"Safety first" applies to a lot of things in life, but especially when it comes to your sexual health. You've heard it time and time again, but it is beyond important to keep up with all the safety precautions needed to stay protected when you're having sex — no matter who your partner is.
Even if you think you've been going about it the right way (using condoms during intercourse, barriers when giving oral, washing your sex toys with antibacterial cleansers and getting checked regularly for STIs), there are still other factors that could lead to contracting an STI. Take, for example, the STI that doesn't show up on any test for men: HPV.
Typically, there's more concern from women about this STI, since it has been directly linked to cervical cancer. But men can also be infected with HPV, and can carry it without even knowing — a big reason why this disease spreads, and so many people have it. Just how many people are we talking? It's estimated that 75% of the reproductive-age population is infected, and up to 5.5 million new cases get reported each year, according to the CDC.
Want to know more? We've got you covered. From the symptoms to the diagnosis and how to prevent it, here's everything you need to know about HPV.
What Is HPV?
HPV isn't just one virus — there are a ton of different strains of this disease. "HPV (Human papillomavirus) are a group of viruses that affect the skin and moist membranes lining the body such as in the mouth and throat, anus and penis. Infection with the virus often causes warts," explains public health epidemiologist Leah de Souza-Thomas. "There are more than 100 types of HPV and more than 30 human papillomaviruses known to infect genital areas." Also, as mentioned earlier, if you're going to accidentally contract any STI, this is likely to be the one. "Genital HPV infection is highly contagious and common, with the CDC reporting that most sexually active people in the United States will have HPV at some point in their lives," she says.
Symptoms Of HPV
Why has HPV become so common? One big factor is that the symptoms of this STI rarely show up. And if you don't know you have it, you're likely not taking all of the precautions needed in order to not spread it to others. "Most HPV infections do not cause any sign and symptoms and resolve spontaneously," says Dr. Ameer Pirzada. "However, in some cases it may cause warts that may persist and lead to precancerous lesions. Precancerous lesions increase the risk of developing malignancy." In other words, cancer. Which is a pretty scary symptom of a disease that most of the population has — or will have at some point. "Precancerous lesions may be seen around the cervix, vulva, vagina, penis, anus, mouth or in the throat," says Dr. Pirzada. "Most people have the virus, but it remains dormant and disappears without any medical intervention. However, in an active virus, skin infections may start to appear and these are called warts. Warts are basically rapid growth of cells on the cutaneous (skin) region."
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Warts that show up because of HPV come in a few distinct shapes, and show up on certain places of the body. "'Common warts' are warts that are usually found on hands and feet," says Dr. Pirzada, "but it is also well documented that they may appear in other areas such as the elbows or knees. Common warts resemble the appearance of a cauliflower and they are mostly raised above the surrounding skin. Plantar warts are mostly found on the soles of feet. They are known to grow in an inward direction rather than an outward direction. Generally, these warts may cause pain when walking. Subungual and periungual warts are mostly found under the fingernails. Flat warts are most commonly found on the arms, face or forehead."
If left untreated, HPV can cause some more serious complications. "Genital warts caused by HPV can grow fairly large and can disfigure the penis and scrotum in men, and labia in women if left untreated," explains Dr. Alex Shteynshlyuger, MD, Director of Urology at New York Urology Specialists. "High-risk HPV infection can predispose to cervical cancer in women, [as well as] oro-pharyngeal cancer (from oral sex), penile cancer and anal cancer."
How Is HPV Spread?
There's only one way to make absolutely sure you're protected against contracting HPV — and you're not going to like it. "Abstinence is the only 100% way to prevent the transmission of HPV," says Dr. Pirzada. "The risk of transmission can be reduced if a person limits his sexual partners that way the spread can be controlled. Another way to reduce the spread is to pick sex partners who have had few or no partners in the past. Condoms provide limited protection against HPV transmission. Unfortunately, HPV is transmitted primarily by skin-to-skin contact."
How To Prevent HPV
Aside from safe sex practices and limiting your amount of sexual partners, there are vaccines that can help prevent you from getting this disease. However, these vaccines have age restrictions due to the fact that the younger you get vaccinated, the more effective the treatment is. "Gardasil Vial (vaccine) is approved to be used in boys and men of age ranging between 9 and 26 years for the prevention of genital warts," Dr. Pirzada says. "This vaccine has the capability of preventing genital warts caused by two strains of HPV, these are HPV 6 and HPV 11."
There is another type of HPV vaccine that works well in preventing the disease from being contracted — as long as it is given early on. "Gardasil 9 HPV vaccine is available for men and women and protects against nine different viruses that cause genital warts and cancer," says Dr. Shteynshlyuger. "Gardasil 9 works best if given before exposure/infection essentially before onset of sexual activity. It protects against 90% of viruses that cause genital warts and 85-90% of viruses that cause cervical cancer. Usually, three doses are given. The second dose is given at least two months after the first and the third dose, six months after the first dose. For children, studies showed that two doses are usually sufficient. Adults over 26 can also benefit from Gardasil but the benefit is decreased; as a result Gardasil is usually recommended to men and women under age 26."
How To Diagnose HPV
Yet another reason why the majority of the population has this STI — it doesn't show up when you screen for it. "Currently, there is no reliable test for HPV infection in men," de Souza-Thomas explains. "Men who are at high risk of anal infection and developing anal cancer may be offered an anal smear. Genital warts are a sign of infection with HPV and are in most cases easy to see. Check for abnormal growths on your penis, scrotum or around the anus and see your doctor if you suspect you have genital warts."
If you do see warts that match up to the description of the types listed earlier, Dr. Shteynshlyuger says your doctor can test to confirm. "Genital warts associated low-risk HPV strains can be diagnosed visually by an experienced physician; biopsy of genital wart can confirm the diagnosis," he explains. "In gay men, anal testing can test for high-risk cancer-causing HPV."
AskMen Recommends: Concerned you may have picked up an unwanted infection from a recent sexual encounter? We're not here to shame you. But before you let things fester (or sleep with other people), you should find out what your STI status is, and, if you have one, take action immediately. If you don't have the opportunity to see a doctor or to go to a health clinic, consider getting ordering an at-home test kit. Check out our list of the best at-home STI kits so you can find out where you stand ASAP.
How To Treat HPV
Since most HPV cases are asymptomatic, there's not much that can be done in the way of treatment options, since there isn't anything to treat. "Occasionally warts go away without any intervention, particularly in children," Dr. Pirzada says. "However, there’s no cure for a virus, no one can make it completely go away, it may remain dormant but is never eliminated from the body. Even after successful treatments, warts can appear in other areas as well.
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Medications — typically, topical ointments — will be prescribed; these are directly applied on the lesion. When medications do not work, your doctor may ask you to undergo a small surgery. He/she can remove the wart by freezing with liquid nitrogen (cryotherapy), burning with an electrical current (electrocautery), surgical removal or laser surgery." If you do end up having to seek treatment to remove warts caused by HPV, make sure you speak with your doctor about the best course of after care — including how long you should wait before having sex again. Typically, doctors recommend waiting at least two weeks until everything is healed, but this can vary depending on the extent of the warts being removed.
The good news is that although this STI is extremely common and easy to pass along, those that do wind up contracting the disease rarely experience complications from it, and for the most part, HPV is asymptomatic. Of course, this is not to downplay the dangers of this STI. Although there is no cure for it, if you do contract HPV chances are that you won't notice much of a change in your day-to-day. Armed with this knowledge, it's probably a smart bet to start being more diligent in how you choose your sexual partners, and how many partners you have. Less is more when it comes to preventing HPV.