title: HPV infection in women: psychosexual impact of genital warts and intraepithelial lesions.
abstract: BACKGROUND
  Genital Human Papillomavirus (HPV) infection is the most commonly occurring sexually transmitted viral infection in humans. HPV is a wide family of DNA viruses, which may cause benign skin and mucosal tumors (genital, anal, or oral warts), intraepithelial neoplasias, and/or malignant cancers in different organs. Women are more susceptible to the oncogenic effect of HPVs, mostly at the genital site on the uterine cervix.
  
  
  OBJECTIVE
  This review analyzes the impact of: (i) genital warts (GWs) and their treatment; (ii) HPV-related genital, oral, and anal precancerous lesions on women's sexual function.
  
  
  METHODS
  A Medline search was carried out. Search terms were HPV, GWs, intraepithelial neoplasia, cervical cancer, anal cancer, oral cancer, epidemiology, HPV risk factors, sexual dysfunctions, desire disorders, arousal disorders, dyspareunia, vulvar vestibulitis, vulvodynia, orgasmic difficulties, sexual repertoire, couple sexual problems, depression, anxiety, pap smear, screening program, therapy, and vaccines.
  
  
  METHODS
  Sexual consequences of HPV infection in women, specifically GWs and intraepithelial HPV-related neoplasia.
  
  
  RESULTS
  Psychosexual vulnerability increases with number of recurrences of HPV infections. Depression, anxiety, and anger are the emotions most frequently reported. However, to date, there is no conclusive evidence of a specific correlation between HPV infection and a specific female sexual disorder. The relationship between HPV and vulvar vestibulitis/vulvodynia-related dyspareunia seems not to be direct. Counseling problems, the role of anti-HPV vaccine, and the concept of the high-risk partner are discussed. The reader is offered a practical approach with clinically relevant recommendations that may prove useful in his/her daily practice when dealing with HPV-infected women and couples.
  
  
  CONCLUSIONS
  The evidence of psychosexual consequences of HPV-related GWs and intraepithelial lesions is limited. Specific research on the sexual impact of GWs and intraepithelial HPV-related lesion in women is urgently needed.
authors.affiliation: H San Raffaele Resnati Center of Gynecology and Medical Sexology, Milan, Italy. a.graziottin@studiograziottin.it
authors.forename: Alessandra
authors.initials: A
authors.lastname: Graziottin
authors.forename: Audrey
authors.initials: A
authors.lastname: Serafini
mesh_terms: D001008:Anxiety Disorders / Q000453:epidemiology / Q000523:psychology; D003218:Condylomata Acuminata / Q000523:psychology*; D003866:Depressive Disorder / Q000453:epidemiology / Q000523:psychology; D004414:Dyspareunia / Q000453:epidemiology; D004848:Epithelium / Q000473:pathology* / Q000821:virology*; D005260:Female; D006801:Humans; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000453:epidemiology*; D012307:Risk Factors; D020018:Sexual Dysfunctions, Psychological / Q000175:diagnosis* / Q000453:epidemiology*