[Question #419] Hpv from receiving oral sex

94 months ago
Hello dr
i have some small warts in my penis which make me crazy so i appreciate ur help 
1-My concen is what is the risk of me contracting genital hpv from receiving unprotected oral ?
2- if it possible . Is this mean my wife is on a risk of getting cervical cancer ?
H. Hunter Handsfield, MD
94 months ago
Welcome to the forum. Thanks for your question.

Sorry to hear about your genital warts. The first thing is to see a doctor to make sure the diagnosis is correct. Other skin conditions or even normal skin can cause bumps that can appear like warts to medically untrained persons.

Assuming the diagnosis is correct, and answering your second question first: As you already know, warts are caused by HPV. There are over 100 types of HPV that infect the genital area. Almost 90% of genital warts are caused by only two of these types, HPV types 6 and 11. These types do not cause cancer, so your warts carry no risk of cancer for your wife. However, many people with genital warts also are infected with other HPV types at the same time, so it is possible you also are infected with HPV that could risk cancer in your wife. However, even the cancer-causing types don't usually cause cancer. All women should have regular pap smears, although this is more difficult in some countries than others. (I don't know where you live.) If your wife does that, it will protect her from cancer, because paps are designed to detect pre-cancer changes many years before they actually become cancer, and can easily be treated. If paps are not easily available in your country, your wife still should speak with her doctor about cervical cancer prevention.

As for your first question, almost certainly you did not catch your warts from oral sex. It is much more likely you caught HPV from genital intercourse. Oral HPV is less common than genital, and even when present, is not frequently transmitted by oral sex.

Finally, both you and your wife should speak with your doctor(s) about getting the HPV vaccine, which will prevent future infection with 9 types of HPV, preventing over 90% of cervical cancers.

So to summarize: confirm the diagnosis; if warts, your wife should be on the lookout for warts herself; whether or not you have warts, your wife needs regular pap smears if available; don't worry about oral sex; and consider vaccination against HPV.

Finally, excellent information about HPV and warts is available on line. Start with ASHA (www.ashasexualhealth.org) and CDC (www.cdc.gov/std).

I hope this has helped. Best wishes--  HHH, MD
94 months ago
Thank you dr for your reply 
I have 3 more questions and i appreciate your help
1- is any wart in the genital area means that it is transmitted sexually? 
2-i have only 1 small wart noticed it before around 6 months , will it possible if it is hpv to get more warts in future?
3- is it necessary to remove this wart in order to decrease my chance of getting more warts?
H. Hunter Handsfield, MD
94 months ago
Gential warts usually do not occur singly. If there is only one, my guess that it isn't a wart at all. The first advice in my initial reply was to make sure the diagnosis is correct. Self diagnosis by medically untrained persons often is wrong; there are many kinds of non-wart skin bumps. Please answer the question I asked:  Have you seen a doctor who confirmed the diagnosis? Also, tell me exactly where it is: penis? If so, where on the penis? Scrotum? Groin? Pubic area? 

1) The large majority of warts "in the gental area" are sexually acquired, especially of the penis. If "genital area" means groin, upper thighs, or lower abdomen, some probably are not sexually acquired.

2,3) As I said, maybe this isn't a wart. If it is, it should be treated or removed to reduce the chance of getting more of them.

94 months ago
Its in the hair growing area in the begging of the shaft skin. i ve seen a doctor ,and  he didnt confirm it , he just gave me possibility of hpv . 
I ve talk  with my wife and she told me that she got hpv vaccine before 4 years, she was 29 old , from what i read online that vaccine is recommended for age 13 to 26, 
does this mean there is no benefit from her vaccine ?
H. Hunter Handsfield, MD
94 months ago
"Possibility of HPV" doesn't make the diagnosis. In addition, the location is wrong. Initial genital warts occur at the sites of maximum friction during sex, because the virus has to be massaged into the tissues or infection usually doesn't take hold. And I'm willing to bet that the oral exposure you are concerned about didn't come into close or repeated contact with the hair-covered area you describe. Also, intial wart infections almost always cause multiple warts, not just one. And as already discussed, oral sex rarely transmits genital warts or HPV.

And by the way, when was that oral event? It takes at least 2 months for new warts to appear, usually 6-12 months. A more recent exposure could not have caused this wart.

Accordingly, I am now even more convinced you do not have genital warts. If you do, it is from some distant past exposure.

The vaccine is highly effective at age 29. The recommended age cut-off of 26 years is because new HPV infections are uncommon over age 26. But the vaccine works just fine, against the 4 HPV types that it covers.

If the penile bump continues to concern you, return to your doctor or get a second opinion, ideally from a dermatologist. Until then, you can go forward with confidence that it probably is not a wart.

That completes the two follow-up questions and comments included routinely, and so ends this thread. Do your best to stop worrying about all this!

Best wishes--  HHH, MD