What are genital and anal warts?
Genital warts, which include anal warts, are lesions (thickened abnormal tissue) in the vulva and in the genital-anal region that are caused by infection with human papillomavirus (HPV), which is transmitted as a sexually transmitted infection (STI) during physical contact involving the mouth, vagina, anus, or penis, when one of the people involved carries HPV. About 90 percent of these warts are caused by HPV strains 6 and 11. The transmission can happen through contact, even when sexual intercourse does not take place. The warts can be present both in non-pregnant and pregnant women.
How common are genital warts in pregnancy?
HPV infection presenting with warts in the genital-anal region occur in more than 1 percent of people between ages 15 and 49, meaning that the condition is fairly common during pregnancy. It is estimated that up to 50 percent of the population is infected with sexually transmitted HPV at some point in life. Genital warts are estimated to affect a total of 5.5 million people in the US each year and to be present in 20 million worldwide.
How are genital warts, including anal warts, diagnosed?
Your physician can diagnose genital warts, including anal warts, by looking for lesions with a specific appearance. The lesions appear as what are called papillomatous plaques, which is to say flat lesions. The lesions can be single (condyloma acuminatum) or multiple (condylomata acuminate), and sometimes combine into a bigger lesion. The color of the lesions can vary from light tan to white, pink, or brown. The lesions can be located on the vagina, vulva, cervix, the edge of the urethra, or the area around the anus.
Do genital warts cause problems during pregnancy?
Genital warts often produce itching, discomfort, swelling, and bleeding during intercourse. Anal warts can produce a variety of problems, such as growth around the anus, itching (pruritus), difficulty cleaning the anal region, and sometimes discharge, bleeding, odor, and tenesmus (a persistent urge to have a bowel movement). During vaginal delivery of a baby, stretching of genital warts can lead to bleeding and other discomforts.
Do genital warts cause problems for the baby?
In rare cases, a baby born vaginally to a mother with genital warts can be infected with the HPV virus and develop warts in the throat.
What to consider about taking medications when you are pregnant:
- The risks to yourself and your baby if you do not treat the genital warts, including anal warts
- The risks and benefits of each medication you use when you are pregnant
- The risks and benefits of each medication you use when you are breastfeeding
What should I know about using medication to treat genital warts during pregnancy?
Medications for HPV warts include Podofilox 0.5% solution or gel, Imiquimod 5% cream, Sinecatechins 15% ointment, Podophyllum resin 10%25% in a compound tincture of benzoin, and Trichloroacetic acid (TCA) or Bichloroacetic acid (BCA) 80%90%.
Podofilox 0.5%: CDC recommends to NOT use during pregnancy, and the manufacturer recommends use if potential benefits outweigh risks to the fetus. There have not been any well defined studies in pregnant women.
Imiquimod 5%: Pregnancy risk category C. Safety is not well established, and its use is not recommended during pregnancy. Use during pregnancy if potential benefits outweigh potential risks to the fetus.
Sinecathecins 15%: Limited data in pregnant women. Use during pregnancy if potential benefits outweigh potential risks to the fetus.
Podophyllum resin 10%-25%: Contraindicated (do not use) in pregnancy.
Trichloroacetic acid: Considered to be safe, but there is a lack of safety data on use over large surface areas in pregnant women.
Who should NOT stop taking medication for genital warts, including anal warts, in pregnancy?
Use of these medications is recommended if the potential benefits outweigh the potential risks to the fetus. Please discuss with your doctor before taking any medication.
What should I know about choosing a medication for genital/anal warts in pregnancy?
You may find Pregistrys expert reports about the individual medications to treat genital warts, including anal warts here. Additional information can also be found in the sources listed at the end of this report.
What should I know about taking a medication for genital warts, including anal warts, when I am breastfeeding?
The use of these topical ointments varies as to whether they should be used during breastfeeding. Podophyllum is contraindicated in patients who are breastfeeding. Benefits should be weighed against risks, and you should consult with your doctor before taking. Also, you should wash your hands thoroughly after handling your genitals and the medication prior to handling the infant.
What alternative therapies are there besides medications to treat genital warts during pregnancy?
Genital warts, including anal warts, can be treated successfully using cryotherapy, which uses liquid nitrogen or a cryoprobe to freeze the lesions. The treatment generally is repeated a few times over a few weeks.
What can I do for myself and my baby when I have genital warts, including anal warts, during pregnancy?
Work in consultation with all of your physicians, and be assured the condition is easily treatable.
Resources for genital warts, including anal warts, during pregnancy:
For more information about genital warts during pregnancy, contact http://www.womenshealth.gov/ (800-994-9662 [TDD: 888-220-5446]) or read the following articles:
- Mayo Clinic: Genital Warts
- Healthline: Genital Warts in Pregnancy