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HPV and genital warts

Human papillomavirus (HPV) are a group of over 100 types of virus, including more than 40 types that involve the genitals. Three out of four women will have an HPV infection at some time in their lives.

Most of the time, HPV infection is not serious, does not have any symptoms and will go away on its own without treatment. Because HPV often has no symptoms, it is easy to pass from one person to another without knowing it. Some types of HPV cause bumpy genital warts that do not cause cancer. Other types of HPV are more serious and may cause cancer of the cervix, penis, vulva, anus and throat. Routine Pap tests are done to screen women for cervical cancer.

The HPV vaccine can help prevent 70% of genital cancers and 90% of genital warts. This vaccine is available for men and women. It is recommended that young people get the vaccine before they become sexually active. The vaccine does not have an effect on any type of HPV that a person may already have.

Cause

The types of HPV that cause genital warts are most often spread by skin-to-skin contact during vaginal (frontal) and anal sex. The virus is most commonly found on the genitals and anus. It is found less often on the mouth or in the throat.

People who have HIV are more likely to develop genital warts if they come into contact with the virus. When a person has HIV, sometimes their ability to fight off viruses is lower, making it easier for more warts to grow.

During anal sex, HPV can be spread into the anal canal. Some types of HPV can cause changes in the cells inside the anus that can lead to anal cancer. The chances may be higher in men who are HIV positive and have sex with other men.

Symptoms

Symptoms of genital warts can include painless bumps on your genitals and/or around your buttocks. Genital warts may appear near the opening of the urethra (pee hole), under the foreskin, on the shaft of the penis, near the opening of the vagina and inside the anus.  Warts can be different sizes and shapes; some look like flat white patches and others look like tiny bunches of cauliflower.

It may take from four weeks to eight months, or longer, for the warts to appear after contact with the virus. Sometimes warts never appear or you can't see them. Whether you can see warts or not, the virus can still be passed on to others.

Often there are no symptoms with early stage cervical cancer related to HPV. Symptoms may include unusual or heavy bleeding from the vagina and bleeding between periods. It is important to see a health care provider if you notice these symptoms.

Complications

For most people, there are no long-term problems from genital warts. A pregnant person who gets HPV may have warts that increase in size, bleed, or become infected. Genital warts may be passed onto the newborn, but this is extremely rare.

Some types of HPV cause changes in the cells that can lead to cervix, penis, vulva, anus, and throat cancer. Of these types of cancers, cervical cancer is the most likely.

Tests and Diagnosis

A health care provider can usually diagnose genital warts by asking about your symptoms and looking at the warts.

To screen for cervical changes caused by HPV infection, a health care provider will do a Pap test.  A Pap test screens for changes to the cells of the cervix that could lead to cancer. If changes are found, your health provider may recommend further testing, more frequent Pap testing, or treatment if needed. Often Pap tests find changes early enough that treatment can be given before cancer develops.

Some experts recommend that men who have receptive anal sex should have a routine anal Pap test, especially if they are also HIV positive. Talk with your health care provider to find out what is best for you. 

Treatment

In most cases, an HPV infection that causes genital warts will clear on its own. It usually takes anywhere from a few months to a couple of years.  Genital warts can disappear on their own or with treatment, but a person may still have the virus in their body.

Many people want to get treatment to make the visible warts go away. It is important to remember that even when you can no longer see the warts, HPV may still be on the skin and it can be passed to partners.

Genital warts can be treated by applying a liquid medication or by freezing them. You may need to go for several treatments over a 4 to 16 week period. Your doctor may prescribe a chemical or a cream that you can use yourself.  Discuss your options with your health care provider to find the best treatment for you. Genital wart treatment is covered by BC Medical Services Plan (MSP).

Caution: Do not use non-prescription wart removal products that you can buy in the store to treat genital warts. They are not meant for the genital area and may cause serious burning.

Resources

ImmunizeBC – HPV vaccine information
HealthLink BC – HPV infection information
HealthLink BC – HPV vaccine information
HPV Info – What is HPV?


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