or anal sex with an infected partner. You can also get them by skin-to-skin contact during vaginal, anal, or (rarely) oral sex with someone who is infected. About two-thirds of people who have sexual contact with a partner with genital warts will develop warts, usually within 3 months of contact.

Diagnosis of genital warts

Your health care provider can usually diagnose genital warts by sight. If you are a woman with genital warts, you also should be examined for possible HPV infection.

Your doctor may be able to identify some otherwise invisible warts in your genital tissue by applying acetic acid (vinegar) to areas of your body that might be infected. This solution causes infected areas to turn white, which makes them more visible. In some cases, your doctor will take a small piece of tissue from the cervix and examine it under a microscope.

Genital warts treatment

Genital warts often disappear on their own, but there is no way to predict whether they will disappear or continue to grow. If you suspect you have genital warts, you should be examined and treated if necessary.

Depending on factors such as the size and location of your genital warts, your health care provider will offer you one of several ways to treat them:

• Imiquimod cream
• 20 percent podophyllin antimitotic solution
• 0.5 percent podofilox solution
• 5 percent 5-fluorouracil cream
• Trichloroacetic acid (TCA)

.

If you are pregnant, you should not use podophyllin or podofilox because they are absorbed by your skin and may cause birth defects. You should also not use 5-fluorouracil cream if you are pregnant.

If you have small warts, your health care provider can remove them by one of three methods:

• Freezing (cryosurgery)
• Burning (electrocautery)
• Laser treatment

.

If you have large warts that have not responded to other treatment, they may require surgery.

Some health care providers inject the antiviral drug alpha interferon directly into warts that have returned after removal by traditional means. The drug is expensive, however, and does not reduce the rate that the genital warts return.

Although treatments can get rid of the warts, none gets rid of the virus. Because the virus is still present in your body, warts often come back after treatment.

HPV prevention

The only way you can prevent getting an HPV infection is to avoid direct contact with the virus, which is transmitted by skin-to-skin contact. If you or your sexual partner has warts that are visible in the genital area, you should avoid any skin-to skin and sexual contact until the warts are treated.

Gardasil is the only vaccine that may help guard against diseases caused by human papillomavirus (HPV) types 6, 11, 16, and 18:

• Cervical cancer
• Cervical abnormalities that can sometimes lead to cervical cancer
• Genital warts

.

HPV Types 16 and 18 cause 70% of cervical cancer cases, and HPV Types 6 and 11 cause 90% of genital warts cases.

Historically, research studies have not confirmed that male latex condoms prevent transmission of HPV. Recent studies, however, demonstrate that consistent condom use by male partners may offer strong protection against low- and high-risk types of HPV infection in women. Unfortunately, many people who don’t have symptoms don’t know that they can spread the virus to an uninfected partner.

Risks of genital warts during pregnancy and childbirth

Genital warts can multiply and become brittle, which may cause a number of problems during pregnancy. Your health care provider can discuss options for their removal if necessary. Genital warts also may be removed to ensure a safe and healthy delivery of the newborn. Sometimes genital warts grow larger during pregnancy, making it difficult to urinate if the warts are in the urinary tract. If the warts are in the vagina, they can make the vagina less elastic and cause obstruction during delivery.

Rarely, infants born to women with genital warts develop warts in their throats (respiratory papillomatosis). Although uncommon, it is a potentially life-threatening condition for the child, requiring frequent laser surgery to prevent obstruction of the breathing passages. Research on the use of interferon therapy with laser surgery indicates that this drug may show promise in slowing the course of the disease.

.
For more information or to schedule an appointment, please contact the Center for Women’s Health at 913-491-6878.

Gardasil is the only vaccine that may help guard against diseases caused by four types of human papillomavirus (HPV): 6, 11, 16, and 18. These diseases include:

• Cervical cancer
• Cervical abnormalities that can sometimes lead to cervical cancer
• Genital warts

.

Help protect yourself today

Gardasil is for girls and young women ages 9 to 26. Gardasil works when given before you have any contact with HPV Types 6, 11, 16, or 18. If you’ve already been infected with HPV, you may still benefit from Gardasil, because it is unlikely that you have been infected with all 4 types of the virus covered by the vaccine. That’s why we feel it’s important for you to know about this vaccine now.

Important information for young women ages 18 to 26

Vaccination with Gardasil does not take the place of Pap tests (cervical cancer screenings). Pap tests will still be an important part of taking control of your health and taking care of yourself.

Pap tests have been proven to help save lives. A Pap test looks for abnormal cells in the lining of the cervix before they have the chance to become precancerous or cervical cancer. The more severe the abnormality, the more likely it is that cervical cancer could develop in the future.

Having an abnormal Pap test isn’t any reason to panic — it doesn’t always mean that you are at risk for cancer or even have HPV. Your doctor or healthcare professional may repeat the Pap test or do other tests as needed.

Important information for mothers of girls ages 9 to 17

Pap tests have been proven to save lives. Your daughter’s doctor or healthcare professional can tell you when you should schedule her first Pap.

In the meantime, you can start teaching her good healthcare habits now. Take her for regular wellness exams. Understanding the importance of wellness visits now may help her maintain regular checkups as she gets older.

Important information about Gardasil

HPV types 16 and 18 cause 70 percent of cervical cancer cases, and HPV Types 6 and 11 cause 90 percent of genital warts cases. Gardasil will not treat these diseases and will not protect against diseases caused by other types of HPV.

Gardasil may not fully protect everyone and does not prevent all types of cervical cancer, so it is important to continue regular cervical cancer screenings.

Anyone who is allergic to the ingredients of Gardasil should not receive the vaccine. Gardasil is not for women who are pregnant.

Gardasil is given as 3 injections over 6 months and can cause pain, swelling, itching, and redness at the injection site, fever, nausea, and dizziness. Only a doctor or healthcare professional can decide if Gardasil is right for you or your daughter.

.
For more information or to schedule an appointment, please contact the Center for Women’s Health at 913-491-6878.