HPV

What it is

HPV (human papillomavirus) is the most common sexually transmitted infection, and most sexually active people come into contact with the virus at some point in their lives. In most cases, the body clears the virus on its own, without symptoms. In others, HPV can cause genital warts or lesions on the cervix that, without follow-up, may progress over the years to cervical cancer. Diagnosis is made through the Pap smear, HPV testing and colposcopy with biopsy when necessary. Follow-up is determined by the type of virus and the grade of the lesion: it may involve only observation with periodic exams, or treatment such as removal of the warts and loop electrosurgical excision procedure (LEEP) for cervical lesions. The HPV vaccine is discussed during the consultation, including for adult women.

Most common symptoms

• No symptoms in most cases
• Warts on the vulva, vagina, cervix or anus
• Small lesions, single or clustered, shaped like cauliflower
• Itching or discomfort where warts are present
• Bleeding after intercourse
• Abnormal Pap smear result

Causes and risk factors

• Sexual contact with an infected person, even without penetration
• Intercourse without a condom
• Early sexual debut and multiple partners
• Low immunity, which makes it harder to clear the virus
• Smoking, associated with the infection persisting
• Not being vaccinated against HPV

How it is diagnosed

HPV usually causes no symptoms, so periodic screening is the main way to diagnose it. At the consultation, your gynecologist reviews your medical history, examines the vulva, vagina and cervix, and collects the Pap smear. HPV testing identifies the presence of the virus and the higher-risk types. When there are abnormalities, colposcopy examines the cervix under magnification and allows biopsy of suspicious areas. Genital warts are usually recognized on clinical exam, supported by vulvoscopy when necessary.

How we treat it at Femi Saúde

There is no medication that eliminates the virus, and in most women the infection clears on its own. For this reason, management is determined by the type of virus and the grade of the lesion: often, it's just follow-up with Pap smear, HPV testing and colposcopy at defined intervals. Genital warts can be treated with topical medications or removed with CO₂ laser, depending on the case. High-grade lesions on the cervix are treated with the loop electrosurgical excision procedure, LEEP (CAF), which removes the affected area for analysis. Femi Saúde's gynecology team provides guidance on the HPV vaccine, including for adult women, and on evaluating the partner.

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