An extra hour of sleep 'boosts women's likelihood of sex'

For women, each additional hour of sleep increases the likelihood of sex by 14%. This is according to a new study published in The Journal of Sexual Medicine.

"Sleep disturbance may contribute to sexual complaints and reduced sexual activity," the study concludes.

Although previous studies have looked closely at medical illness, psychological disorders and relationship dissatisfaction as factors that can lead to sex problems for women - such as a lack of sexual fantasies or diminished arousal - sleep problems have been largely overlooked as risk factors for sexual dysfunction.

"As a step toward addressing this gap, we examined the influence of nightly sleep on sexual response and activity in young women," write the authors of the new study.

The researchers say they were interested in exploring the hypothesis that poor sleep duration and quality lead to increased difficulties with sexual function, as no previous studies have explored this. Some studies have found a link between sexual response and untreated sleep-related breathing disorders, but were unable to determine if the poorer sexual response was directly caused by the sleep problems.

For the new study, the researchers recruited 171 healthy women. More than half of the sample reported having at least one sexual partner at the start of the study.

To avoid confounding the results, the study did not include any participants that had recently used antidepressants, which are known to reduce sexual response.

Sleep quality and sexual activity were tracked on daily basis

Every day for 2 weeks, participants were asked questions relating to sexual activity, such as "Did you have sex (oral, anal, hand, vaginal, etc.) with another person within the past 24 hours?" and "Did you masturbate within the past 24 hours?" Regarding sleep quality, they were asked after waking each morning, "How many hours of sleep did you get last night?" and "How long did it take you to fall asleep last night?" and they were also asked to rate their quality of sleep.

The researchers found that each additional hour of sleep increased the likelihood of sex with a partner by 14%, and that vaginal arousal was also improved among women who slept longer on average.

In the conclusion to the study, the authors say their findings prove that good sleep is important for maintaining healthy sexual functioning. Levels of desire, genital response and likelihood of sexual activity are all predicted by both nightly and habitual sleep duration. The researchers explain that these effects were independent of age, sexual distress, daytime fatigue or menstruation.

"These findings suggest that acute sleep disturbance may contribute to sexual complaints and reduced sexual activity," the authors write. They make the following recommendations for clinicians and future researchers:

"Future research may benefit from taking a more comprehensive approach to examining sleep parameters by using both subjective and objective measures. Additionally, the relationship between insomnia and sexual dysfunction may prove to be an overlooked and important area of interest for clinical research. Clinicians may consider assessing patients' sleep habits and insomnia symptoms as potential factors influencing sexual difficulties."

In 2013, the journal Sleep published a study that suggested one night of sleep deprivation causes an increase in men's perceptions of women's sexual interest and their intent to have sex.

The researchers behind the Sleep study found that, when well-rested, both men and women rated the sexual intent of women as being significantly lower than that of men. Following a night of deprived sleep, however, men's rating of women's sexual intent increased to the extent that women were no longer perceived as having lower sexual intent than men.

Sleep deprivation is known to cause frontal lobe impairment, explained the authors, which has a negative effect on "risk-taking sensitivity, moral reasoning and inhibition."

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Husbands Who Share Housework Have Less Sex

Husbands who help out with household chores have less sex than men in so-called "traditional" marriages where housework is done exclusively by the wife, researchers from the USA and Spain reported in the journal American Sociological Review.

In faithful relationships, the wife whose husband is involved in housework obviously has less sex too, the authors added.

This latest study contradicts most previous ones, which tended to imply that married men generally have more sex in exchange for doing housework. However, those studies did not take into account which chores the husbands did.

The researchers, all sociologists, said that their study demonstrated that sex is not a bargaining chip in marriage. Rather, it is associated with the kinds of chores each partner completes.

Married couples reported greater sexual frequency if the women did the cooking, cleaning and shopping and the men did the gardening, electrics and plumbing, car maintenance and paid the bills.

Co-author Julie Brines, professor of sociology at the University of Washington, said:

"The results show that gender still organizes quite a bit of everyday life in marriage. In particular, it seems that the gender identities husbands and wives express through the chores they do also help structure sexual behavior."

