Medically reviewed by: Dr. Kimberly Langdon (M.D) on 2 January 2022
HPV or human papillomavirus is the virus that is responsible for the infection which shares the same name, i.e, HPV.
It is mostly spread through sexual contact or close skin-to-skin contact during sex.
Many sexually active individuals get HPV at some time in their lives.
In the U.S. alone, more than 70 million individuals carry HPV, along with more than 12 million fresh cases diagnosed each year.
HPV has various strains. Some of which increase the chances of cancer in certain individuals.
Every year more than 19000 women and 12000 men in the United States suffer from HPV-related cancers¹.
In this article, we will learn about HPV, its transmission, various HPV symptoms, and its treatment.
We will also learn about the vaccination types available for HPV, and other ways to save ourselves from this disease.
Signs and Symptoms of HPV
HPV has no definite signs. This is because many individuals who carry the infection may or may not be symptomatic, and the infection usually goes away on its own.
However, those who carry a high-risk HPV strain,i.e, HPV strain 16 and 18 can develop certain forms of cancers.
These may include, cervical cancer, anal cancer, mouth, throat, and vulvar cancer in females. While men may suffer from mouth cancer, throat cancer, anal cancer, and penile cancer, etc.
If symptoms do occur, these may appear years after exposure.
While other strains lead to genital warts.
An individual with genital warts usually has skin filled with small bumps or a cluster of cauliflower-like bumps, with variable sizes.
These may be whitish, pink reddish, purplish-brown, and even skin-colored.
These can be present on the genitals, including the penis, scrotum, vulva, and groins.
These warts lead to itchy and burning sensations on the skin and other associated discomfort.
Other types of warts include flat warts, plantar warts, and common warts.
Common warts are raised bumps that appear on the hands, elbows, and finger sticks, and tend to be rough.
Plantar warts appear on the soles of the feet and tend to be grainy.
However, flat warts often appear on the face or neck and are slightly raised with a flat top. These are darker than the skin around them.
Some symptoms of HPV in the mouth may include:
- ● Hoarseness in the voice
- ● Persistent sore throat
- ● It hurts when you swallow something
- ● Sudden weight loss
- ● Swelling in the lymph nodes
- ● Earache
We will also learn about the vaccination types available for HPV, and other ways to save ourselves from this disease.
Causes of HPV
HPV spreads via skin-to-skin contact, including sexual intercourse.
The infection is mostly present in sexually active people, and may or may not be symptomatic.
HPV can spread from individual to individual, even if a person is asymptomatic.
There are strains of HPV that lead to warts, which are different from those that cause cancer. HPV-related cancers will be discussed in the next subheading shortly.
HPV can spread to an infant during childbirth, although the risk is relatively low, as the immune system can combat the infection in this situation.
An infant with HPV can develop symptoms like warts on the skin or lesions in the mouth.
If a young child exhibits HPV symptoms, it may point towards child sexual abuse.
The risk factors that increase the risk of developing HPV include,
- ● Being polygamous
- ● Having sex with your infected spouse
- ● Having sex with a spouse who was infected with HPV in the past, or any other sexually transmitted disease (STD)
- ● Having condomless sex
- ● Having direct contact with the HPV warts
- ● Having contact with the surfaces that are exposed to HPV
- ● Not getting vaccinated for HPV
- ● Has had a sexually transmitted infection, like chlamydia in the past
- ● Has birthed many children
- ● Consumes tobacco
- ● Has a weak immune system.
How Does HPV Cause Cancer?
The majority of the individuals suffering from HPV do not develop cancer.
However, the infection does increase the risk of cancer, specifically in individuals with a weak immune system.
A high-risk strain of HPV can alter the way of communication between cells, thus causing them to grow uncontrollably in many people.
However, people with a strong immune system combat these unwanted cells. But if an individual has a weakened immune system it is unlikely that it defeats these unwanted cells.
This is when it causes cancer.
Also, it can take almost one to two decades to develop a tumor, according to the National Cancer Institute (NCI).
In the United States, almost 3% of all women suffering from cancer and 2% of all men suffering from cancer are HPV-related.
HPV, thus, increases the risk of developing cancer in the:
- ● vagina
- ● penis
- ● anus
- ● vulva and cervix
- ● tonsils
Getting screened regularly can help in early diagnosis and timely cure of the disease. Thus, preventing cancer from advancing.
Also, the type of cancer determines its type of treatment, in addition to the person's age and the stage of cancer, etc.
Your diagnosis depends upon the visibility of your warts or lesions. Your physician will diagnose the infection with a physical exam.
Additionally, various testing procedures confirm the presence of HPV or HPV-related cellular changes in the cervix. These may include:
- ● A pap smear: Also termed as a cervical smear, Pap smear is a testing method that involves collecting and examining the cervical or vaginal cells. This exam helps detect the presence of any cancer-causing cellular changes in these cells.
- ● A DNA test: This testing method is used to determine the high-risk HPV strains. Your physician may use it in conjunction with a Pap smear.
- ● A biopsy test: This testing procedure involves scraping an infected part of the skin to reveal any abnormal cell changes.
Unfortunately, the testing options for men are limited. Urethral swabs can be used to detect internal warts.
In Pregnant Women
In pregnant women, genital warts are rarely problematic during pregnancy and childbirth. This holds for pregnant women who usually don't have visible genital warts.
