Ways to Prevent Transmission of genital warts

Vaccination, use of condoms and sexual barriers, avoiding multiple and high-risk sexual relationships, personal hygiene, strengthening the immune system, and regular screening and checkups are 6 effective and practical strategies for preventing genital warts. In 2023, the United States National Library of Medicine published an article showing that from 2014 to 2018, Americans spent 9 billion dollars each year directly on prevention and treatment of genital warts and HPV-related diseases. This figure is genuinely striking and shows the importance of this disease.

In this article, we present useful and practical strategies for preventing genital warts and the harms associated with human papillomavirus (HPV).

Core principles of genital warts prevention

As the name suggests, genital warts are a sexually transmitted infection that appears as fleshy growths in the genital area, including inside or outside the vagina, on the genitalia of men and women, around the anus, or in the groin. These fleshy lesions are caused by transmission of certain types of human papillomavirus (HPV). For a more detailed introduction to this common condition, you can read the article What are genital warts? for more information.

One point some people do not know is that there are more than 200 HPV strains, divided into high-risk and low-risk types. The similarity between high-risk and low-risk HPV strains is that both can cause genital warts; the difference is that high-risk strains can cause problems such as cancers of the cervix, anus, penis, and throat.

The Minnesota Department of Health in the United States, in its report HPV-Associated Cancer, clearly states that more than 90 percent of sexually active men and 80 percent of sexually active women are infected with at least one type of HPV during their lifetime, and about 50 percent of HPV infections are linked to high-risk types of the virus and may lead to cancer. This is where prevention of genital warts in women and men becomes important.

The broad transmission of genital warts among women and men led us to prepare this article and review ways to prevent this sexually transmitted infection. HPV vaccination, use of sexual barriers such as condoms, strengthening the immune system, and avoiding multiple and high-risk sexual relationships are some of these methods, which we discuss fully below.

Transmission routes and risks: preventing genital warts by understanding the source of infection

There are different ways genital warts can be transmitted, with vaginal, anal, and oral sex considered the main routes. Skin-to-skin contact in the genital area, even without full penetration, can also transmit genital warts.

Some studies on genital warts and pregnancy show that in rare cases, genital warts may be transmitted from mother to newborn during delivery. In very rare cases, a newborn born to a mother with genital warts may develop warts in the throat. This serious problem is called respiratory papillomatosis and may require surgery to prevent the warts from blocking the newborn's airway.

6 key strategies for preventing genital warts

To prevent genital warts and reduce the risk of HPV infection, a set of medical, hygiene, and protective measures is necessary. Methods for preventing genital warts in men and women are the same. When performed correctly and on time, these measures can effectively reduce the risk of transmission and infection with genital warts.

Below, we review the most important recommended strategies.

1. Vaccination and medical prevention: the main way to prevent genital warts

The best strategy for preventing genital warts is HPV vaccination. According to the Australian Department of Health and Aged Care, three types of vaccines are available to prevent genital warts: the bivalent HPV vaccine (2vHPV), the quadrivalent vaccine (4vHPV), and the 9-valent vaccine (9vHPV). As noted earlier, HPV has different types, and each of these vaccines covers a number of viral strains. Below we explain these three vaccine types:

• Bivalent HPV vaccine (2vHPV) helps protect against the two high-risk HPV strains 16 and 18, which cause most cases of cervical cancer.

• Quadrivalent HPV vaccine (4vHPV) protects against strains 16 and 18 as well as the two low-risk strains 6 and 11.

• 9-valent HPV vaccine (9vHPV) protects against nine HPV strains (6, 11, 16, 18, 31, 33, 45, 52, and 58) and is useful for preventing most HPV-related cancers.

In the market, 3 vaccine names are commonly known: Papilloguard, Gardasil 4, and Gardasil 9 (Gardasil 9). Papilloguard is the bivalent HPV vaccine, and its purpose is prevention of cervical cancer, anal cancer, and genital-area cancers.

For simultaneous prevention of cervical cancer and genital warts, Gardasil 9 can be administered. It is the 9-valent HPV vaccine (9vHPV) and is considered beneficial for both women and men.

One essential question about HPV vaccination and prevention is: when is the best time to receive the vaccine? The U.S. Centers for Disease Control and Prevention (CDC) identifies ages 11 to 12 years as the ideal age for HPV vaccination in girls and boys, because at this age the immune system responds best to the vaccine. HPV vaccination may begin at age 9, and children from age 9 can receive this vaccine. Below are some points about the HPV vaccine:

• Ages 9 to 26 years are an appropriate time to receive HPV vaccination. If people receive the vaccine at ages 9 to 14, two doses are sufficient. The second dose should be given 6 to 12 months after the first dose.

• If the vaccine was not received between ages 9 and 14, people can receive it from ages 15 to 26. In this age range, however, three HPV vaccine doses are needed. The second dose is given 1 to 2 months after the first dose, and the third dose 6 months after the first dose.

• Note that people with immune deficiency should receive three vaccine doses even if they start vaccination before age 14.

• HPV vaccination may also be useful for people aged 27 to 45. Decisions in these cases should be made in consultation with a physician.

• An important point to keep in mind is that protection from Papilloguard and Gardasil vaccines lasts up to 15 years, and after the recommended vaccine doses are given, a booster dose is not needed.

In this section, we tried to provide complete explanations about the HPV vaccine. For full information on this topic, you can read the article vaccine for prevention of genital warts.

2. Screening and periodic examinations: are screening and medical tests necessary?

Another way to reduce complications of HPV infection is HPV screening, checkups, and regular periodic medical examinations. The Pap smear is one of the periodic examinations that should be performed for women. This test examines cervical cells to identify abnormal HPV-related changes.

