HPV, or human papillomavirus, is a very common infection in the United States – and many people may not even know that they have it.
That’s because many people with HPV don’t experience any symptoms. This is why it’s important to know about this infection and how you can protect yourself and others during sexual activity and other close contact.
Keep reading to learn more about HPV – what it is, how it spreads, its symptoms and how you can protect yourself.
What is HPV (human papillomavirus) and how is it spread?
HPV is a virus that can infect your skin on the outside of your body, as well as the skin forming the lining of body parts like the mouth, vagina, cervix and anus. There are more than 150 types of HPV, with most of these causing benign warts on fingers, hands and feet.
There are about 40 types of HPV that are spread through intimate or sexual contact, and can infect your genitals, mouth and throat. The types of HPV that are not spread through sexual contact can be spread through close skin-to-skin contact with someone who has the infection.
Here, we’ll focus on the HPV types that are spread through intimate or sexual contact.
HPV is an extremely common infection
Human papillomavirus is the most common sexually transmitted infection in the U.S. In fact, it’s so common that the Centers for Disease Control and Prevention (CDC) says that nearly every person will get HPV at some point in their life. Most people may never know they’ve even had it since the infection often doesn’t cause any symptoms and can go away on its own.
How HPV is sexually transmitted
All HPV strains are contagious and spread through contact with infected skin cells that have sloughed or exfoliated. This is why sexual contact gives the virus plenty of opportunity to spread to the mouth, throat, penis, vagina, vulva, cervix or anus.
HPV can spread even when there are no signs or symptoms of the infection. Symptoms can develop years after having sex with someone who has the infection, making it hard to determine when you got infected.
What to know about HPV symptoms
Most sexually transmitted HPV infections don’t cause any symptoms and resolve on their own. The 40 or so types of HPV that can be spread through sexual contact are put into two categories: low risk and high risk.
- Low-risk HPV may be an asymptomatic infection or present as an STD that has resulted in warts (condyloma) on or around the genitals, mouth and throat. There are no differences in the symptoms of low-risk HPV between women and men.
- High-risk HPV begins as an asymptomatic infection, but can lead to cancer of the cervix, vagina, vulva, penis, anus and throat. With precancerous changes, there may be no symptoms or subtle symptoms such as itching, color or texture changes of the skin, or bleeding. HPV-related cancer might not cause any symptoms early on, but may eventually cause a visible or palpable mass, bleeding and pain.
How common is HPV-related cancer?
While most genital HPV infections aren’t harmful, HPV strains that cause high-risk infections can lead to cancer. Although it is most commonly linked to cervical cancer, high-risk HPV can also lead to cancer in the vulva, vagina, penis, anus, mouth and throat.
In the United States, the CDC says human papillomavirus causes more than 37,000 cancer cases each year. The percentages of specific cancers caused by high-risk HPV are:
- Cervical (91%)
- Anal (91%)
- Vaginal (75%)
- Oropharyngeal (70%)
- Vulvar (69%)
- Penile (63%)
It’s important to know that having a high-risk HPV infection doesn’t mean you’ll get cancer. But if the infection does progress to cancer, symptoms can include:
- Cervical and vaginal cancer symptoms may show up as pelvic pain, pain during sex, or bleeding not related to a menstrual period.
- Vulvar and penile cancer symptoms may include changes in the color or thickness of the skin in the area. There may also be a sore or lump.
- Anal cancer might cause anal bleeding, pain or changes in bowel movements.
- Throat cancer can cause chronic ear pain, pain or trouble swallowing, or a lump or mass in your neck.
How HPV is diagnosed
When it comes to low-risk HPV, testing isn’t done for an asymptomatic individual. So a diagnosis is based on a person’s symptoms, specifically finding warts. A biopsy may be performed to confirm if it’s HPV.
For high-risk HPV, testing is only recommended as part of preventive cervical cancer screening, or in some cases, anal cancer screening. That’s because most HPV infections resolve on their own, plus there’s no treatment for an asymptomatic infection. Also, those with precancerous or cancerous cells often don’t experience any symptoms in the early stages of a disease, which is why they’re often diagnosed during a preventive screening.
A cervical cancer screening may include a Pap test, an HPV test or both, depending on your age and risk factors.
- A Pap test (also known as cytology) is a common screening exam where a doctor tests the cells of the cervix to check for abnormalities in the cells that could be precancerous or, more rarely, cancerous. Starting at age 21 a cervical cancer screening with a Pap test is recommended for all women or those assigned female at birth.
- An HPV test, also called primary HPV testing, is a screening test that specifically looks for HPV virus in the cells of the cervix. HPV testing can be done alone or with a Pap test (which is called co-testing).
HPV-related precancers and cancers may also be diagnosed through examining the mouth, vulva, vagina, penis or anus, or by taking a biopsy of suspicious tissues or growths in these areas. This is the only diagnostic option for children, men and women under 21 years old. Currently, routine testing for HPV-related diseases in men before there are symptoms is not recommended.
How to prevent HPV (and protect others): Vaccination and safe sex
The best way to protect yourself or your child from HPV is getting vaccinated. The earlier you receive the vaccine, the better it is at preventing infection. Also, practicing safe sex is important for helping prevent all sexually transmitted infections.
Get the HPV vaccine
The HPV vaccine is the most effective way to protect yourself against HPV infections and HPV-related cancers. The vaccine can protect against nine of the 40 types of HPV, seven of which are high-risk types for cancer. The CDC recommends that all children who can get the vaccine to receive it between ages 11-12, but vaccination can start as young as 9 years old for some. If not vaccinated at these ages, the CDC still recommends that children and young adults through age 26 get vaccinated.
The vaccine is approved for people 27-45 years old but isn’t part of the routine vaccination schedule. It’s a good idea to talk with your doctor to determine if vaccination is right for you.
Practice safer sex
Don’t forget, you can still pass HPV to your sexual partners even if neither of you show symptoms. That’s why practicing safer sex is so important. Condoms and other barrier methods can help lower your chances of getting or passing along the infection, but HPV can still affect the areas not covered by the condom.
HPV treatment options: Prescription creams and wart removal
The good news is that most HPV infections will go away on their own. Your immune system is effective at getting rid of the virus and can clear most HPV infections within two years.
The treatments currently available for HPV focus on alleviating the symptoms of HPV, not curing it. HPV symptom treatment is typically the same for both men and women.
Common HPV symptom treatment options for genital warts
When genital warts go untreated, they may go away on their own, but they can also stay the same or grow in number and size.
Topical medicines, like imiquimod and podofilox, are a common treatment for genital warts, but there are also several other removal techniques. The best removal technique will depend on the location of the warts.
Treating HPV-related precancer and cancer
If precancer or cancer related to an HPV infection is diagnosed, your care team will walk you through all the next steps.
Get vaccinated against HPV if you can (and don’t ignore strange symptoms if they arise)
Taking steps to protect yourself and others from HPV is important, but it’s also important not to ignore strange symptoms you notice. HPV is the most common sexually transmitted infection in the United States, so there’s nothing to be ashamed of. Most people have been exposed to human papillomavirus and don’t even know it.
While usually harmless, it’s important to take the necessary steps to protect yourself and others by practicing safer sex through getting vaccinated, and using condoms or other barrier methods. HPV infections don’t always have symptoms, but if you start showing signs, like genital warts, reach out to your doctor right away.