Lead author, Sabino Kornrich, warned that men should not assume from these findings that they should not become involved in traditionally female household tasks, such as shopping, cleaning or cooking. "Men who refuse to help around the house could increase conflict in their marriage and lower their wives' marital satisfaction."

The researchers gathered and examined data from a national survey of approximately 4,500 heterosexual married couples in the USA who took part in the National Survey of Families and Households. The survey, the largest to measure sexual frequency among married couples, included data from 1992 to 1994.

Brines does not believe that the division of household chores - which in this study did not include child care - and sex have changed much since 1994.

"Traditional female tasks" include shopping, cleaning, looking after the kids, and cooking

According to the study, husbands and wives spent an average of 34 hours each week on traditionally female chores. The men's average age was 46, and the women's 44. The couples spent an extra 17 hours each week on "men's work".

On average, the males were involved in about one-fifth of traditionally female chores, and slightly more than half of male-type work. The researchers found that women tend to be more involved with helping out in traditionally male chores, than men do with female tasks.

The couples reported having sex approximately five times, on average, during the four weeks before the survey. In marriages where the woman carried out all the traditionally female tasks, the couples had sex 1.6 times as often, compared to couples where the man was involved in all the female chores.

Brines says she is not surprised that there was more sex among the traditional couples. "If anything surprised us, it was how robust the connection was between a traditional division of housework and sexual frequency." Brines is an expert in family and household dynamics.

The following possible explanations for their findings were ruled out by the researchers:

• Male coercive behavior played no role, because women reported similar satisfaction levels in their sex lives in both types of households (traditional or "modern")


• In two-income households, the difference in sexual frequency was still driven by male behavior regarding traditional female chores. Also, the wife's income had no impact on sexual frequency.


• The following had no impact on sexual frequency - gender ideology, religion, and happiness in marriage.

Brines said:

"Marriage today isn't what it was 30 or 40 years ago, but there are some things that remain important. Sex and housework are still key aspects of sharing a life, and both are related to marital satisfaction and how spouses express their gender identity."

Recovery from Workload Influenced by Housework and Leisure Activity Balance

How rapidly and effectively male and female spouses recover from the burdens of work is probably influenced by a balance of housework time and leisure time, a study by experts from the University of Southern California reported in the Journal of Family Psychology.

Over half of all married couples in the USA are two-income households. The authors wondered whether the winner was the one who had the most help with the housework.

They found that what seems to be good for the male partner was bad for the female, but what is good for the female does not have enough of an impact on the male.

In another study involving 17,000 people in 28 countries, researchers from George Mason University found that married men did less housework than live-in boyfriends. The study was published in the Journal of Family Issues.

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Boys Starting Puberty Earlier, Like Girls

Boys in the United States are reaching puberty some 6 months to 2 years earlier than a few decades ago, reflecting the trend in girls, according to a new study by the American Academy of Pediatrics (AAP) published online before print on Saturday. The study authors suggest more research should now be done to find out why this is happening.

Lots of published evidence shows girls are reaching puberty earlier, and this is now generally accepted, but until now, there hasn't been as much research on whether today's boys are also showing a similar tendency.

AAP researchers designed and carried out the study through hundreds of pediatricians all over the US who belong to the AAP Pediatric Research in Office Settings (PROS) network and contribute data for research on children's health.

Data from this same PROS network was used in a large study that in 1997 showed US girls were reaching puberty earlier.

Parents and Doctors Need to Know

The data for this latest study covers more than 4,100 boys, and was recorded by 212 pediatricians carrying out well-child care in 144 practices in 41 states.

American boys appear to be reaching puberty at a younger age, with African-American boys entering puberty earlier than white or Hispanic boys.

Co-author Richard C. Wasserman, director of PROS, says:

"All parents need to know whether their sons are maturing within the contemporary age range, but, until now, this has not been known for US boys."

To assess puberty in boys, pediatricians measured two features: genital and pubic hair, and testicular enlargement, both standard indicators of start of puberty.

