[Question #4143] follow up

32 months ago
Once again thank you doctor for everything. I  was traveling for work and could not follow up on my last post. I do have one issue and want to discuss. The rash looked like it cleared up. There is a slight blemish but almost gone. My issue is this. My partner has been told that she may have fibromyaglia. She has some bumps in her vagina and the doctor wants to make sure they are not cancer.  Is this an STD like HPV? We been together for 5 years and I have never had intercourse with anyone else just the condom oral thing.  She had a lesion that bleed also recently. Maybe an inveown hair. Please advise. Thank you. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
32 months ago
Welcome back to the forum, but sorry you find it necessary. As it happens, I'll be answering this time, but I have reviewed your other discussions with Dr. Hook.

As you were told in all three of your previous threads, it is not possible to catch STDs through intact condoms. Once in a while, infection occurs because of contact with an area of skin not covered by the condom, but it is rare. In addition, your description of your previous rash, and its clearance without syphilis treatment, further prove syphilis was not the cause. Dr. Hook gave you other reasons as well not to worry about syphilis.

As for your partner's symptoms, fibromyalgia is not sexually acquired and there are no STDs likely to mimic its symptoms. So that part can be dismissed.

Genital warts are the most common cause of painless "bumps" in the vaginal area of women (and on the genitals and anal area in general); and any cautious doctor will closely examine any genital bumps to be sure they are not cancerous. The large majority of all people (over 90%) get one or more genital HPV infections; HPV is pretty much unavoidable. Skin contact above condoms commonly transmits HPV -- condoms moderately reduce the chance of transmission but do not prevent all cases. Genital warts are due to particular types of HPV; genital cancers are caused by different types. However, warts generally generally do not appear until a few months, sometimes years after catching HPV. Genital skin cancers due to HPV take even longer to make their appearance. Therefore, this problem almost certainly is unrelated to the sexual exposures you described in your previous three threads. Also, HPV is uncommonly transmitted by oral sex. If indeed your partner has genital warts, she may have had the underlying HPV infection for many years, either from a past partner or even from you. (That you haven't had HPV symptoms doesn't mean anything. Most HPV is entirely asymptomatic.)

Warts don't bleed. Whatever lesion bled is not a wart or skin cancer. An ingrown hair is a good bet, or just a standard pimple.

At this point, speculation doesn't help. Your partner needs to follow up with her doctor. Once the diagnosis is clear, feel free to return and I might have additional advice. Until then, I can't say anything more than I have. However, even now I can tell you that if you're not seeing any warts or wart-like bumps of your penis or genital area, you are not at risk of anything serious. (While you wait for confirmation of her diagnosis and her doctor's recommended treatment, you might want to read up on HPV. Two excellent sources are CDC (www.cdc.gov/std) and the American Sexual Health Association (ASHA, the sponsor of this forum:  http://www.ashasexualhealth.org/stdsstis/hpv/). (If you explore the website, you can even find two videos about HPV that I recorded a few years ago.)

In the meantime, I hope this information is helpful.

HHH, MD
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32 months ago
Thank you Dr. H.  Just some follow up.  I hear you about the rash. Time to move on with it. Last question on it. Do you think I should have an HIV test from last exposure? I am assuming your answer will be no.

I have been doing some research on HPV since last night. It is pretty common. Some follow up questions.

I do not see any warts on me. You stated that if I don't see any, I would not be at risk for anything serious. What did you mean by that?

The reason my partner is being checked according to the gyno doctor is for fibro. He never mentioned warts. Would he not see it durning the annual check up and state this concern? He made no mention of this. I brought up HPV to you. This doctor has 20 plus years of experience.

Do women get tested for HPV when they are pregnant? Can you have it before being pregnant and show up years later even after being pregnant?

I do not know anything about fibro. They say it is painful durning intercourse for some women. Why? Would a doctor examine a women for cancer if she had fibro? He said it is somewhat common.  I know this may not be your area of expertise but any help would be appreciated.


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
32 months ago
Thanks for doing some research on HPV.

Most health problems caused by HPV in men would cause a skin abnormality of the penis (wart, pre-cancer, cancer) that would be easily visible. If nothing is there, you have no serious HPV problem.

I'm confused -- you said your partner has vaginal area bumps that her doctor wants to check for cancer. I assumed that meant it was her doctor's advice. Maybe her bumps aren't anything important and not warts. I have no way of knowing. I brought up HPV because genital warts are among the most common kinds of genital "bumps".

HPV testing is not usually routine in pregnant women, but if your partner has had pap smears over the years, she has been checked for HPV.

You're right:  I have no expertise in fibromyalgia. I have not heard of it causing painful intercourse or increasing the risk of any kind of cancer.

You have one more follow-up comment and reply remaining in this thread. Let's have no more discussion now; I'll be happy to comment further after your wife has seen her doctor, if she turns out to have any sort of problem related to HPV or other STDs.

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32 months ago
Ok doc. I almost did not return but I wanted to finish this and to provide info to the reader if he or she is in this situation.  My partner appears to have fibroids. This is not an STD. We will work together to deal with any issues on this.  This experience has taken a toll on me and want to move on. With this being said.

1. In relation to std can I move on?
2. I had an hiv test done in April I belive and it came back neg. I only had this one other protected oral exposure when she put the condom on with her mouth. Do I need hiv testing again or can I move on without it? I am going to assume I do not need testing.

3. I understand about HPV and you never had a case where someone got warts from oral alone. Is this correct?

4. I understand that we cleared my rash situation. I have moved on with this.

5. I have hsv 1 and so does my partner so I am not worried about this. 

6. It has been over 2 months from my last exposure without discharge or burning. Can I move on without worrying about the bacterial stds?

7. I think I covered every thing. I guess I want to know if I can move on without any additional testing at this point? Would you move on if you were in my shoes?

I want to take the time to thank you all. I don't know what we would do without your help. Please understand that you all have helped so many people.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
32 months ago
Correct, uterine fibroids have nothing to do with HPV or any other STD. You apparently misunderstood your partner's description of her problem.

1,2) Already answered. Move on, no further testing.

3) Penile warts probably are sometimes acquired from oral sex. It's rare, and I have never personally seen a case in which this seems to have happened.

4,5) I'm glad you understand.

6,7) Yes, move on. I would do so if somehow I were in your situation.

Thanks for the thanks about our services. However, please note the policy about repeated anxiety driven posts. This will have to be your last one about this exposure and these symptoms etc. Best wishes and stay safe.
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