HPV / Genital Warts

WHAT IS IT?

HPV stands for Human Papillomavirus. There are more than 100 different types of HPV. About 30-40 of these types can lead to genital warts or cancers of the cervix, penis, anus, vulva, and oropharynx (mouth). Please note, however, that the types that cause genital warts are not the same types that cause genital cancers. HPV is one of the most common STIs, and it is estimated that 75% of sexually active adults will have at least one HPV infection during their lifetime (Health Canada, 2007).

HOW WOULD I GET IT?

HPV is passed on through direct sexual contact – mostly vaginal and anal sex, but oral sex also carries a risk. It is also possible to become infected with HPV through other types of sexual activity that involve direct skin-to-skin contact, such as rubbing genitals together without having intercourse. In rare cases, a mother can pass on HPV to an infant during delivery.

Because HPV can live on the skin surrounding the groin area, including the upper thighs, condoms do not offer complete protection against this STI. However, they still offer some protection, so we highly recommend using them!

HOW WOULD I KNOW I HAD IT?

Many individuals infected with the types of HPV that cause genital warts do not develop any symptoms. In some people, warts will develop within 1 – 8 months on the vulva, cervix, penis, scrotum, anus, or in the urethra. It is also possible that someone could carry the virus for many years before developing symptoms. Therefore, it is often impossible to determine exactly when and from whom someone contracted the virus. Genital warts typically appear as small, soft, flesh-colored growths, with a cauliflower-like appearance. The size and number of warts will vary from person to person and within an individual there may be one or several outbreaks over time. Genital warts are diagnosed through a visual inspection by a doctor. There are currently no tests available in Nova Scotia that can tell someone who doesn’t have symptoms if they are carrying the strains of HPV that cause genital warts. Other symptoms may include itchiness, discomfort during intercourse, and bleeding with intercourse. During pregnancy, warts may increase in size and number, then regress/resolve after delivery.

As noted above, some strains of HPV can cause cell changes that may lead to cancer. For this reason, it is very important for women who are sexually active to get regular Pap tests. Pap tests look for changes in the cervical cells that could potentially turn into cancer. Some strains of HPV can lead to other types of cancer, such as penile, anal, and oropharyngeal (throat). Unfortunately, in Nova Scotia, we do not have screening tests available for these types (e.g., anal pap).

CAN IT BE TREATED AND CURED?

Genital warts can be treated with liquid nitrogen that is applied to the bump(s). Someone with genital warts may be required to come for treatment once a week for 6-12 weeks, or they may only need to come for 1-2 treatments. How many treatments someone requires will depend on the severity of the outbreak. Someone may also choose not to receive treatment. Research has shown that up to 70% of people infected with HPV will clear the virus on their own within the first year, and up to 90% will clear the virus within the first two years (Center for Disease Control, 2004).

There is a vaccine available for young women and men in Canada that may help to prevent infections caused by 4 types of HPV. It is called GARDASIL and is most highly recommended for individuals aged 9-26 who have not had sex. GARDASIL may help prevent cervical cancer, vulvar/vaginal cancers, cervical dysplasia, and genital warts. However, like any vaccine, it comes with its own risks; therefore, if you are interested in receiving GARDASIL, it is important for you to have a discussion with your doctor to see if this is a safe and useful option for you.

Because of the complex nature of this infection, some people may find it helpful to talk to a health care practitioner or a counselor about the potential impact on their sexual well-being. This may include issues such as depression or challenges within sexual relationships.

IF IT ISN’T TREATED, CAN IT LEAD TO MORE SERIOUS PROBLEMS?

Yes. Untreated HPV can lead to cervical, vulvar, vaginal, anal, penile, and other cancers (although – as noted above – the types of HPV that cause genital warts are not the same types that can lead to cancer). It can also lead to blockage of the urethra or vaginal opening. In chronic cases, untreated HPV may lead to emotional issues such as depression and/or sexual dysfunction. We have wonderful nurses, doctors, and a sexuality counselor at HSHC that can help you work through these issues so that you can feel good about yourself sexually and learn ways to talk about HPV with your sexual partner(s).