The results showed that puberty onset was happening some 6 months to two years earlier than it was several decades ago, according to records from that time.

Ethnic Differences

Overall, African-American boys are more likely to enter puberty earlier than white or Hispanic boys.

Across three ethnic groups, pediatricians recorded the earliest stage of puberty as 10.14 years in non-Hispanic white boys, 9.14 years in non-Hispanic African American boys and 10.4 years in Hispanic boys.

The authors write:

"The causes and public health implications of this apparent shift in US boys to a lower age of onset for the development of secondary sexual characteristics in US boys needs further exploration."

21st Century Standards

In a press statement, lead author Marcia E. Herman-Giddens thanks the doctors and boys who provided much needed data for "this exciting study":

"Contemporary data on the ages of pubertal characteristics in US boys from onset to maturity, lacking until now, are needed by pediatricians, public health scientists, and parents," she explains.

Wasserman says the landmark PROS study that was done in the 1990s provided up to date information on puberty in girls: it was logical there should be a similar one for boys:

"The PROS study provides 21st century standards," says Wasserman.

"Our pediatric endocrinologist colleagues now use the PROS puberty assessment training materials in their own studies and fellowship training," he adds.

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CDC Reports HIV Infection Rates Steady

The number of new human immunodeficiency virus (HIV) infections nationwide has continued to remain stable, according to a new report by the Centers for Disease Control and Prevention.

HIV is still a serious issue, with an estimated 47,500 new infections in the United States in 2010. Certain groups, including latinos, gay and bisexual men of all ethnicities, and African Americans, remain disproportionately affected.

Two other significant trends were also noted: early signs of a reduction in new HIV infections among black women as well as a worrisome and consistent rise in new infections among bisexual and gay men.

Homosexual men continue to be the group that is most affected. New infections for this group rose from 26,700 in 2008 to 29,800 in 2010. These men account for four percent of the U.S. population, however, they make up 63 percent of the total of new infections.

Previous research suggests that individual risk behavior does not represent the disproportionate presence of HIV among men who have sex with men.

Other factors that contribute include: a high incidence of HIV among men having sex with other men (MSM), causing a higher risk of HIV exposure with each sexual experience; the high proportion of MSM who do not know about their infection; stigma and homophobia; lack of insurance and worries about confidentiality; and high rates of some STDs. Also MSM typically underestimate their own personal risk.

Women account for 66 percent of new HIV cases among heterosexuals, however, that portion has declined since 2007.

Blacks account for 14 percent of the population and represent about 44 percent of new HIV infections, while hispanics account for 16 percent of the population and make up 21 percent of new infections. New infections continued to be steady among Hispanics and blacks between 2008 and 2010, according to the CDC. These numbers show that minorities are still disproportionately affected.

Whites make up a third (31 percent) of all new HIV infections but had a much lower infection rate than Hispanics or African Americans. There was no significant change in total HIV incidence among whites from 2008 to 2010.

The research indicates that the annual number of new infections has continued to be steady even though there has been a rise in the number of people living with HIV. This suggests that treatment, prevention programs, and testing are all having a significant impact. However, rates of new infections remain too high.

The CDC has planned a new approach in an attempt to achieve an AIDS-free generation. They will focus on the following five areas:

• Supporting Prevention Programs
• Tracking the Epidemic
• Supporting HIV Prevention
• Raising Awareness
• Supporting Structural Interventions

More involvement will also be put into action among community leaders from the African American, Latino and gay populations. The CDC hopes all people will be able to get the facts regarding HIV, get tested and take proper actions to protect their partners and themselves.

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What Is Chlamydia? What Causes Chlamydia?

Chlamydia, or chlamydial infection, is a sexually transmitted infection (STI) caused by Chlamydia trachomatis (C. trachomatis), a bacterium that only infects humans. Although we usually think of the sexually transmitted disease (STD), chlamydial infection refers to infection caused by any species of the Chlamydiaceae bacterial family.

Chlamydia is a common infectious cause of genital and eye diseases in humans. It is the leading bacterial STI worldwide.