Screening does not itself play a role in preventing genital warts in women, but it helps detect HPV infection earlier. With timely diagnosis and action, precancerous and cancerous changes can be prevented.

Women are advised to have this test regularly from age 21, and the testing interval varies according to age.

• Women aged 21 to 29 are advised to have this test every 3 years.

• Women aged 30 to 65 should preferably have this test every 3 years, or have a Pap smear with an HPV test every 5 years.

• Women over 65 may not need to continue Pap smears if they have had normal screening results and are not at high risk for cervical cancer. The decision should, however, be made on the recommendation of a specialist physician.

If Pap smear results are abnormal, the physician may use colposcopy to examine the cervix more carefully with a special device.

HPV testing by PCR is one of the most accurate methods for detecting the virus and identifying its type. This test directly detects HPV in cervical cells and is recommended for women over age 30.

In men, the HPV test described above is usually used to determine whether the virus is present and which type it is, often to protect and reassure a sexual partner about whether the person is infected with HPV.

3. Daily-life prevention by avoiding high-risk sexual relationships

Different methods can help prevent genital warts in daily life, including strengthening the immune system, personal hygiene, and use of sexual protective tools such as condoms.

Another prevention method that is extremely important for avoiding genital warts is avoiding multiple and high-risk sexual relationships. Having several sexual partners naturally increases the chance of contact with people infected with HPV.

Some people have sexual relationships with different partners without using protective tools such as condoms, increasing their risk of genital warts. At the same time, multiple sexual relationships themselves can increase the chance of this disease and can lead to several concurrent infections. The result of multiple diseases in one person is weakening of the immune system and a more complicated treatment process.

Some ask whether HPV is transmitted only through sexual intercourse, and whether skin contact can transmit the virus. In response, HPV is mainly transmitted through direct skin-to-skin contact during sex. However, transmission through nonsexual skin contact, even minor contact, is also possible.

It should be noted that HPV transmission through nonsexual contact is much less common than through sexual contact. Still, washing the hands with soap and water after touching genital warts can significantly reduce the risk of viral transmission. For your own health, avoid touching other people's genital warts.

4. Strengthening the immune system: a foundational technique for fighting human papillomavirus

The role of strengthening the immune system in preventing genital warts and HPV should not be underestimated. If the body's immune system is strong, it can suppress human papillomavirus much more easily. It can be said that strong immunity helps prevent genital warts after intercourse.

Below are several key techniques that help strengthen the immune system:

• Healthy nutrition is the foundation of immune support. By eating fruits and vegetables rich in vitamins, minerals, and antioxidants, we can take an important step toward strengthening the body and making the immune system more resistant to HPV.

• Protein intake is necessary for building and repairing immune cells, and you can meet your body's protein needs by consuming meat, poultry, fish, eggs, legumes, and nuts.

• Also prioritize reducing sugar and processed foods, and do not neglect healthy fats such as olive oil and fatty fish so you can build a stronger immune system.

• At least 30 minutes of exercise per day and at least 150 minutes per week is beneficial for your immune system.

• Good sleep builds a good immune system, so give yourself 7 to 8 hours of sleep each night.

• Cigarettes and other tobacco products weaken the immune system and reduce its ability to fight infections such as HPV. Take smoking cessation seriously as part of genital warts prevention.

Note: immune support, home methods, and genital warts prevention in traditional medicine are not reliable on their own and are not substitutes for HPV vaccination.

5. Personal hygiene and protection: another way to fight genital warts transmission

Regular washing of the genital area with water and mild soap, keeping the area dry, avoiding scented products in this area, and not sharing personal items are among the most important personal hygiene measures that help prevent genital warts transmission. Below we explain these points briefly and clearly:

• Regularly washing and drying the genital area: Wash the genital area with water and mild soap, and avoid scented soaps and strong cosmetic products so the skin is not irritated. Viruses and infections favor moist environments, so try to keep the genital area dry and dry it promptly after washing.

• Using cotton underwear: Cotton underwear helps ventilate the genital area and prevents moisture buildup. Avoid tight and nylon underwear, because such clothing can promote moisture.

• Not sharing personal items: Do not share personal items such as towels, razors, blades, toothbrushes, or underwear, because these items may be contaminated with HPV or another virus and infect you. Also, never share sex toys.

• Avoid manipulating genital warts: Try not to touch genital warts and avoid picking or scratching them. If you touch the warts, be sure to wash your hands with soap and water. This helps prevent genital warts from increasing.

6. Using protective methods to prevent transmission of genital warts and sexually transmitted infections

Using male and female condoms can significantly reduce the risk of transmitting HPV and other sexually transmitted infections, but it cannot by itself completely prevent HPV transmission, because the virus may be present in areas that the condom does not cover.

Conclusion

According to World Health Organization statistics, HPV caused about half a million people to develop cervical cancer in 2022, and 250 thousand people died from this cancer. In fact, the importance of preventing genital warts in men is that they do not transmit it to their sexual partner, because its complications can be very dangerous for women. To prevent HPV-related problems and complications, preventive methods must be used. In this article, we tried to explain 6 key points for preventing genital warts and to describe each technique fully.

One essential strategy for preventing genital warts is consultation with a urology specialist. A urologist can provide patients with accurate, up-to-date information about HPV, genital warts, transmission routes, prevention, and treatment. The urologist also performs the necessary examinations and explains treatment, protective methods, and HPV vaccination.

Dr. Mahdi Ghazi, surgeon and specialist in kidney, urinary tract, and genital diseases in Mashhad, is one of the leading specialists for counseling about prevention and treatment of genital warts. If you would like to book an appointment with this doctor, simply visit the online appointment system or call ۰۹۳۹۷۸۰۵۹۰۲.

Frequently asked questions

In this section of the article, we answer common and frequently asked questions about prevention of genital warts.