[Question #4744] What to tell my new partner about my condyloma

26 months ago
Dear Experts

Thank you for being there to help. I just completed my second cryotherapy session on genital warts diagnosed 10 days ago. Today the MD said "they are tiny at this time" and my next cryotherapy appointment is in 7 days.

My dating partner and I want to have sex soon (we haven't yet). I have not told him about my condyloma. He has most likely had the HPV vaccine (he's 21 years old). I have started the Gardisil9 series, awaiting my second injection (I am older and just learned I am eligible to receive Gardisil9 this year). 

When I talk to him, how can I convey his level of risk of acquiring HPV from me and getting genital warts from me? After reading your responses to other questions, it seems like there is no numeric answer for this, but that the risk is lower once the warts are gone from my skin. I want to provide my partner with as accurate a level of risk as possible.

So far I thought of telling him I have a history of condyloma on my skin, which has been treated. I was going to ask him if he's had the HPV vaccine. I was going to say that since he's (likely) been vaccinated, once my condyloma are gone, and if we use condoms, his chances of acquiring my strain of low risk HPV are less than 10% and that even if he acquires it, he may never present with condyloma. I was also going to suggest we both stop shaving our genital areas to reduce risk of transmission?

What do you advise I tell my partner? How can I frame this to him?
Edward W. Hook M.D.
Edward W. Hook M.D.
26 months ago
Welcome to our Forum.  I'll be glad to comment.   Let me start by providing a bit of background on our perspective on HPV infections.  Let me start by congratulating you on getting the vaccine.  If your partner has been vaccinated against HPV then he can be confident that he will not get infected with the HPV that you are being treated for since that vaccine protects against the two HPV types that cause nearly all genital warts.  If he has not had the vaccine but that risk is small and if he has had sexually active prior to your current relationship, it is more likely than not that he already has HPV, whether he knows it or not.  

Virtually all sexually active Americans acquire HPV at some time in their lives (even those who are monogamous!)  and from a medical perspective for all but a fraction (a small fraction of 1%) of those who infected the disease is nothing more than a nuisance- sometimes cosmetically  as genital warts, sometimes otherwise.  As noted above, virtually all sexually active persons get this chronic viral infection so, unless you are feeling guilty because you have had sex with more than a single partner in your life, for practical purposes, this is just part of being a sexually active person.  

There are no data on just how likely he is to acquire genital warts from having sex with you but given that you are being treated, the risk is low.

On the matter of telling him, that is a personal decision.  In general we do not feel that it is critical to tell partners of the presence of an HPV infection as the infection is so very common and because of the potential for misunderstanding.  Your situation may be a bit different.  I hope that the information I've provided will be helpful.  EWH


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25 months ago

Dear Experts 


Thank you for your input and perspective. My 3rd cryotherapy visit was 1/3/19. It was a different physician. He said “I can’t see anything” but stated he would apply liquid nitrogen. I came away with 7 oblong burns in locations where the condyloma had been but had already been clear tissue. 


I’m unclear what happened. The physician’s notes after the visit stated “pt desired tx”. I am still processing this event, but seems (and feels!) like liquid nitrogen was applied to cleared, healthy skin. The burns are deep red and would be obvious against my pale skin during sex. 


In addition to processing this terrible experience, I am faced with the difficult issue all over again- what to tell future partners about the burns in that area. From your advice, seems once treated I am not obligated to disclose lowrisk hpv. But now the burns may cause curiosity in future partners - they may ask what happened. Or is it inappropriate for them to ask? Do I owe an explanation? If I do, I thought of saying a skin condition was treated there in the past but I’m ok. Not sure what is ethical or advisable? Wouldn’t have even come up if the md didn’t burn me, and burns take a while to fade if ever. 

Edward W. Hook M.D.
Edward W. Hook M.D.
25 months ago
Ouch, sorry to hear this.  Most typically however, the redness and burns which result from liquid nitrogen therapy heal without scarring.  If this does not occur, then I would suggest that the best course of action would be to be matter of fact without too much detail.  Those are scars from an overzealous doctor who thought he was treating genital warts.  Any discussion of HPV that might ensue would acknowledge that many unvaccinated people have HPV but do not know it, might lead to asking your partner if they were vaccinated and if not, why not, and might point out that you have had the vaccine.  

As I said above however, my guess is that he redness and irritation you have experienced will heal completely.  EWH 
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25 months ago
Dear Experts 

You were right, the burns resolved after about 2 weeks and my skin is totally free of EGWs and burns now. It is a huge relief and I really appreciate your help. 

Do recurring EGWs generally present in the same location? Or do they come back anywhere? The condyloma I had were on regular skin, not mucosa like the vulva. I am really hoping I don’t have a recurrence on the mucosa because cryotherapy there sounds painful! 

What is likelihood of recurrence? Does likelihood decrease with time? Is there an average number of recurrences that happen? Can EGWs present at any later time in my life?

Thanks again Experts!!! Sad this is my last entry :( but I have really benefited from your help and hope others do too :))
Edward W. Hook M.D.
Edward W. Hook M.D.
25 months ago
Yes, if your treatment failed, a wart would be expected to recur on about the same location as the original lesion.  Typically this occurs within 3 months of treatment.  If the wart does not recur by then, it almost certainly will not.  

Thanks as well for your thanks.  I'm pleased the information I provided was helpful and hope it will be helpful to others as well.  As you point out, as this is my 3rd response to your questions, this thread will be closed shortly.  take care.  EWH
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