USA - Approximately 2.3 million people in the USA are currently infected with Chlamydia. Less than half of the women in the U.S. who are at risk for Chlamydia are being screened for the sexually transmitted infection, according to the CDC (Centers for Disease Control and Prevention).

Recurring Chlamydial infections are prevalent in young women ages 14-19, according to a Yale Department of Epidemiology and Public Health study. Over half of the study's 411 participants were initially diagnosed with chlamydia and then, in a rate higher than previously recorded, nearly 30 percent reported repeated infection throughout the four-year Project.


UK - In the UK the number of new cases diagnosed each year has been steadily rising since the mid-1990s - it is now the most commonly diagnosed STI in the country. In 2004, 104,733 new diagnoses of Chlamydia were made - in 2005 there were 109,958 new diagnoses. According to the NHS (National Health Service), UK, women under the age of 25 who are sexually active have a 10% chance of becoming infected with C. trachomatis. The peak age range for male infection risk is 20 to 30 years.

Chlamydia is an easily treatable disease which, unfortunately, often has no early symptoms and is not treated until complications have emerged.

According to the World Health Organization (WHO) 15% of blindness cases worldwide were caused by Chlamydia conjunctivitis (trachoma) in 1995, dropping to 3.6% in 2002.

What is the difference between an STI and an STD?

A sexually transmitted infection (STI) is the infection, the entering of the bacterium, virus, or parasite into the human body (host).

When symptoms appear it is called a sexually transmitted disease (STD).

A person may have no symptoms and have an STI, while a person with an STD can't (STDs have symptoms). In short, everyone who has an STD also has an STI, but not everyone who has an STI has an STD - because not everyone has symptoms.

An STI is caused by a bacterium, virus or parasite from sexual intercourse or a sexual encounter. An STD is caused by an STI with a bacterium, virus or parasite from sexual intercourse or a sexual encounter.

What are sexually transmitted infections?

Sexually transmitted infections (STIs) are infections that spread primarily through person-to-person sexual contact. The word "primarily" is used here because sexual contact is the main or original source of infection and the main means of transmission; however, in some cases the infected person may pass the infection on without sexual contact, as might be the case when giving birth (mother infects baby), or if an infected person donates blood which is later used in a blood transfusion and infects a patient in hospital.

There are over 30 different sexually transmissible bacteria, viruses and parasites. Below is a list of the most common ones:

Common sexually transmissible bacterial infections


• Neisseria gonorrhoeae - causes gonorrhea or gonococcal infection.
• Chlamydia trachomatis - causes chlamydial infections.
• Treponema pallidum - causes syphilis.
• Haemophilus ducreyi - causes chancroid.
• Klebsiella granulomatis - previously known as Calymmatobacterium granulomatis causes granuloma inguinale or donovanosis.

Common sexually transmissible viral infections


• Human immunodeficiency virus - causes AIDS.
• Herpes simplex virus type 2 - causes genital herpes.
• Human papillomavirus - causes genital warts. 15 subtypes lead to cervical cancer.
• Hepatitis B virus - causes hepatitis and chronic cases may lead to cancer of the liver.
• Cytomegalovirus - causes inflammation in a number of organs including the brain, the eye, and the bowel.

Sexually transmissible parasitic organisms


• Trichomonas vaginalis - causes vaginal trichomoniasis, also known as "trich".
• Candida albicans - causes vulvovaginitis in women; inflammation of the glans penis and foreskin in men (balano-posthitis).

What are the symptoms of Chlamydia?

Some people refer to Chlamydia as a silent disease because there are rarely any noticeable symptoms initially. Experts say that approximately 50% of infected men and 70% of infected women will have no symptoms at all. Others will have such minor symptoms that the infection goes unnoticed.

Women

Genital Chlamydia does not usually present symptoms in women. However, there may be non-specific symptoms, including:

• Cystitis - inflammation of the bladder.
• A change in vaginal discharge.
• Slight lower abdominal pain.

Women with any of the symptoms mentioned above should visit their GP or family planning doctor. If a Chlamydia test is not offered, ask for one. If Chlamydia is not treated the following symptoms may emerge later:

• Pelvic pain.
• Pain during sexual intercourse - may be every time, or intermittently.
• Bleeding between menstrual periods.

