Doc, I’m worried I might have HPV. How risky is it?


HPV causes growth of warts. PHOTO | FOTOSEARCH

 Dr Flo,

I think I contracted human papillomavirus (HPV), but I am not sure because I have not gone for a check-up. However, I have papillomas on my private parts, which, even though are not painful or itchy, worry me. Please advise me on treatment options and any serious risks. Also, can HPV be transmitted to a baby through breastfeeding?

Dear Martin,
HPV causes growth of warts. The warts can grow on the skin on any part of the body and also on mucous membranes. They are transmitted through skin-to-skin contact. HPV cannot be pass on through breast milk, but the child can get infected through skin-to-skin contact with an affected area. Many times, the body clears the HPV infection before warts can develop. Once warts develop, most heal by themselves over time. Some medication can be applied directly on the warts such as podophyllin, imiquimod, trichloroacetic acid and salicylic acid. In case this treatment fails to work on the warts, they may be removed by cryotherapy, electrocautery, laser removal or through surgery. A few types of the HPV have a strong link with cervical cancer. HPV has also been associated with cancers of the vagina, vulva, anus, penis, mouth and throat (oropharyngeal cancer). Very few people who have HPV or warts will get cancer, and HPV is usually not the only risk factor. There are vaccines that can protect against the strains of HPV that are more likely to cause genital warts or cervical cancer.

Dr Flo,
I have been masturbating and this causes me to have premature ejaculation. What should I do?


Dear Destiny,
The normal male sexual response cycle involves desire, arousal, plateau, ejaculation, and resolution. The average time from beginning of intercourse to ejaculation is five minutes. If ejaculation happens sooner than you or your partner would like, it is called premature ejaculation. If it happens once in a while, then it is not a cause of concern. If it is frequent and is causing frustration, then it needs to be addressed.
It can occur due to psychological and physical factors. Psychological issues include traumatic early sexual experiences, worry about sexual performance, anxiety, depression, guilt, poor self-image or relationship problems. Physical factors include abnormal levels of hormones or brain messengers (neurotransmitters), or inflammation of the urethra or the prostate.
To manage it, any psychological issues need to be addressed, if necessary, by visiting a mental health professional. You also need to have a supportive partner. Some medication can be prescribed and topical creams that have a numbing agent.
Other ways of managing it include: Avoiding sexual intercourse for some time and focusing on other forms of touch to reduce the pressure to perform; strengthening the pelvic muscles using kegel’s exercises – tighten the muscles that you would use to stop urine flow (contract these muscles 10 times and repeat at least three times a day); stop-start technique – during intercourse, when you feel the urge to ejaculate, stop all activity until the urge passes, then start again (by repeating as necessary and with some practice, holding off ejaculation can become a habit; pause and squeeze technique – during intercourse, when you are about to ejaculate, have your partner squeeze the penis where the head joins the shaft for several seconds until the urge passes, then continue; using a condom to reduce sensitivity.

Dr Flo,
Two years ago I used to see blood in my stool, but it stopped. Five days ago, I noticed there is something growing around my anus and it makes me uncomfortable. Please help.  K L

Dear K L,
Bleeding after passing stool could be due to a tear in the lining of the anus or rectum, because of friction from passing large stool, hard stool or from diarrhoea. It could also be due to an abnormal growth in the intestines or rectum.
The bleeding can also be due to piles, otherwise known as haemorrhoids, which are veins that bulge or prolapse in the lower part of the rectum and anus. The walls of the veins stretch and get irritated, and easily get a tear and bleed especially when passing stool. The piles may be on the outside around the anal opening or may “come out” when passing stool, and sometimes can be pushed back in. These are called external haemorrhoids. If there are far up inside that they cannot be seen or felt, they are called internal haemorrhoids. Symptoms include a painful or itchy swelling at the anal opening and pain or bleeding when passing stool.
They can be caused by straining when passing stool, for example due to constipation or diarrhoea; any activity that causes repeated high pressure in the abdominal region such as a persistent cough and lifting weights. They are also more common in people who stand or sit for long periods of time and also during pregnancy. Most of the time, they resolve easily with diet and lifestyle changes and with treatment, though they can recur.
To manage the problem, try and prevent constipation by taking a lot of fluid and high-fibre diet every day, exercise, schedule time each day for a bowel movement and take your time; use baby wipes instead of toilet paper and you can also take a sitz bath - sit in warm water for about 20 minutes twice a day to help soothe the injured tissue.
You can take fibre supplements to help with passing soft stools. There are other laxatives and stool softeners which can be prescribed by the doctor. There are creams and suppositories that can be used to help with the healing of the torn tissue. There are also oral tablets that are prescribed to heal the veins. In case symptoms persist despite these measures, surgery may need to be done to correct the problem.

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