[Question #4103] Genital Wart - 10 Years On

32 months ago
Hello,

I've recently started becoming sexually active with my new girlfriend.

10 years ago I had one genital wart removed from my penis and have had no recurrence.

I was going to tell my girlfriend about this, so she has the knowledge about it before we engaged in intercourse.

She has performed oral sex with me twice.

I am quite concerned that I've put her at risk for HPV.

Should I be concerned?

I'm assuming that we will always need to use a condom should we engage in intercourse.

Much appreciated,




H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
32 months ago
Welcome to the forum. Thanks for your question.

Congratulations for common sense and responsibility reflected in your question. There are two reasons to consider informing new partners of past STDs. First, potentially to prevent transmission and/or allow the partner to make an informed choice about risks. And second, for relationship reasons:  many (but by no means all) couples discuss their past sexual and STD histories as aa mark of respect, trust and commitment. For HPV 10 years earlier, the second reason is the important one. There is no good reason to do it for health reasons.

Your partner is at no elevated risk of HPV because of your past history than if you had never met. Assuming she has been sexually active over the years, it is likely she has already been exposed and perhaps infected with HPV, perhaps several times. One more sex partner won't make that risk any higher, even with a partner with known past HPV. Why not? Because ALL her potential sex partners have had HIV, since everybody gets it. The only difference for you is that you were diagnosed, whereas most infections never come to light. Second, with no recurrence of warts after 10 years, it is very unlikely you still have an active, transmissible infection with the HPV strain that caused the wart.

Genital HPV, with or without warts, is not a good reason to avoid oral sex. Even with an active genital infection, transmission to a partner's oral cavity often doesn't occur. When it does, most infections cause no symptoms, don't lead to warts or cancer, and are cleared by the immune system. Maybe you have read about HPV and throat cancer, but it remains a rare cancer (which the media often don't explain carefully enough); and oral HPV often results in people who never perform oral sex, perhaps because they unknowingly transfer their own genital HPV infection to the oral cavity. On top of all that, the wart causing HPV types so not cause cancer.

Finally, I disagree that you will "always need to use a condom" for intercourse. 90% of all people have had genital HPV, and at any point in time 25-60% have active genital HPV infections. Following your logic, at least half and perhaps 90% of all couples would have to be using condoms all the time. Obviously that's nonsense and nobody does it or would consider it.

Final thought concerns HPV vaccination. If you and your partner have not been immunized, you should consider it if under 26 years old. Beyond that, no need and little point.

Bottom line;  Your past genital wart problem should have absolutely no influence on your sexual plans or choices with your new partner, and certainly not on decisions whether to commit to one another for the long term -- whether or not you decide to discuss your past history with her.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD


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32 months ago
Thank you so much Dr. Handsfield!

I cannot tell you how this has put my mind at ease.

I am 53.

I will be telling her this evening for the second reason as she is a treasure and I am hoping to establish trust with her from the beginning.

Many thanks and grateful for this service!

Take care,
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
32 months ago
Thanks for the additional information, and for your thanks about our service.

So you were ~43 when the warts were diagnosed? Was there any doubt about the diagnosis? Managed by a dermatologist or other professional with lots of experience with warts and HPV?
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