See "Complications of Chlamydia" below for more symptoms in women.

Men - symptoms in men are usually from complications (see "Complications of Chlamydia" below).

What are the causes of Chlamydia?

Chlamydia is a sexually transmitted infection (STI). Chlamydia may be transmitted by:

• Having unprotected vaginal sex with an infected person.
• Having unprotected anal sex with an infected person.
• Having unprotected oral sex with an infected person.
• Having genital contact with an infected person.

As chlamydial infection often presents no symptoms, an infected person may pass it on to his/her sexual partner without knowing.

Childbirth - an infected mother can pass the infection on to her baby during childbirth. Sometimes the infection may lead to complications for the infant, such as pneumonia.

Chlamydia cannot be transmitted through:

• Contact with a toilet seat that has been used by an infected person.
• Sharing a sauna with infected people.
• Sharing a swimming pool with infected people.
• Touching a surface that an infected person had previously touched or coughed/sneezed on.
• Standing close to an infected person, inhaling the air after they have coughed or sneezed.
• Sharing an office with an infected colleague.

Chlamydophila pneumonia, which causes respiratory infections, including pneumonia, is different from C. trachomatis, the sexually transmitted infection. Chlamydophila pneumonia is an airborne bacterium and is not a sexually transmitted infection. This article focuses entirely on C. trachomatis.

A C. trachomatis variety causes LGV (lymphogranuloma venereum), another sexually transmitted disease which is more common in Africa, Southeast Asia, Central/South America and the Caribbean. Signs and symptoms include genital sores, fever and swollen nymph nodes in the groin area. In Europe LGV cases have increased, especially among homosexual and bisexual males. US authorities have expressed concern that LGV is slowly emerging in America too.

How is Chlamydia diagnosed?

Screening

As chlamydial infection frequently presents no symptoms health authorities in most nations recommend screening for some people. The US Centers for Disease Control and Prevention (CDC) recommends Chlamydia screening for:

• Women aged below 25 years - authorities recommend annual screening. Women under the age of 25 who are sexually active are at the highest risk of becoming infected.


• Pregnant women - Chlamydia screening should be done during the first prenatal exam. Women who have had several sexual partners should have another test before the expected delivery date.


• High risk males and females - regular screening is recommended for males and females who either do not regularly use a condom, those who have multiple sex partners, and people who have another sexually transmitted disease.

How is Chlamydia screening done?

• Women - traditionally the doctor or nurse would take a sample of the discharge from the cervix (swab). This was sent to the lab for culture or Chlamydia antigen testing. Nowadays women more commonly will do the procedure at home, either with a urine sample, or by taking a swab form the lower vagina. The swab is placed in a container and sent to a laboratory.


• Men - traditionally, a thin swab was inserted into the end of the urethra through the penis. The sample would be sent to the lab for testing. A urine test is more commonly used today. Although the urine test is not as reliable as using a swab, it is easier to do and painless. Scientists at the University of Cambridge, England, devised a new urine test can detect 84% of infections.

Sometimes a swab of the anus may be done.

Most countries have clinics that specialize in genito-urinary medicine (GUM). In the UK they are known as STI clinics or GUM clinics. UK GUM clinics have dedicated testing facilities, and often help people in contacting previous sexual partners so that they may also be tested and have treatment. Most GP practices also provide STI testing and advice.

What are the treatment options for Chlamydia?

Antibiotics are at least 95% effective in treating Chlamydia if the patient adheres to the doctor's instructions. In most cases they will be pills that the patient swallows. Treatment may consist of:

• Azithromycin (brand names APO-Azithromycin in Canada; Zithromax in Finland, Italy, UK, USA, Australia, Portugal, S. Africa, Canada, Thailand and Belgium; Zithromac in Japan; Vinzam / Zitromax in Spain; Zmax/Sumamed in Croatia; ATM, Aztrin, Zitrocin, Azibiot, Azifine, AziCip, Azi Sandoz, Aziswift in India, Azocam and Bactizith in Pakistan) - the patient receives just one dose.