If you're pregnant, talk to your doctor immediately. This is because warts may:
- ● Grow bigger and bleed
- ● Making it difficult for you to urinate (in case warts are growing inside your urinary tract; though this is rare)
- ● If the warts are present in the vaginal walls, then your vagina is less elastic during childbirth
- ● If these warts block your birth canal, then you might need a cesarean section (though this is rare)
- ● Rarely spreads to the baby during childbirth
Therefore, if you are pregnant talk to your healthcare provider immediately.
He/she may get you tested for HPV, to prevent any future complications.
If left untreated, certain strains of HPV may lead to cervical cancer.
If you have any warning signs of HPV, then getting diagnosed earlier can help prevent HPV from advancing into cancer, especially if you have a weakened immune system, or have had multiple full-term pregnancies in the past.
This is believed to be due to an increase in exposure to HPV due to sexual contact.
The most common type of HPV-related cancer in women is cervical cancer, which is specifically caused by HPV16 and HPV18 strains.
Some risk factors for cervical cancer may be:
- ● If you are a pregnant woman using diethylstilbestrol
- ● If you have a high-risk HPV
- ● If you have a sexually transmitted disease already or had HPV in the past
- ● If you have unprotected sexual intercourse with your infected spouse
Also, if you smoke, then you are more likely to develop precancerous and cancerous changes from an HPV infection, which is a risk factor for many pregnant women, too.
Unfortunately, HPV is incurable at present, therefore, can't be eliminated from the body except by the immune system which can keep it in check.
However, warts caused by HPV can be removed by using certain medications.
● For common warts: Over-the-counter medications, including salicylic acid products, are used. However, your physician may also recommend certain medicines like podofilox and imiquimod, etc. Sometimes surgical methods may also be used to remove warts
● Genital warts: If you have genital warts, don't use any over-the-counter (OTC) medicines for them. Instead, go to your doctor immediately. He/she will recommend you get certain methods for their removal, such as:
Cryotherapy (freezing off warts using liquid nitrogen)
Electrocautery (burning away warts using an electric current)
Laser therapy (removal of warts using a high-powered laser beam)
Surgical methods (cutting away warts by a surgeon)
However, to determine your method of wart removal, the type and location of the wart are important to know.
You can also get vaccinated against certain types of HPV. This holds for people who are as young as nine!
Vaccines include Gardasil 9 and Cervarix, etc, which protect against HPV16 and HPV18 — the major kinds of HPV strains that cause cervical cancers. Also, it can protect you against HPV6 and HPV11, which lead to genital warts.
To prevent HPV from developing, you can:
- ● Get vaccinated against HPV
- ● Having protected sex with your spouse
- ● Refraining from any sexual activity during this time, including oral sex
- ● Don't touch warts unnecessarily
- ● Maintain good hygiene standards, in case you should touch the warts
- ● Use appropriate footwear, in case warts, are present on feet, to avoid its spread
- ● Avoid sharing personal items with other people.
Also, talk to your doctor to ask when getting a vaccination is appropriate. If you're pregnant, wait until childbirth to get vaccinated.
When to See a Doctor
Since HPV may or may not exhibit symptoms in many individuals, make sure that you go to a doctor if you notice any unusual lumps or bumps inside or surrounding your vagina, penis, anus, base of the tongue, or feet. You may also experience certain symptoms of HPV in the mouth and throat, including sore throat.
Also, HPV in men with symptoms differ from those of women.
So, if you suspect any of these, talk to a doctor to begin treatment sooner.
The best way to know whether you have HPV or not is by testing. Your doctor will determine the type of testing after your physical examination.
Then he/she will recommend medications appropriate for your situation.
Most HPV infections take as many as two years to clear. However, if not treated on time, HPV may advance into cancer.
So, stay on your condoms and dental dams during this period. However, it is always recommended to refrain from any sexual activity during this time.
HPV is best diagnosed by testing and the HPV warts usually clear within a few years.
Symptoms of HPV include warts on the genitals and sore throat. Also, flu-like symptoms, like fever, chills, and headaches, along with tingling sensations in the infected body parts, may be present. You may also notice blistered skin, inside or surrounding the genital, and the mouth area.
If you are suffering from oral HPV, then you may have a sore throat, too.
However, many individuals tend to be asymptomatic, too. Thus, testing is the only way to determine whether you have HPV or not.
Unfortunately, the infection can't be cured completely but can be prevented from spreading using proper medical supervision. Also, HPV testing procedures for men are limited at present.
Some strains of HPV can cause cancer.
Thus, getting vaccinated against HPV³, and screened, is important to prevent this infection from developing. Also, HPV symptoms in men differ from those of women.
Certain researches show that HPV can deteriorate the semen quality, although studies are contradictory, and has been inconsistently related to infertility and probably not related to loss of pregnancy in women.
It is also associated with premature birth if the cervical disease is present, low birth weight, and other complications to the infant during childbirth.
The infection can also be passed to your baby during delivery, therefore your doctor may recommend a cesarean section instead of a normal delivery.
However, keeping your body healthy is vital to reduce your risk of spreading the virus, i.e, by practicing safer sex.
It is important to talk to your doctor about getting tested for HPV and when to get vaccinated against this disease.
What do you think about how we can deal with HPV-related cancers? We think it is by getting vaccinated as early as 9! Both genders should consider vaccination.