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The common cold of the sexually active world: HPV

Let’s talk HPV—causes, treatments, and prevention.

by Robin Wallace, MD

One of my patients’ most common questions is, “Um, I’ve got some new bumps...down there. Can you check them out?”

First off, if you ever notice something of concern “down there,” please go see your doctor or nurse and get it checked out right away. Often these new bumps are harmless, caused by ingrown hairs. Other times they are just pesky genital warts… That’s right: genital warts aren’t as bad as you think. They are caused by HPV, short for human papillomavirus.

Let’s talk causes, treatments and prevention for genital warts and other flavors of HPV.

Human papillo-whatsit?

HPV is one of the most common viruses around. There are more than 40 different types (or strains) of HPV that prefer to hang out around genitalia, including the vagina, penis and around the anus. The virus can also survive on any skin or object that’s recently touched genitalia.

HPV can be passed from one person to another without actual sex—just by intimate touching or sharing sex toys—so this virus really gets around! In fact, 80% of women will have had some strain of the virus by age 50.

Most people who have HPV never know it. Like all other viruses, there is no cure for HPV, but there are good treatments for the symptoms. Just to be clear, HPV is totally unrelated to HIV (human immunodeficiency virus) and HSV (herpes simplex virus).

What kind of problems can HPV cause?

Each of the 40 different types of HPV act differently. Some HPV types cause genital warts, which are raised flesh-colored bumps around your vagina, penis, or anus. Most of the time warts are not painful. Sometimes they are itchy, and they can be annoying or embarrassing. The types of HPV that cause genital warts do not cause cancer.

Other types of HPV will cause changes in a woman’s cervix (the opening to her uterus or womb). Often these changes come and go without her ever knowing, but a few types of HPV can linger, leading to long-term changes and ultimately cervical cancer. It takes many years for cervical cancer to develop, which is why regular check-ups and Pap smears after age 21 are recommended. A Pap smear will catch the changes in the cervix, and regular check-ups will ensure the right treatment at the right time.

How do I get rid of warts? Or an abnormal Pap smear?

HPV is a tough virus, but our immune systems are usually tougher. Our bodies start fighting off the virus immediately. When your body conquers the virus, it then has antibodies that protect against that type of HPV. (But not against the 39 other HPV types.)

For some people, genital warts will go away on their own within 3 months. If the warts don’t go away or you want them to go away faster, see your doctor or nurse. They may be able to treat the genital warts that day, usually by freezing the warts or applying a chemical to them. You can also get a prescription gel or liquid medicine that you use at home, usually clearing up the warts in a few weeks. All of these treatments get rid of the warts by irritating them, so be prepared for some discomfort.

An abnormal Pap smear can mean a lot of different things, so be sure to ask your doctor or nurse to explain the results and the recommended treatment completely. Often your body will heal itself and your next Pap smear will be normal. Sometimes you will need a more thorough exam of your cervix, called colposcopy, or a treatment to your cervix directly.

How do I know who gave it to me?

You won’t. If you have an outbreak of warts or an abnormal Pap smear, it could be from HPV you got weeks, months, or even years before. I know this is hard; most of my patients really want to know exactly how it happened. Did I have sex for the first time with someone who sleeps around? Is my boyfriend/girlfriend all of a sudden cheating on me? But I promise, this is one of many times in life when blaming someone just doesn't do any good.

Preventing HPV

There are some things you can do to reduce your risk of getting HPV:

  1. Get vaccinated! There are vaccines against some of the most common types of HPV that cause genital warts and cervical cancer. Talk with your doctor or nurse about whether you are the right age for vaccination. It works best if you get vaccinated before you have sex for the first time, but getting the shot when you’re older may still be helpful.
  2. Smart sex…if at all. The only surefire way to prevent HPV infection is to abstain from sex and genital contact. Research shows that the fewer sex partners a person has in her or his lifetime—especially during the teens and twenties—the less risk she or he has of multiple HPV infections.
  3. Use condoms! HPV cannot pass through a latex condom. But this is the kicker: HPV is frequently carried on skin not covered by condoms. So condoms can help prevent HPV, but they’re not a guarantee.

Remember, HPV will affect almost everyone you know! So being told you have it is no big deal… It’s the common cold of the sexually active world.

Robin Wallace, MD, is a Family Physician for the San Francisco Department of Public Health and is currently a clinical fellow in Family Planning at the University of California, San Francisco. As the middle of three daughters in her family, she has always been a passionate advocate for girl power and women's health, and appeared as Captain Contraception for a super heroes party in medical school.

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