• Doxycycline (brand names may be Vibramycin, Monodox, Microdox, Periostat, Vibra-Tabs, Oracea, Doryx, Vibrox, Adoxa, Doxyhexal, Doxylin, and Atridox) - the patient takes one or two tablets daily for one or two weeks. It is important that the course is completed if you don't want the infection to return.

Some patients, such as pregnant women, may be given alternative antibiotics. Doxycycline or tetracycline may affect the development of the baby's bones and teeth.

The following antibiotics may also be used: amoxicillin, ampicillin, clarithromycin, lymecycline, minocycline, ofloxacin, pivampicillin, erythromycin and rifampicin.

People taking the contraceptive pill or contraceptive patch will need to use additional contraception, such as condoms, because the antibiotics may interfere with their effectiveness. Ask your doctor how long you have to do this for.

Some patients may have the following side effects when they take the antibiotics:

• Diarrhea
• Stomach pain
• Stomach upset
• Nausea

In most cases the side effects will be mild. Patients taking doxycycline may have a skin rash if they are exposed to sunlight.

What are the complications of Chlamydia?

Early diagnosis and treatment greatly reduces the risk of complications. Complications can be prevented with regular screening, or by seeking medical attention as soon as symptoms appear.

Women - Chlamydia complications

• Pelvic Inflammatory Disease (PID) - Pelvic inflammatory disease is commonly caused by chlamydial infections. PID is an infection of the ovaries, fallopian tubes and uterus. PID significantly raises the risk of ectopic pregnancy - the fertilized egg does not settle and grow in the uterus; in most cases it will grow in the fallopian tubes, but may also grow in the ovary, cervix, or abdominal cavity. PID may also cause persistent pelvic pain.


• Cervicitis - inflammation of the cervix (neck of the womb). Symptoms may include a vaginal discharge which may contain pus, pain during intercourse, frequent urination, burning pain when urinating. In chronic cervicitis the cervix may swell and cysts may develop. The cysts may become infected. Some patients experience backache, deep pelvic pain, and constant vaginal discharge.


• Salpingitis - inflammation of the fallopian tubes. If the fallopian tubes become blocked the egg will not be able to pass along or enter the fallopian tube. There is a significant increase of ectopic pregnancy. Microsurgery is sometimes performed to clear the blockage.


• Bartholinitis - inflammation of the Bartholin gland, which produces the lubricating mucus to make sexual intercourse easier. The gland is located in either side of the vaginal opening. Chlamydial infection may cause it to become blocked and infected, leading to a Bartholin cyst. The cyst may develop into an abscess.

Men - Chlamydia complications

• Fertility - Spanish researchers found that Chlamydia can affect the quality of male sperm.


• Urethritis - the urethra, a tube which carries urine from the bladder to the end of the penis, becomes inflamed. Symptoms include a discharge with yellow pus, mucus with pus, or just clear mucus at the opening (the hole at the end of the penis where urine comes out). Untreated urethritis can lead to urethral stricture - the urethra narrows which makes it harder to urinate properly, creating pressure which may damage the kidneys.


• Epididymitis - Inflammation of the epididymis, a structure inside the scrotum (sack that holds the testicles) attached to the backside of the testis (testicles). Signs and symptoms include red, swollen and warm scrotum, testicle pain and tenderness which is usually on one side, painful urination, frequent urination, painful ejaculation, painful intercourse before ejaculation, lump in testicle, swollen inguinal nodes (lymph nodes in the groin), discharge from penis, and blood in the semen.


• Reiter syndrome - a chronic type of inflammatory arthritis. This can include just arthritis, conjunctivitis (inflammation of the eyes), and inflammation of the genital, urinary and gastrointestinal systems. The body's organs as well as the joints can become affected. Serious inflammation can affect the eyes, kidneys, heart, skin, lungs and mouth.

Prevention of Chlamydia

• Condoms - condoms significantly reduce the risk of becoming infected.


• Oral sex - the risk of infection is much higher if either sex partner does not know whether he/she is infected, or if the non-infected partner engages in oral sex without knowing whether the other person is infected.


