HPV: Symptoms, Treatment, & Diagnosis

If you test positive for Human papillomaviruses (HPV), you are far from alone. In fact, you share this diagnosis with roughly 79 million Americans, who acquire approximately 14 million new cases each year. There are over 100 types of HPV, but only 40 strains are sexually transmitted. Nearly all sexually active people who do not get vaccinated against HPV will become infected with it at some point in their lives. There is no cure for HPV infection, and it can have some symptoms and health consequences, but there are treatments for the symptoms and related issues, and the vast majority of people clear HPV on their own without any long-term complications.

What Is Human Papillomaviruses (HPV)?

The 40 strains of HPV that are sexually transmitted can be contracted through vaginal, anal, and oral sex, as well as skin-to skin-contact. The virus is most common in people in their teens and twenties, but any sexually active person who hasn’t been vaccinated against it can contract it. Many strains of HPV cause no symptoms and will resolve on their own, but some strains can cause warts on the genitals, mouth, or throat, or changes in cells that can lead to cancer. However, with early detection and treatment most people experience no long-term health consequences. Men and women between the ages of 9 and 26 can be vaccinated against some strains of HPV known to cause genital warts and cervical cancers.

HPV Symptoms in Women

HPV is the most common STD in women in the US. Most women will not experience symptoms, and will not even know they have it. But those who do have symptoms may develop on their vulva, vagina, cervix, anus, mouth, or throat. The warts can be raised or flat, flesh colored or red, large or small, and some may be clumped together in a cauliflower-like shape. Sometimes the warts can resemble a pimple or ingrown hair, so if you notice unusual bumps or sores in your genital or anal area, it’s a good idea to visit a health care provider who can examine them to make the correct diagnosis.

The types of HPV that cause warts are not associated with cancer, and the types of HPV that can lead to cancer generally don’t cause warts. This is why regular gynecological exams are recommended for sexually active females. A Pap test will show changes in cervical cells that might be precancerous. If your doctor does detect cervical changes, prompt treatment including removal of any pre-cancerous cells is highly effective in preventing progression to cancer.

HPV Symptoms in Men

Like women, most men who acquire HPV won’t develop symptoms, and the infection frequently resolves on its own. However, if HPV does cause symptoms, those are also in the form of warts, lumps, or sores on the penis, scrotum, anus, mouth, or throat. The genital warts are bumps or clusters of bumps that can vary in size and shape. They can be flesh colored or red, large or small, and raised or flat. Some may be clumped like a cauliflower. In men, genital warts form around the penis or the anus. The types of HPV that cause warts do not cause cancer, and treatment is available for the warts. If you notice warts or bumps around your genitals or anus, see your healthcare provider as soon as possible so that they can perform an exam and make the correct diagnosis.

Some strains of HPV infections that do not resolve on their own can cause penile cancer, anal cancer, or cancer in the back of the throat (called oropharyngeal cancer). HPV-related cancers in men are rare, and develop slowly, so early detection often leads to complete recovery. Certain men are more at risk for developing cancer from HPV, including those with weakened immune systems (like those with HIV or AIDS).

General HPV Symptoms

Both men and women can get warts on their anal and genital regions, mouth, or throat. If you notice new or unusual lumps or sores in these places, have them evaluated by a physician as soon as possible.

HPV Risk Factors

The highest risk group for contracting HPV includes sexually active men and women in their late teens to mid-twenties, and those who have multiple sexual partners, and men who have anal sex with men. Other risk factors include:

• Having a weakened immune system: If your immune system is compromised by an infection like HIV/AIDS, by immune system-suppressing drugs like steroids, because of smoking, malnutrition, or stress, or because of medical treatments such as chemotherapy or an organ transplant, you are at increased risk of contracting HPV.
• Having damaged skin: Skin with abrasions or cuts is more vulnerable to contracting infections.

HPV Diagnosis in Women

Health care providers can diagnose HPV in women by examining the warts or by reviewing the results of a Pap test, which can identify changes in the cells of your cervix. If your cervical cells show certain abnormalities, your doctor will obtain a sample that tests for the virus directly. Your health care provider can also perform a colposcopy, taking small samples of abnormal tissue for further testing.

HPV Diagnosis in Men

Some healthcare providers offer anal Pap smears, similar to the cervical Pap smear done in women, for men who could be at increased risk for anal cancer. This includes men who are immunocompromised due to HIV/AIDS and men who receive anal sex. In addition, health care providers can diagnose HPV in men by examining genital, anal, and oral warts, if present.

HPV Treatment

The majority of HPV infection, approximately 70 – 90%, clear on their own. For those who develop warts requiring treatment, there are many options. Treatment options include:

• Cryotherapy: This uses liquid nitrogen to freeze warts off.
• Electrocautery: This uses electrical current to burn warts off.
• Laser therapy: Light is used to vaporize warts.
• Medicated cream: The cream is applied directly to warts.

HPV-related cancers are also highly treatable as long as they are detected early.

Women who show changes that could lead to cancer in their genitals or cervix can have a Loop electrosurgical excision procedure (LEEP), which uses a wire loop to remove abnormal cells. Abnormal or precancerous cells can also be destroyed by Cryotherapy, Electrocautery, or Laser therapy, as described above. Sometimes abnormal cells will resolve on their own, and doctors may recommend a wait-and-see approach.

Maintaining a healthy lifestyle supports your immune system, which can help clear an HPV infection. Lifestyle modifications such as getting enough sleep, drinking plenty of water, avoiding smoking, caffeine, and excessive sugar, and eating plenty of fresh fruits and vegetables are all healthy and easy ways to help boost your immunity. If you or your do partner have genital, anal, or oral warts, it’s important to abstain from sexual contact until the warts cleared. However, remember that most people with HPV have no warts or other symptoms but can still pass on an HPV infection.

HPV Prevention

Using condoms during sex is a great way to reduce the risk of HPV. However, because HPV can also be passed through skin-to-skin contact, and condoms do not completely cover genital skin, there is still a chance you could become infected with HPV even when using condoms. Other ways to reduce your risk of contracting HPV are:

• Get vaccinated against it! There are three HPV vaccines available. They are Gardasil and Gardasil9, for both genders ages 9 to 26, and Cervarix, for women only, to protect against the HPV strains that cause cervical cancer (it does not protect against the HPV strains that cause warts).
• Avoid having vaginal, anal, or oral sex with anyone who has genital or oral warts.
• Women should get regular Pap tests to look for abnormal, potentially precancerous cervical cells.
• Have sex in the context of a long-term, monogamous relationship.
• Have open conversations with new sexual partners about your sexual histories.
• Use male and/or female condoms for genital intercourse, dental dams for oral sex, and latex gloves for manual stimulation.

When to See a Doctor

If you are sexually active and devlop warts or any unusual lumps, bumps, or sores in your genital or anal areas, or feel them in your mouth or thorat, it’s important to see a medical professional as soon as possible for an accurate diagnosis and to begin treatment. If you think that you have been exposed to HPV, or if you are at high risk for contracting HPV, see your healthcare provider for further guidance.