Human Papillomavirus: What You Need to Know

What is HPV?

What is HPV? Human Papillomavirus (HPV) is one of the most common sexually transmitted infections. It is used to describe a group of viruses that can infect the penis, vulva (area outside of the vagina), anus, and the linings of the vagina, cervix or rectum. Most of the time HPV infection is not serious, does not have any symptoms, and will go away on its own without treatment. HPV is most commonly found on the genitals and anus and is found less often on the mouth or in the throat. Approximately 75% of sexually active individuals will have at least one HPV infection in their lifetime, with the highest rates of HPV infection occurring in young people aged 15 to 24. There are more than 100 known types of HPV with at least 40 that cause genital warts and cancer. Low-risk types of HPV, which cause genital warts, often clear on their own. The 13 cancer-causing HPV types, the most common being HPV types 16 and 18, can also go away on their own, but if the infection lingers it can lead to cancer.

Symptoms of HPV

Genital Warts

Genital warts are often the only visible sign that someone has an HPV infection. These are small growths that appear on or inside the sex organs several weeks, months, or even years after sexual contact. They often look like small, red or white cauliflowers; they may be flat or feel like small raised bumps. The warts can come as only one or there could be many. In women, genital warts appear on the vulva, urethra, cervix, vagina, anus or thighs. In men, warts can appear on the penis, scrotum, anus or thighs. Genital warts are not a sign that you have cancer or that you will get cancer; they are not precancerous. Genital warts are usually painless but can sometimes cause itching or burning. When genital warts are visible, it can cause embarrassment and affect relationships because of the reluctance to talk with your partner about it.

Cervical Cancer

In case HPV becomes a chronic infection, it is important to know the symptoms of cervical cancer as HPV can lead to cancer. However, is important to remember that the signs of cervical cancer can also be caused by other health conditions. Thus it is important to discuss these with your doctor rather than trying to self diagnose. Symptoms include abnormal vaginal bleeding, pain during sexual intercourse, increased discharge from the vagina, pain in the pelvic area or lower back, weight loss, lack of energy and shortness of breath.

Symptoms of HPV can vary from person to person. In general, these are the common symptoms.

Genital warts:

No symptoms
Itchiness
Discomfort during intercourse
Bleeding with intercourse or with shaving
Warts on the penis or vulva, which appear as small cauliflower-like growths
During pregnancy, warts may increase in size and number and then regress/resolve after delivery

Cervical cancer:

Often no symptoms
Bleeding between periods or after intercourse
Found after an abnormal Pap test

Recommended Read: Papillomavirus Vaccine

Testing of HPV

Most genital warts are diagnosed by visual inspection. If there is any doubt, a biopsy can be taken. There are no HPV tests for men. Women can detect HPV on pap screening. A Pap test is a simple screening method that uses a cotton swab to obtain a sample of the cells on the cervix. The cells are sent to the lab where changes in your cervix cells can be detected. Regular Pap tests are the best way to find abnormal cervical cells early and treat them before they develop into cervical cancer. The U.S. Food and Drug Administration (FDA) approved the first DNA test for HPV in 2014. An HPV DNA test is generally recommended for women over 30 whose Pap test results show specific abnormalities. However testing recommendations differ by geographic location.

There are HPV tests that can be used to screen for cervical cancer also. These tests are only recommended for screening in women aged 30 years and older. HPV tests are not recommended to screen men, adolescents, or women under the age of 30 years. Most people with HPV do not know they are infected and never develop symptoms or health problems from it. Some people find out they have HPV when they get genital warts. Women may find out they have HPV when they get an abnormal Pap test result (during cervical cancer screening). Others may only find out once they’ve developed more serious problems from HPV, such as cancers. Updated guidelines recommend that women have their first Pap smear at age 21 and be tested for HPV at the same time, regardless of the onset of sexual activity. After that, women aged 21 to 29 should undergo a Pap test every three years. Regular Pap tests help to identify abnormal cells in women. These can signal cervical cancer or other HPV-related problems. Women ages 30 to 65 should then be screened every five years with Pap and HPV tests at the same time. If you’re younger than the age of 30, your doctor or gynecologist may also request an HPV test if your Pap smear results are abnormal.

If you have one of the 15 strains of HPV that can lead to cancer, your doctor may want to monitor you for cervical changes. You may need to get a Pap test more frequently. Cervical changes that lead to cancer often take 10 or more years to develop,and HPV infections often go away on their own in one or two years without causing cancer. You may want to follow a course of watchful waiting instead of undergoing treatment for abnormal or precancerous cells resulting from an infection. Your doctor may also want to do some follow-up testing with a colposcopy. This procedure uses an instrument (a colposcope) to examine your vagina and cervix more closely to look for abnormal areas. If you have new warts or notice other changes after sexual activity, contact your doctor for an assessment.

Prevention of HPV

HPV is spread by skin-to-skin contact. This can be during oral, vaginal or anal sex, or during any other sexual activity in which skin-to-skin contact takes place.

You can do several things to lower your chances of getting HPV.

Get vaccinated

The HPV vaccine is safe and effective. It can protect against diseases (including cancers) caused by HPV when given in the recommended age groups. The recommendation for 11 to 12-year olds is to get two doses of HPV vaccine to protect against cancers caused by HPV. Vaccination works best before you are sexually active or have already become infected or exposed to an HPV virus but can help reduce the risk of HPV-related disease at any time, even after an abnormal Pap test.

Get screened for cervical cancer

Routine screening for women aged 21 to 65 years old can prevent cervical cancer.

If you are sexually active:

Use latex condoms the right way every time you have sex. This can lower your chances of getting HPV. But HPV can infect areas not covered by a condom – so condoms may not fully protect against getting HPV
Be in a mutually monogamous relationship – or have sex only with someone who only has sex with you.

Treatment of HPV

There is no treatment for the virus itself. However, there are treatments for the health problems that HPV can cause:

Genital warts can be treated by your healthcare provider who may recommend using topical medication or freezing or with prescription medication. These are usually applied to the area over a 4 to 16-week period. The length of treatment may vary depending upon the severity of the warts and the treatment that is used. These treatments do not get rid of the HPV infection; a person who has been treated may still pass it on, even if the warts are no longer visible. If left untreated, genital warts may go away, stay the same, or grow in size or number.

Caution: Do not use non-prescription wart removal products to treat genital warts. These products are not intended for use in the genital area and may cause serious burning.

Cervical pre-cancer can be treated. Women who get routine Pap tests and follow up as needed can identify problems before cancer develops. Prevention is always better than treatment.
Other HPV-related cancers are also more treatable when diagnosed and treated early.
Since having a healthy immune system can help defend against viruses, you can further reduce your risk of contracting HPV and other illnesses by taking steps to improve your immune system.