• New sexual partner - if you have a new sexual partner and you can both be tested before sexual intercourse, your risk of infection is almost completely eliminated.


• Regular screening - regular screening for people in high risk groups reduces the risk of transmitting the infection or becoming infected.


• Avoid douching - douching lowers the number of "good bacteria" in the vagina, which raises the risk of infection - not just chlamydial infection but many other types of infection. Douching means using water or a medicated solution to clean the vagina. ACOG (American College of Obstetricians and Gynecologists) recommends against douching.


• Tell people - we can all help reduce the incidence of Chlamydia by telling people about Chlamydia, risks of infection, risk factors, the benefits of regular screening, using condoms, etc. Sexually transmitted infections are more common where ignorance is higher. Ignorance means not knowing enough about a disease, its risk factors, treatment, possible complications, and effective prevention measures.

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What Are Genital Warts? What Causes Genital Warts?

Genital warts are also called venereal warts or condylomata acuminate. Genital warts are one of the most common kinds of STDs (sexually transmitted diseases) or STIs (sexually transmitted infections). According to Medilexicon's medical dictionary, a genital wart is "a contagious projecting warty growth on the external genitals or at the anus, consisting of fibrous overgrowths covered by thickened epithelium showing koilocytosis, due to sexual contact with infection by human papillomavirus; it is usually benign, although malignant change has been reported, associated with particular types of the virus."

Genital warts are an infection of the skin of the genital and anal area, as well as the lining (mucous membranes) of the vagina, cervix and rectum.

It used to be thought that young children with genital warts or anal warts were victims of child abuse. However, this article explains that this may not necessarily be the case.

This article does not cover non-genital warts. We have a separate article called What are warts? What causes warts?

What causes genital warts?

Genital warts, like other non-STD warts, are caused by various types of the human papilloma virus (HPV) that infect the top layers of the skin. There are over 100 different types of HPV that may cause warts, but only a small number of strains can cause genital warts. Those that do cause genital warts, unlike other wart-causing HPVs, are highly contagious and are passed on through sexual contact with a person who is infected. HPV types 6 and 11 cause the majority of genital warts.

It is estimated that over 60% of people who have sexual relations with a person who has genital warts will become infected and develop them too. Generally, the genital warts will appear about three months after infection - however, in some cases there may be no symptoms for many years.

A study found that 10% of young women in England have been infected with one or more strains of the human papillomavirus by the age of 16. Another study found that 26% of US girls aged 14 to 19 have at least one sexually transmitted disease.

What are the risk factors for genital warts?

• Having unprotected sex
• Having unprotected sex with many different people
• Having sex with a person whose sexual history is unknown
• Starting sexual relations at a young age (however, this study seems to contradict this)
• Having stress and other viral infections (such as HIV or herpes) at the same time

A US study found that women with certain gene variations appear to be protected against cervical cancer.

What are the complications of genital warts?

Cancer - HPV infection has been closely association with cervical cancer, as well as cancer of the vulva, anus and penis. The majority of cervical cancers globally are caused by HPV infection. Even though not all HPV infections lead to cervical cancer, it is crucial for a woman's long-term health that she has regular Pap tests. This study revealed that some HPV infections are also closely linked to head and neck cancers. Another report says that HPV is also linked to oral cancer.

Pregnancy problems - pregnant women who have genital warts may have problems urinating. If there are warts on the vaginal wall her vaginal tissues may stretch less during childbirth. There is a very small risk that a mother with genital warts when she gives birth may cause the baby to have warts in his/her throat (laryngeal papillomatosis) - when this does happen surgery may be needed to prevent the airway from becoming obstructed.

Hormonal changes that occur during pregnancy may cause genital warts to grow, bleed, or increase in number.

Diagnosing genital warts

• Women - genital warts may exist on the vulva, cervix, upper thighs, inside the vagina, on the anus, and inside the anus. (vulva = lips around the opening of the vagina. Cervix = entrance to the uterus or womb)


• Men - genital warts may exist on the penis, scrotum, urethra, upper thighs, on the anus, and inside the anus. (urethra = tube than urine passes through. scrotum = sac that holds the testicles)

If oral sex raises the risk of genital warts developing in the mouth or throat.

