[Question #9288] HPV Concern
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34 months ago
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Hello and sorry to be back but I have a new area of concern I suppose you could say.
Background Info: I’m currently 24. I had my first sexual encounter a month before turning 20. I’ve had 4 sexual partners (all straight men) and I haven’t had sex in 3 years. I was vaccinated at age 12 with the first version of the HPV vaccine with 3 shots. I don’t smoke, drink, I workout, but I do occasionally experience stress because of my anxiety.
I’ve had one occasion where I may have had genital warts although I’m not sure that’s what they were. It was in 2020 a few months after my last sexual encounter. They appeared on the border of my upper thigh and lower butt cheek and they were 2 skin tag looking blemishes. I haven’t had any similar looking pop up since then but I did get a pimple like bump on my outer lip a few months ago.
My concern now is that I’m 24 and after 3 years of no sex having my first Pap smear next week. I know it’s recommended at 21 and I’m late, but due to covid and general anxiety I couldn’t make it.
What do you think the chances of me having an HPV strain show up on the test is? I’m most concerned about cervical cancer as I’ve been experiencing some lower abdominal pain, but because I’ve recently started pursuing a new relationship honestly any strain causes me worry.
So with all information available, how likely is it I’ll test positive for an HPV strain?
Thank you.
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Edward W. Hook M.D.
34 months ago
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Welcome back to the Forum. I'll do my best to provide some information and advice but the most important advice I can provide is to not worry. HPV is widespread and you have do ne the single most important thing a sexually active person can do to avoid HPV by getting vaccinated and, more importantly, to prevent complications of HPV (which are rare). Further, I have to say, your anticipatory, "what if" questions are of little benefit to you. I'll make some comments but the best advice I can provide is for you to wait until you have had your examination and tests and, then if HPV is found, we can discuss things.
The likelihood that HPV will be found on your tests is low- the vaccine is more than 97% protective against the most common HPV types and in women who do happen to get infected, well over 90% of them clear their infection within 2-3 years of infection. In the unlikely event that HPV is detected, progression to cancer occurs only in a majority of persons and when it does, the progression allows highly effective treatment
Bottom line, it is unlikely you will test positive and, in the unlikely event that you do, there is highly effective treatment, should it be needed. This is not something to be worried about at this time. EWH
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34 months ago
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Thank you doctor I do want to clarify again though, I had the first version of the vaccine. I wasn’t even aware there’s now a second that prevents against more strains until this week. Does having Gardasil 4 vs Gardasil 9 change your opinion in my likelyhood of testing positive?
Also in your reply you said
“In the unlikely event that HPV is detected, progression to cancer occurs only in a majority of persons and when it does, the progression allows highly effective treatment”
Did you mean only in a *minority of persons?
And I’m trying my best to remain calm but my concern is my new potential relationship. I wouldn’t know how to disclose that sort of information or if I’d even want to continue pursuing a relationship in that scenario out of fear of infecting him.
However I understand that neither of us can know until I get my results so I will hold off my final reply for them. I just wanted to clarify the two points I mentioned!
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Edward W. Hook M.D.
34 months ago
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I'm quite aware that you received the initial version of the vaccine. This in no way changes my assessment of advice. Given your high degree of anxiety you may want to discuss a single dose of the newer vaccine to address your anxiety.
I apologize for the typo. My response should have read, "“In the unlikely event that HPV is detected, progression to cancer occurs only in a minority of persons and when it does, the progression allows highly effective treatment"
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34 months ago
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Sorry for being back before results but I have some questions and the internet seems to be indecisive in terms of answers
These questions are specifically in regards to cervical cancer rather than HPV
I had both a pelvic ultrasound and pelvic exam (no pap) done within the last month. The ultrasound picked up a cyst on my left ovary but nothing else and nothing out of the ordinary for my pelvic exam. Would either of these be reassuring in terms of not having cervical cancer? Also considering it’s only been 4 years since I’ve started being sexually active would that be enough time for irregular cells to convert to cancer?
Thank you and hopefully everything is fine.
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34 months ago
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I do also have some stabbing pain in my vagina that comes and goes. Usually just once or twice every few days. Not sure if that’s a bad sign.
And just to repeat my last reply
These questions are specifically in regards to cervical cancer rather than HPV
I had both a pelvic ultrasound and pelvic exam (no pap) done within the last month. The ultrasound picked up a cyst on my left ovary but nothing else and nothing out of the ordinary for my pelvic exam. Would either of these be reassuring in terms of not having cervical cancer? Also considering it’s only been 4 years since I’ve started being sexually active would that be enough time for irregular cells to convert to cancer?
Thank you and hopefully everything is fine.
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Edward W. Hook M.D.
34 months ago
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We provide up to three responses to each client's questions. This is my 3rd and therefore final reply.
The internet is not your friend and to expect clear answers from the internet is a mistake. Much of what is there is incorrect, either because it is out of date, taken out of context, or just plain wrong. Please stay off the internet and work with a trusted clinician to sort out your issues.
Your test results are indeed reassuring. The development of cancer is a slow process, taking years to occur and which is reliably detected early, at a time is readily available long before the process proceeds to cancer.
Vaginal pain is NOT a sign of cancer or, for that matter, a typical sign of any STI.
Please don't over react to your risk for any STI including HPV. If you are not vaccinated for HPV, please do so- it is highly effective and safe. Other than that, please do your best not to worry. EWH
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