Sexually Transmitted Diseases/do I have any disease?


is it a diseases?
is it a diseases?  

what is the yellowish spots
what is the yellowish  
Hello dr. Mark
I'm Sarah 24 years old
I got married 2 months ago and had sex for the first time too so my husband is the only partner that I had
After marriage I had some secretions, itching and burning in my vaginas I thought it's a yeast infection and then I noticed these bumps and the yellowish spots on my labia so I got scacred that I got STD, is it HPV warts? Do I have any disease? And what are the tiny yellowish or white spots I got them on my lips too         
Please dr. Mark is there anyway to remove the bumps and the spots I'm freaking out because of them, is there any treatment ? Why I got those after marriage?
Thank you Dr. Mark

Hello Sarah,
Everything looks normal to me, Sarah. The little bumps you have circled are normal parts of the vulva, and are known as "squamous papillomatosis." Some women have them, some may not.  They have no clinical or pathologic significance, although an inexperienced person may misidentify them as warts caused by HPV.  They are NOT, however. The itching and discharge you notice may in fact be due to a yeast infection.  These may occur periodically, and may be due to acid-base (pH) differences that your vagina undergoes during the monthly cycle.  These are guided by the cyclic hormones that you have, and may also be influenced by sex with your husband. Friction, rubbing, and hormonal changes with differences in pH may promote the growth of yeast. The yellow spots that you may see are also NORMAL parts of the vulva.

I cannot say that you do not have any diseases, because you need lab tests to rule out such infections. However, the photos and your descriptions are not suggestive of anything abnormal.

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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