A patient needs to be examined by a health care professional - this could be a nurse - to confirm a diagnosis of genital warts. In the UK people can either go to their GP (general practitioner, primary care physician), a GUM (genitourinary medicine) clinic, or a sexual health clinic.

Even if a person's partner has no symptoms it is still possible to have genital warts. People should go for a checkup if:

• The patient or partner has genital warts symptoms
• The patient recently had unprotected sex with a new partner
• The patient or partner have had unprotected sex with somebody else
• The patient's partner tells him/her that he/she has an STD
• The patient has an STD
• The patient is pregnant
• The patient is trying to get pregnant

A healthcare professional can usually diagnose genital warts if any are visible. The examination may involve looking inside the vagina or anus. On rare occasions a biopsy of the wart may be taken.

Sometimes, even if no warts are detected, the doctor or nurse may ask the patient to come back at a later date. Visible warts may not appear straight after infection.

What do genital warts look like?

• They may appear as flesh-colored or gray swellings (bumps) in the patient's genital area.


• If several are clustered together they may appear to have a cauliflower shape.


• Some genital warts are so tiny that they can only be detected with a colposcopic exam of the cervix and vagina or a Pap smear.

What is the treatment for genital warts?

Doctors will only treat patients who have visible warts. The type of treatment depends on:

• The location of the warts
• How many warts there are
• What the warts look like

Treatment is aimed at getting rid of the visible warts and lowering the number of viruses present. If the amount of viruses can be lowered the patient's immune system has a better chance of fighting them off. The following treatments are effective in getting rid of visible warts:

• Topical medication - a cream or liquid is applied directly onto the warts for a few days each week. This may be either administered by the patient at home or at a clinic - it depends on the kind of treatment. Treatment may continue for several weeks.


• Cryotherapy - the warts are frozen, often with liquid nitrogen. The freezing causes a blister to form around the wart. As the skin heals the lesions slide off, allowing new skin to appear. Sometimes repeated treatments are needed.


• Electrocautery - electric current is used to destroy the wart. The patient will generally be given a local anesthetic.


• Surgery - the wart will be cut out (excised). A local anesthetic will be used for this.


• Laser treatment - an intensive beam of light is used to destroy the wart.

It is not uncommon for doctors to use more than one treatment at the same time. Treatments are not painful, but may sometimes be uncomfortable, with some soreness and irritation for one or two days. Ordinary over-the-counter painkillers may be taken by patients after treatment. Some patients who feel sore may find that a warm bath helps. After the bath make sure you dry the affected area completely. Do not use bath oils, soap, creams, etc., until well after the treatment is completed.

Over-the-counter treatments for ordinary warts (non genital warts) are not suitable for genital warts treatment.

Genital warts will usually eventually go away, even if left untreated. They do sometimes get bigger in size and populate in larger numbers, without treatment. Experts say that untreated genital warts are not harmful for to the health of the infected person, but they may be uncomfortable and not look appealing. However, treating warts greatly reduces the risk of passing them on to another person.

A US Study found that male circumcision cuts the risk of genital herpes and human papillomavirus (HPV) infection, but not syphilis. However, the USA has - by far - the highest rate of male circumcision in the developed world, and also a much higher rate of sexually transmitted diseases among males.

Why are Pap tests important?

A pap test is also known as a Pap smear. It is a procedure to test for cervical cancer in women. The test involves collecting cells from the woman's cervix. Cervical cancer is a possible complication of HPV infection.

Women should have regular pelvic exams and Pap tests. These also help detect cervical and vaginal changes which may be triggered by genital warts.

Experts say that a woman should have a Pap test either at the age of 21 or within three years of having sex, whichever comes first. Women who have had genital warts should have a Pap test every three to six months.

There is a greater chance of curing a woman's cervical cancer if it is detected and treated early. A Pap smear can also detect changes in the woman's cervical cells that may indicate a higher probability of cancer developing in future.

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