PregnancyThe retrospective study analyzed data from more than 11,000 births to women in New Jersey from 2005 to 2007. All the women were continuously enrolled in Medicaid for the 6 months prior to and 12 months after delivery. The International Classification of Diseases diagnosis codes or prescription records for an antidepressant or antidiabetic medication identified the women with diabetes and depression. Of the study population, 100 women with prepregnancy or gestational diabetes were identified. The women in this group had nearly double the risk of depression during pregnancy or in the postpartum period compared to women without diabetes (15.2% versus 8.5%.) Women with diabetes, but no history of depression, experienced postpartum depression at a rate of 9.6%, compared to 5.9% of women without diabetes or history of depression.

Depression during pregnancy and the postpartum period poses great risk to the mother and child, including impaired functioning for the mother, decreased bonding between mother and child, and maternal thoughts of harming herself or her baby. Depression can lead to inadequate care of both the new mother and the child, posing long-term health and safety risks to both if left untreated.

Previous studies concluded that women with gestational diabetes had more negative perceptions about their health than women without diabetes. These women also had higher anxiety levels during pregnancy and lower sense of overall well-being and health than non-diabetic women. In the same way, many studies have indicated that diabetes unrelated to pregnancy is associated with depression, so this new link may not be entirely pregnancy-related. Additionally, this study looked at women in a low-income demographic, which, can itself, be a risk factor for depression.

Depression affects at least 10% of mothers during the perinatal period. Likewise, diabetes occurs in nearly 9% of pregnancies. Women with gestational diabetes, and their children, are more likely to experience birth-related morbidity and develop chronic disease in the future, including diabetes and hypertension, even if their blood glucose returns to normal after pregnancy. Improved outcomes in pregnancy-related diabetes can be achieved through improved compliance to diet and medication regimens, better control of blood glucose before and during pregnancy, improved neonatal care, and early screening for glucose intolerance and fetal abnormalities. The American Diabetes Association recommends screening women for glucose intolerance in the first trimester of pregnancy if they possess a risk factor for diabetes, as well as screening all women between the 24th and 28th weeks of pregnancy. The American College of Obstetricians and Gynecologists supports theses guidelines.

Women with diabetes during pregnancy are more likely to experience a numerous medical complications before, during, and after pregnancy, as are their infants. Now, depression may need to be added to the list of adverse outcomes associated with diabetes in pregnancy. With growing populations of ethnic groups in the US at increased risk for diabetes, as well as an increase in obesity and an increase in childbearing age in women, the prevalence of gestational diabetes will continue to rise. The newest study asserts that more research is needed to understand the exact relationship between diabetes and depression, but the increased risk of new-onset depression related to gestational diabetes calls for more intervention for women at highest risk for both diabetes and depression.

Studies have shown that the ideal time to vaccinate is prior to sexual activity. While the vaccine will never full protect against cervical cancer, it will significantly reduce the incidence according to results of years of research. While children will benefit the most, it would seem adult women can still be protected.  However, the studies caution that the vaccines are preventative and will not help those who already have genital warts or signs of cervical cancer. The vaccines are administered in three separate injections.

The chances of getting HPV and genital warts

There are certain factors which can put you at a higher risk of getting genital warts:

• If you have multiple sexual partners.
• If you do not know the status of your sexual partner.
• If your sexual partner has multiple sexual partners.
• If you start to become sexually active at an early age.
• If you are a heavy smoker and drinker.
• If you suffer form other viral infections such as HIV or herpes.
• If you suffer from stress.
• If you have unprotected sex whether vaginal, anal or even oral.

The hard fact is that the only 100% way to prevent genital warts is not to have sex.

In addition, there is no test available to determine if a male is carrying the HPV virus. It is only when visible genital warts are present that HPV can be confirmed. In a female, the Pap smear test can detect an abnormality in the tissue of the cervix which may indicate HPV.

Therefore to minimize the risks of passing on the HPV virus, any genital warts should be treated as soon as possible while some protection will be afforded by properly using a latex condom every time you have any form of sexual intercourse.  The concern is that condoms may not give complete protection because the virus can be in those areas of the genitals not covered by the condom.

The ways in which genital warts are spread

Genital warts are highly infectious and are spread mainly through direct skin-to-skin contact with the infected genital area during vaginal, anal or oral sex. They can even be passed on through non penetrative sex play, hand transmission or from the use of sex toys.  Although lesbian sex is generally considered to be low risk for sexually transmitted infections, studies have shown that genital warts can be spread between women.  In rare cases, genital warts can even be spread without direct sexual contact – if you use a towel to wipe your genitals after it has just been used by someone who has the virus to dry an area where there are genital warts. The obvious rule here is always to use your own personal towel.

