Sexually Transmitted Diseases/Genital Warts?


QUESTION: Hi,  I am 33 and pregnant with my second child.   Recently I have noticed bumps on my hymen remnants and inside my vagina.   They are flesh colored.   3 of these "bumps" look like they are on my rugae but don't look like folds but more like bumps.   Could this be genital warts?   I am not comfortable posting a pic but can email one if that helps

ANSWER: Hi Destiny,
Could they be warts? Yes. Pregnancy dampens the immune system, and allows warts/HPV, if present, to proliferate during the pregnancy. Applying plain vinegar may make warts look very white in comparison to the surrounding skin.  But they sound more like squamous papillomatosis, a normal variant.  Since you are pregnant, you should be taking prenatal vitamins daily, and get regular and routine prenatal physical exams.  During these exams your ob/gyn can assess you and then tell you what you need to do!

Good luck!

---------- FOLLOW-UP ----------

QUESTION: Can squamous pappilomatosis happen inside the vagina entrance?   Also the bumps I feel are on the rugae and when applying vinegar they turned a shade lighter but still very pink.  Again I can email a pic

Hello Again, Destiny,
Squamous papillomatosis usually occurs at the introitus, the opening of the vagina. I am familiar with its appearance on the inside of the vagina, but it is uncommon. One should not feel them as bumps, though. That may be a score of other normal or abnormal conditions. An examination by a knowledgeable health care provider would be helpful.

Good luck!

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Mark P. Behar


Almost any question or concern about gay men's health issues, sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), etc. There is no such thing as “d/d free” or “clean” (free of infection), so why do so many of us deceive ourselves into thinking that some people are indeed totally free from a potentially infectious disease, like HIV, herpes, hepatitis, syphilis, chlamydia, warts, gonorrhea, etc., just because they say so? Clinical laboratory tests are not perfect, and having a “negative” or “nonreactive” test does not mean that a person is free from infection. Perhaps at the moment the test was taken, the person was uninfected; or, perhaps, the test wasn’t sensitive enough to detect presence of the infection. There is really no way that anyone can determine that they are truly “disease free,” and there are over a hundred of infectious conditions that can be spread without your knowing anything. Rather than trying to “pre-screen” or “serosort” a potential sex-mate with deceptive questions that are impossible to know by today’s technologies, a wiser option may be to consider everyone infected with something, and either use appropriate protective measures (“safer sex”), or accept the responsibility and consequences of possibly “catching” something from someone who’s hotter than expected (pun intended!). There is much research that supports the contention that an HIV positive person reliably taking HIV medications, and having an undetectable viral load, presents a lower risk for transmission of HIV than people who may think or say they are HIV negative, but are not. Food for thought!


Family Practice PA since 1981; Volunteer Clinician for Brady East STD (BESTD) Clinic, Milwaukee, since 1977; answered STD questions submitted to their web site. Professionally lectured at national and regional Physician Assistant and Nurse Practitioner conferences, and at national gay & lesbian health conferences on topics including HIV/AIDS, herpes, hepatitis, STDs, human papilloma virus (the cause of venereal warts), abnormal Pap smears, gay and lesbian health issues, among others.

Co-Founder, Lesbian, Bisexual, & Gay Physician Assistant Caucus of the American Academy of Physician Assistants, Inc.; American Academy of Physician Assistants; Wisconsin Academy of Physician Assistants; National Co-Chair (2012-16), National Association of Black and White Men Together: A Gay, Multiracial Organization for All People (NABWMT)

Journal of the American Academy of Physician Assistants (JAPA) Q Visions, Quarterly Newsletter of the NABWMT

Bachelor's of Arts, 1972 (University of Wisconsin, Milwaukee, WI) Graduate Credits Experimental Psychology, 1972-75 (Tulane University, New Orleans, LA) Physician Assistant, Bachelor's of Science, 1981 (George Washington University, Washington, DC); Masters in Physician Assistant Studies, 2000 (University of Nebraska Medical Center, Omaha, NE)

Awards and Honors
Colposcopy Recognition Award (CRA), the American Association of Colposcopy and Cervical Pathology; Distinguished Fellow, Clinical Preceptor, American Academy of Physician Assistants; Fellow, Wisconsin Academy of Physician Assistants

Past/Present Clients
Brady East STD Clinic, Milwaukee, WI Milwaukee Health Services, Inc. (Martin Luther King Heritage Health Center), Dept. of Family Medicine and Early Intervention Program for HIV Infected Persons

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