Sexually Transmitted Diseases/HPV on cervix?


QUESTION: Hello Dr. Mark  
My name is leticia i have 21 years old im sexuale active I have a question is this normal? put vinegar and became white. could be HPV ? Thank you

ANSWER: Hello Leticia,
I am unable to see any white on your cervix. Vinegar on the cervix should make any HPV become very apparent! The external vaginal opening is too unclear to know. The redness of your cervix signifies a normal physiologic process and appearance known as metaplasia. It is an area of rapid cell growth due to your normal monthly estrogen levels.

Good luck!

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

QUESTION: So it is normal to see red the cervix ? if it is painted white is HPV ?
Thanks De.Mark

Hello Again, Leticia,
All women experience hormonal changes that generate a growth and maturation of the cervix known as metaplasia. Younger women's cervices frequently, but not always, have an extensive red (rather than pink) zone around the opening. As the cervix matures over a 10-20 year period, the cervix becomes pink because different cells literally grow over the cells producing the earlier red appearance. This is all driven by the effects of estrogen, which among other things causes an acidification of the inside of the vagina, which is maintained by the normal lactobacilli microbes that live inside the vagina normally. When vinegar is applied to the cervix, it may temporarily turn a uniform paler shade that we call "white" although it won't be "snow white" in color.

If you have HPV, than it may look white without applying the vinegar. Applying vinegar makes it look even whiter!

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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