Remember that genital warts are not necessarily a sign that you or your partner has been unfaithful in the relationship – the virus can lie dormant in the skin for many years.

The different types of genital warts

In women, genital warts can grow on the lips of the vulva, around the clitoris or the urethra and on the area between the vagina and the anus. We tend to give these warts all the name of vaginal warts. The main genital warts symptoms are the appearance of small red or white bumps on the genitalia. Sometimes they are single, other times in cauliflower like clusters. They may even be flat and barely visible.

In men, genital warts can appear on the tip or the shaft of the pens, on the scrotum and on the area around the anus.  Their appearance can be tiny warts or they can also accumulate into large masses on the genital tissue.  They can have rough or smooth surfaces and are typically flesh colored.

All of the above are external genital warts.  Internal genital warts can also occur on the inside of the vagina, the cervix, inside the anus and even inside the mouth or the throat following oral sexual contact with an infected person.

The important thing is to get any warts or sores which appear on your genitalia correctly diagnosed and treatment started.

Genital warts in the very young

In rare cases, babies born to women who have genital warts develop warts in their throats.  Although this is very uncommon, it is a potentially dangerous condition for a baby who would require laser surgery to prevent the obstruction of his or her breathing passages.

If a child is found to have genital warts, you should be very alert to the fact that sexual abuse may be the cause.

Genital warts and teens

Genital warts and other sexually transmitted diseases have become a serious health problem in teens with nearly 1 in 5 requiring treatment by the age of 21 in the US alone.  Teens do not need to have sexual intercourse to become infected – all it takes is skin to skin contact with an infected area. There have been many studies about teen sexual activity in the US which suggest that more teens engage in oral sex than intercourse itself. Many teens think they are safer if they have oral or anal sex, so are less likely to use protection. They are not safer as viruses or bacteria can enter the body through small cuts or tears both in the mouth and the anus.

In an ideal situation and before becoming sexually active, a teen should have a gynecological or male genital examination. This gives the doctor the chance to teach a teen about STDs and how to protect him or herself as well as giving the doctor the opportunity to check for STDs while they are still in their earliest, most treatable stage.

Genital warts and women

Statistics show that most women who contact HPV do so before their third experience of intercourse and it is therefore the young and sexually active woman in her early twenties who is at greatest risk.  As I have said earlier, genital warts can appear in different areas of the genitalia including inside the cervix. Many women clear the HPV infection through their body’s own immune response but if you suspect genital warts (and women are more prone to genital warts than men) then it is very important to see your doctor or go to a clinic for a definite diagnosis and treatment options.

The genital HPV virus can be classified as either low or high risk. While the low risk can cause genital warts, the high risk HPV can lead to cancers of the cervix, vagina and anus in women. Regular Pap smear tests in women will pick up changes or growths on the tissue of a woman’s cervix so that treatment can be commenced immediately.

Pregnancy and genital warts

If you are pregnant and have genital warts, you will be concerned about your baby’s welfare.  Although the majority of pregnant women with a past history of HPV and genital warts have healthy pregnancies and deliveries, it is vital that genital warts are treated as soon as possible.  If not treated, genital warts may cause a number of problems during pregnancy: 

• Sometimes genital warts get larger during pregnancy, making it difficult for the mother-to-be to urinate.
• If the genital warts are in the vagina, they can cause the vagina to become less elastic and possibly cause an obstruction during the actual delivery of your baby. There is also the risk that warts begin to bleed during the birth so that a C-section is necessary.
• If the baby becomes infected with HPV, he may also develop genital warts. The virus can even remain dormant in a child for up to 3 years after the birth.

Genital warts and men

The most frequent sites for genital warts in men are the anus area and the external genitalia including the head and the shaft of the penis as well as the scrotum.  Internal genital warts are less likely.  Visible genital warts will be diagnosed by your doctor. If they are very small or invisible, your doctor may use a colposcope to magnify the area or a solution of vinegar can be applied and this will turn any warts present white. Unfortunately, there is no accurate HPV test for men because it is difficult to collect an adequate sample of cells.

High risk HPV can very occasionally cause cancer of the anus or penis.

