[Question #2141] HPV GW questions help plz

93 months ago

Hello, I am a 31 yr old male. Please allow me to describe the sequence of facts and events and then I'll ask few questions. I've only had a few partners in my life with no issues in the std department whatsoever, until now with my current gf of 1.5 yrs.

Fact #1: In January I develop GW. I can barely type the words, can never say them. We had plenty of unprotected sex all the time and it was perfect, until now.

Fact #2: Her pap smears had been showing "abnormal cells" from before we ever met. When I told this to my dermatologist, he said "you should be careful who you have sex with buddy, you never know anyone's past". The next visit, unprovoked, he said, "Are you still with her, the same girl with hpv who gave you gw?". I love her so much it was not pleasant to hear a doctor say this stuff. ANYWAY, i had to always fight off negative thoughts about her, about myself about it all and i had been going around in my mind wondering how the hell could this happen to me? Who gave me this? why me? and just devastating feeling of helplessness as there is no cure and all information online is vague or contradictory. Yes the warts go away, no they dont, they last 3 months, they last years, could get hpv and not show symptoms for years, then some articles say shows up in max 6 months. The lack of accurate info is frustrating and depressing even.

3) For months I'm getting cryo treatments (Haven’t tried Aldara) (4 freezing now but still recurring symptoms) and i had assumed her abnormal pap tests directly meant she had hpv then, her clinic, finally suggests doing hpv test claiming it was not necessarily HPV. TEST COMES BACK NEGATIVE.

QUESTIONS: So now what? she did not give me hpv? and i did not give it to her? YET? Whats going on here? Did she have it without symptoms, pass it to me with symptoms and then beat it out of her own system? Should she get the vaccine now? She’s 26. No more oral sex ever? PLEASE ANSWER ALL QUESTIONS WOULD BE GREAT. DESPERATE FOR ANSWERS.

H. Hunter Handsfield, MD

93 months ago

Welcome fo the forum. Thanks for your question.

First some blunt talk -- but bear with me. An online forum cannot be the only answer to dealing with the emotional aspects of your question. Probably you are going to need professional counseling. Your use of terms like "just devastating", "feeling of helplessness", "why me" etc are existential cries for help and indicate pretty deep anxities and depression. Not even being able to type or say the words all by itself indicates an abnormally severe emotional reaction to all this. Having said this, I have to wonder if you're in a particularly bad spot as you write all this. Perhaps, and I hope, you're not quite this down about it all the time. This really isn't the end of the world, or of your sexual health and satisfaction.

Your doctor didn't help any of this. Assuming your description of his comments and his treatments is accurate, it is obvious he does not understand HPV and its transmission, and is out to lunch in the sensitivity department. Everybody gets genital HPV at one time or another, most of us several times, and it is not a sign of promiscuity or sexual irresponsibility. People with HPV are no more sexually active, i.e. have no larger number of lifetime sex partners or more frequent changes of partners than anyone else. Your doc's comment "Are you still with her?" is horrible and wrong. The assumption that you caught your warts from this particular partner also may not be warranted. Given the timing of your relationship and onset of warts, it is likely, but not necessarily; and in any case, there is no blame here.

A few more facts that may help you mellow out: Not only does almost everyone (90% at least) get genital HPV, but the best estimate is that up to 25% of all Americans are diagnosed with genital warts. So you're not exactly alone in this! As for "why me?", it's just random bad luck. You're not a bad person for it and neither is your girlfriend. And it doesn't mean your immune system or other health aspects are abnormal. The inconsistency of information online and elsewhere can be frustrating; it reflects both uncertainties (because warts are not especially serious, there really isn't that much research on them) but also the fact that anyone can post anything on the web, and some sources are simply irresponsible or lack basic knowledge. I strongly recommend you spend time on two website, and only these two until you have absorbed pretty much everything they offer: the American Sexual Health Association (ASHA), sponsor of this forum (www.ashasexualhealth.org) and the Centers for Disease Control and Prevention (www.cdc.gov/std). Both has extensive, accurate information on HPV and warts. (On the ASHA site, you can even find two videos that I have personally recorded about HPV, which you might find reassuring.) Once you have read all you can find on those sites, then feel free to look for others -- but even then, best to limit to medically responsible sites, like health departments, academic centers, and so on. The very worst sources for information about STDs in general or HIV/warts in particular are those run by and for people with the problem themselves. Such sites tend to attract those with atypical cases, poor understanding, and often wacky information that serves mostly their own psychological needs.

