[Question #13403] VP or HPV Guidance

1 days ago

I am a 55 year old woman who has had 21 male partners since I was 18. 30 of those years I was married to 3 different men and have no known history of HPV or GW. I am recently divorced and had unprotected vaginal sex with a man who is 38 four times between 7/17 and 8/4. He had no evidence of GW nor disclosed HPV. Following a UTI I noticed some shiny, soft, translucent finger like projections in my Vestibule on both sides, but more prominent on the right side. Each projection appears to have its own base and are not fused and are arranged in mostly symmetric lines. I’ve never noticed these before so I had a telehealth dermatology consult and was told they look like VP and not GW. They also look like pictures of VP on the internet. I’ve read several of your posts and plan to have my gyno confirm the diagnosis, but want to ask some questions to put my mind at ease in the meantime.

1. In previous posts it seems like it would be rare for someone my age with the # partners to have GW from these recent encounters. Thoughts?

2. It sounds like it takes 2-3 for GW to show up, so does 1.5 month seem unlikely?

3. I also noticed some internal bumps behind my pubic bone on the ceiling (toward stomach) that I’ve never noticed. They are soft and extend upward toward the cervix on both sides, does this sound like GW?

H. Hunter Handsfield, MD

1 days ago

Welcome to the forum and thanks for your question.

VP is not a standard or commonly used medical abbreviation, but in this contact you clearly mean vestibular papillomatosis. As you apparently know (but for other readers' benefit), these are flesh colored small protrusions of the skin or mucosal surface of the vulva, typically at the vaginal opening and/or involving the labia minor. Your description of "translucent" is typical. They are not considered abnormal and do not require treatment.

Of course I cannot tell for certain whether you have VP or genital warts, but all you have said -- your description, the opinion of a dermatologist, and the images you found -- all favor VP. I don't really think you need to see a gynecologist, but of course you are free to do that if you desire further confirmation. In addition, I will add that it's too soon for genital warts from your most recent sexual encounters: warts typically take at least 6 weeks and usually over 2 months to show up, and often it's months or more than a year. To your numbered questions:

1. "...rare for someone my age with # of partners to have GW...?" I agree in regard to your age. Many people with the number of lifetime sex partners you've had get genital warts. But I've already commented on your most recent partnership.

2. Oops -- I didn't read ahead to this question when I commented about time to onset of GWs. You are exactly right; 1.5 months is unlikely.

3. This description also doesn't sound like genital warts. Of course you'll show them to your gynecologist, but I'm betting they aren't warts.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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