[Question #11839] Concerns about HPV.
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12 months ago
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Dear
Doctors,
I'm a
36-year-old male getting married soon and have concerns about HPV transmission.
My situation:
- Sexually active since 18,
inactive last 16 months
- Fiancée is a virgin, but we've
had oral sex
- Both received Gardasil 9 (all 3
shots) this year
- Recent STD/STI screenings negative
- Small, soft bump under glans; 3 dermatologists confirmed not a genital wart
- Shrinks during erection, moves easily, no pain/itch, size unchanged during time
Questions:
- What's my risk of transmitting
HPV to my wife?
- Is unprotected oral sex safe,
given the benign bump?
- Should I remove the bump for
peace of mind?
- Any additional precautions to
minimize HPV transmission risk?
Thank you
for your expertise.
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Edward W. Hook M.D.
12 months ago
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Welcome to our forum. Thank you for your questions. I’ll be glad to comment. it would be helpful to know when you received your HPV vaccine. Irrespective, the fact that your fiancé has received the vaccine provides virtually complete protection against the vaccine strains of HPV, making the likelihood of your transmission of infection to very, very low. In reply to your specific questions
1. See my comments above. The HPV vaccine is highly effective protection against the most common types of HPV. Your partner should be well protected.
2. You have been told by three highly trained clinicians that the bump you are concerned about is not HPV. Consequently, I would have no concerns about the possibility that the bump is due to HPV or transmitting it.
3. Removing of the bump as a personal decision. Did the dermatologist tell you what it might be? There are many benign conditions which caused bumps on the penis. Personally, I see no need to remove it.
4. I congratulate you on doing the thing that is most important for prevention of transmission of HPV, getting both you and your partner vaccinated. Nothing you have said in your post suggest that you have HPV. . Consequently I would have no concerns about transmitting HPV going forward. Perhaps I’m missing something if so, please let me know in a follow-up note.
I hope the information I have provided has been helpful. I think you are far more about HPV than you need to. EWH.
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12 months ago
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Dr. Hook,
Thank you for your initial response. I'd like to provide some additional information and follow up:
I received the Gardasil vaccine in 2024, with the first shot in January, the second in March, and the last shot in July. Same for my partner. I'm aware that Gardasil 9 is not a therapeutic vaccine, but I took it as an extra measure even though I was already sexually active.
Regarding the bump, the dermatologists diagnosed it as a skin tag. As I've described before, it has never changed in size, it's not particularly hard to the touch, but it has been present for more than a year now. While three dermatologists never suggested removing it, I understand that Gardasil protects against low-risk HPV types 6 and 11, but I'm worried about the possibility - if the bump is indeed a wart - of transmitting oral HPV to my partner (which I don't think the vaccine protects against).
Could you please address these additional points and concerns?
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Edward W. Hook M.D.
12 months ago
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Thank you for the additional information. Given that you have been sexually active for about six years prior to receiving the HPV vaccine it is almost certain that you have acquired HPV of some sort in the past. The vaccine will prevent future infection with the HPV types included in the vaccine and, in theory, it may reduce the likelihood of recurrence from any HPV infection you may already have. MST importantly however, your fiancé is highly protected.
I not aware of any reason for the vaccine to not protect against oral HPV.
---Skin tags are normal and readily distinguishable from warts. I’m not sure why you doubt 3 trained clinicians. They are easily removed if that is your wish but nothing you mention suggests any medical or scientific reason to remove it. EWH
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12 months ago
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Dear Dr. Hook,
Thank you for your detailed and reassuring response. I greatly appreciate your taking the time to address my concerns.
As someone who struggles with health anxiety, I've been particularly worried about potentially transmitting something harmful to my wife. Your explanation about the HPV vaccine's protection, especially for my fiancée, is very comforting.
I understand from research that vaccination significantly reduces the risk of oral HPV transmission. I'd be grateful for your expert opinion (a scientific explanation) on this matter, as it would help alleviate my concerns further.
Regarding the skin tag, I apologize if I seemed to doubt the dermatologists' assessments. My anxiety sometimes leads me to seek excessive reassurance. Your confirmation that skin tags are normal and easily distinguishable from warts is helpful.
Lastly, based on my recent negative STI and STD results, am I correct in assuming that my wife and I can engage in safe sexual activities?
Thank you again for your patience and expertise. Your reassurance means a great deal to me as I prepare for this important step in my life.
Sincerely,
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Edward W. Hook M.D.
12 months ago
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The HPV vaccine produces very high levels of antibodies to the HPV types found in the vaccine. FYI, it is not a live virus vaccine but constructed only of non-viable virus proteins so it cannot cause infection itself. It is safe and effective
Yes, you can certainly engage in unprotected sex with your wife.
As you know, we provide up to three responses to each client's response. This is the 3rd response so the thread will now be closed. Take care. Please don't worry. EWH
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