Warts need not last more than a few weeks. Any single treatment method, including cryotherapy, works about 70-80% of the time. If one method isn't working after 2-3 treatments, it's time to switch. And combination treatment, such as cryotherapy plus podophyllin or podofilox (Condylox) or imiquimod (Aldara) often works well. If these all fail, they can easily be removed at once with minor surgery or cautery. Given the depth of your reaction to them, I would recommend you explore surgery or cautery in particular: just get them gone. That said, you probably should find a different doctor. If you have a PCP, ask for referral to a different dermatologist.

Your partner's abnormal pap definitely was due to HPV. This is virtually the ONLY caus of abnormal cells on pap smear, even if the test for HPV has become negative in the course of her treatment. FYI, different strains of HPV usually cause warts versus abnormal paps. Your partner could have more than one type, or your warts might be a recurrence from a distant past infection from someone else. You'll never know for sure, but it shouldn't matter. As I said, there is no blame game (or should not be) in catching or transmitting HPV or warts. How can you blame someone when everybody has it?

That will have to do it for now. Let me know if anything isn't clear. I hope this gets you started down a path to acceptance and understanding. But please do seriously consider my advice about counseling.

HHH, MD

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93 months ago

Thank you for the quick reply Dr.

And yes i do realize my reaction is exaggerated, It is hard to control my negative thoughts on the matter and I already had a booked appointment for therapy so im on it although your direct message maybe all i needed to hear.

I do have some further questions though, thank you in advance for taking the time to answer them.

1) You say the abnormal pap smears are definitely due to HPV but the clinic people say it was just inflammation but test was negative for hpv? Can i assume they are just incompetent?

2)Having had a lot of unprotected sex with my visible warts present, should we assume my partner had virus in the past at least? or is it possible that she was just lucky thus far and didn't contract it from me yet?

3) Now should she take the vaccine? should i?

4) When you say aldara and cryo in combination, are you suggesting i apply the aldara onto the scabbed/frozen wart? or how do you mean in combination?

5)At first it was 2 considerably large warts on the base of the shaft + a cluster on the left side of shaft base right at the edge of the scrotum. The first treatment was very effective on the 2 large warts but 4-6 tiny warts appeared on the shaft in other areas about 2 weeks later. Should it be aldara for small ones and cryo for big ones or cryo for all?

6) Finally, we slowed down on sex since the warts appeared, but i continue to masturbate, should i stop? could it be i caused the smaller ones from sex/masturbation?

Thank you Dr.

H. Hunter Handsfield, MD

93 months ago

1) Perhaps I shouldn't have made assumptions, and I see no evidence the clinic folks are incompetent in any way. The vast majority of "abnormal cells" found by pap smear are of the sort caused by HPV. If you have said "inflammation" at the start I would have said her abnormal pap has nothing to do with your warts or HPV. Finding inflmmatory changes on pap is so common it can be considered a variation of normal. To leave no stones unturned, such women should be tested for common STDs (gonorrhea, chlamydia), yeast infection, and other possible causes. But HPV generally is not an issue.

2,6) Having had regular sex for over a year, any HPV in either of you has already infected the other; you can assume your partner is infected to the HPV causing your warts, or perhaps immune due to prior exposure. In any case, there is absolutely no reason for you to have reduced your sexual frequency or to make any changes in the future. You're not preventing anything in either one of you.

3) For the same reasons there is no point in either of you being vaccinated at this point; and you are beyond the recommended top age limit of 26. If your partner is under 26, she could consider immunization -- but not on account of your warts. Only to protect her from other HPV infections you don't, which would come up only if or when she has other sex partners.

4) I'm not giving you specific advice to use such treatment, and will not instruct how to do that. This forum is for general advice; we do not provide direct health care or prescribe or recommend particular treatments. This is just an option you could discuss with your doctor(s).

5) It is possible that there is no longer any wart tissue remaining, just normal or reactive skin that doesn't need and will not respond to wart treatment. This is another reason to consider seeing a new dermatologist.

I'm glad to hear potential counseling is already in the works. I would encourage you to go ahead with it. Even if this discussion helps ease your concerns, I suspect the underlying emotional issues will remain pretty important.

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