Congratulations on your daughter's decision (and perhaps yours on her behalf) to be immunized against HPV. Every young person should do it! Even though she probably had her wart-causing HPV infection before she got the second dose of vaccine, she is protected against any of the vaccine types to which she hasn't been exposed. But it has no effect on HPV infections already acquired before completing at least two of the 3 Gardasil shots. The most important benefit is a much lower chance of cervical cancer and pre-cancerous Pap smear abnormalities. Did she get the original Gardasil vaccine, which covers 4 HPV types? Or the newer Gardasil-9? G-9 protects against the same 4 types plus 5 more, and is quite a bit more effective in preventing cancer and pre-cancer of the cervix.

Finally to your main question:  Menstruation has no effect on clearance of HPV. Her diabetes also won't have any significant effec on this. Your daughter's immune system will clear her wart-causing HPV infection over the next few months, regardless of having a regular menstrual cycle. Of course, the warts themselves should be treated as well. Presumably that's being done, right? Either with treatments in the doctor's office or prescription medication at home. Treatment usually gets rid of visible warts quite quickly, typically within 2-4 weeks.

I hope this has helped. Best wishes--  HHH, MD

Although Gardasil-9 was approved in January, it was expected to take a few months to become routinely available. When it is, your daughter definitely can and should receive its expanded protection, with at least 2 doses and maybe three. It won't improve prevention of the 4 original HPV types, but it's not at all harmful -- in effect it will count as booster doeses for those types.

It sounds like your daughter may have fairly extensive, large, or treatment-resistant warts. If they indeed are very large (any lesions over an inch or so) or extensive, surgery may be the best option. However, if she has only seen her ObG so far, consider consultation with a dermatologist before making a final decision. In general, dermatologists have the greatest experience in wart treatment and might have suggestions for other approaches short of surgery. They also are often best at judging whether especially large warts might have pre-cancerous components -- not common at your daughter's age, but better safe than sorry if they indeed are large.