Genital warts and the gay lifestyle

Anyone can have health problems regardless of sexual orientation and genital warts on the penis occur in both heterosexual and gay men.  However, anal warts tend to be more frequent in gay men and are primarily a result of unprotected anal intercourse and direct penis-to-rectum contact during sex.  Anal cancer can also occur in men who have sex with men.   The risk for anal cancer is 17 times higher among gay and bisexual men than among heterosexual men.

Although there is public education about STDs, this tends to be taught from a straight perspective.  Many gay men (and especially gay youth) cannot relate to a heterosexually orientated education program. And there is almost no information about STDs (apart from HIV) specially geared for gay men.

Genital warts and the risk of cancer

As I have already said, high risk HPV can lead to cancerous and precancerous changes in the cervix.   If women have HPV and the herpes virus together, then the risk of cervical cancer is much higher.  The American Cancer Society estimate approximately 10 000 women are being diagnosed with cervical cancer each year. 

The figure is much lower for men with some 1500 being diagnosed with penile cancer and 2000 with anal cancer each year.  Sadly, there are currently no tests approved to detect early evidence of HPV associated cancers in men.  Those men living with HIV and fighting an immune deficiency disease are especially vulnerable to developing cancer from anal warts.  Anal cancer is difficult to treat, and like most cancers, the odds of survival are much higher if detected early.

Genital warts treatment

As I have emphasized earlier, it is most important to treat any genital warts as early as possible and there are many treatment options to choose from. Do your own research and decide which the best is for you.  To help you on your way, I have listed the different treatments below: 

• Natural warts treatment – with the recent revival and interest in natural and alternative methods of treating various conditions, you might like to go the natural route.  Such methods are usually safe and successful and can be ordered easily online and used in the privacy of your own home.  Just make sure that any treatment is specifically for use on genital warts. Always consult a physician.
• Over the counter - such medications should not be used on genital warts as this is a very sensitive skin area and they can contain harsh ingredients and chemicals.
• Prescription medications to use at home – Imiquimod induces the body to produce proteins that act against the HPV and boost the immune system locally while Podofilolx lotion or gel is applied twice daily and stops the growth of the wart cells.
• Prescription medications to be applied by a health professional – Podophyllin resin is a plant extract that is applied every one to two weeks; while Trichloroacetic acid (TCA) or bichloroacetic acid (BCA) is applied weekly until the warts have gone; Fluouracil is a cream which is also applied weekly until the warts have disappeared.
• Crotherapy – very cold liquid nitrogen is used directly onto the warts.  This freezes the wart tissue and destroys it.  This is a very successful treatment for treating those hard to reach internal warts.  The procedure takes up to 15 minutes depending on the number and size of the genital warts.
• Laser treatment – is used for vaporizing warts.  It is very precise and can be used to treat warts in difficult to reach areas.  Laser treatment also has a low risk of damage to surrounding tissue.
• Electrocautery – this is where the wart tissue is destroyed with heat from an electric current, literally burning warts off.
• Surgical excision – here the warts are cut away as a surgical procedure under a local anesthetic.  This treatment is usually offered as a final option or if there are a few but large warts that are easily accessible.

Your health professional will help and advise you on the best way to treat genital warts.  But you can do your part by researching the different treatments I have listed above so that you are informed and aware.  You will then know which treatment you feel would suit you best, taking into account the cost, the pain involved and the probable success rate.

Genital warts home care

Since poor nutrition, a weakened immune system and emotional stress can contribute to your vulnerability to getting genital warts (if you are carrying the HPV virus) follow this advice:

• Take daily supplements of Vitamin A, Zinc Picolinate and Vitamin C.
• Try to eat fresh foods in as natural and unprocessed state as possible with organic being even better.
• Every day make sure you eat plenty of leafy green vegetables, whole grains, fruit and proteins.
• Limit your intake of sugar and refined carbohydrates (such as white bread and white rice) as well as reducing animal fat.
• Keep alcohol to a minimum and do not smoke.
• Take plenty of regular exercise while making sure you get sufficient rest and a good night’s sleep.

Genital warts and how to reduce stress

It is only natural that anyone diagnosed with genital warts will feel very upset and worried.  It is highly likely that the diagnosis will induce stress and stress is something you should definitely avoid when fighting the HPV virus. Part of your treatment should be to learn to relax. 

Genital warts – the conclusion

If you think you are free of HPV with no visible genital warts, be cautious about your sexual partners and become informed about the possibibility of vaccination as a preventative method. This is a golden opportunity to protect yourself.

If you suspect you carry HPV or have been definitely diagnosed, try to take good care of your health and do all you can to boost your immune system. Living a healthy lifestyle will go a long way to keeping you free of genital warts.