[Question #9944] Disclosure of Possible Genital Wart Infection to New Partner
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27 months ago
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I noticed a bump on the shaft of my penis about 4 weeks ago. I work in remote areas and could not immediately see a doctor. I was afraid it could be a genital wart. I have OCD and this caused me quite a bit of anxiety. I resorted to using online doctors and sending photos of the bump in the hopes of alleviating the anxiety. I asked multiple doctors. Some said that it looked like a genital wart, while others said it didn’t, so this obviously didn’t help. 2 weeks ago, I was able to get back home and went to an STD clinic. The sexual health nurse who examined me said that it didn’t look like a genital wart and said that I didn’t need to disclose it to future sexual partners. The next day I had a 1 night stand with a new partner. A condom was used during intercourse but she did perform oral sex on me. A few days ago I was overcome with extreme guilt about not telling this person about the bump. I feel I acted unethically as I don’t know for certain what the bump is.
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Edward W. Hook M.D.
27 months ago
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Welcome to our forum. Thanks for your questions. I’ll be glad to comment. The topic of whether or not to disclose the presence of a genital wart or human papillomavirus infection is a common one. I will make some comments and share our perspectives on this with you below, however I would strongly encourage you to look at previous Questions which remain posted on the forum. We have intentionally left those questions in our responses on the forum and available to all for purposes of education and learning.
Let’s start with the whether or not the bump you noticed was a genital, wart or not. There are many many different, benign, non-infectious varieties of skin lesions, which can occur in the genital regions. You have been examined by an experienced clinician, whose opinion is worth more to you than any number of online consultations and examination of photographs. She stated that the lesion did not appear to be a genital wart. I would believe that, and that being the case there is no reason for disclosure.
But, what if it was a wart? Even then, our stance on this forum is that there is no reason for disclosure. Human papillomavirus infections, including genital, warts, are so common that, unless someone has been vaccinated to prevent them, virtually every sexually active person will have had HPV at some time in the past. (Estimates are that amongst sexually active adults, nearly 80% of persons are or have been infected. (Not all HPV infections cause visible, genital warts). This being the case, and given the widespread misunderstanding of how common HPV is, disclosure is not necessary. If you review other our responses to other questions on this forum, you will see this perspective stated numerous times using somewhat different words.
I hope this perspective is useful to you. Guilt is not an appropriate response to your situation. Single exposures to infected partners typically do not lead to transmission of infection, transmission through oral sex, is less common than through general sex, and you used a condom, reducing the possibility that even if a wart/HPV infection happened to be present, the likelihood of transmission would be dramatically reduced. I hope this perspective is helpful to you. EWH.
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27 months ago
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Thank you for your thorough response. I have a couple more questions. So the big concern with HPV seems to be that some strains cause cancer. However the strains that cause genital warts are relatively low risk for causing cancer. Is this correct? Next, is it okay to receive oral sex from someone if I have a genital wart on my penis? Could my partner get genital warts in the throat or mouth area? Next, can it be the case that someone has one of the strains that produces genital warts but doesn't actually get them?
Ultimately from your response, it sounds like if I do have genital warts, which I don't even know if I do, it's actually not a big deal, and I can carry on with my sex life as if I didn't have them?
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Edward W. Hook M.D.
27 months ago
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You are correct, the HPV strains which are associated with visible genital warts are not associated with cancer. Also, please remember, nearly all of the so-called "high risk", cancer-associated HPV strains resolve without treatment or progression in over 97% of infection. In the small proportion which persist, the persistent process is very slow, taking years or even decades and is typically reliably discovered in women through routine recommended sexual health check-ups. The rate of progressions is even lower still and not a concern unless a persistent lesion of uncertain origin is discovered.
The strains of HPV associated with warts are very, very rarely transmitted through oral sex.
Your summary is correct. If you do have gential warts, or HPV or any sort which it is likely you do, it just not a big deal as long as your and your partners practice regular, routine sexual health care. EWH
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27 months ago
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Sorry what do you mean by routine sexual healthcare?
So for the sake of this discussion essentially an HPV infection that produces genital warts is no worse or more serious than one that is asymptomatic?
Can I view genital warts as harmless and a minor cosmetic inconvenience? Can I view genital warts as a manifestation of a virus that nearly all sexually active people have or will get and a subset of that group experience physical symptoms in the form of warts?
Again, if I do have genital warts, are there any precautions I should take when it comes to having sex moving forward? Or can I pretty much act as if they're not there?
Lastly, specifically if I do have genital warts, can I receive oral sex from someone? Will I be putting them in harm in any way?
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Edward W. Hook M.D.
27 months ago
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Regular gynecological check ups are recommended for women, previously on an annual basis but now somewhat less frequently.
HPV that causes genital warts is a nuisance but of little or no other health consequence. OTOH, some of the types associated with asymptomatic infection but no visible lesions, go on to cause precancerous lesions ( about 2%) which are readily detected and at routine gynecologic evaluation. They are less of a problem for males.
You are correct, genital wart infection is very common and a nuisance. If you have genital warts you can receive oral sex. If you are concerned you can seek the HPV vaccine which covers the 9 most common HPV types, is highly efficacious and has few side effects.
As this is the 3rd response to your post, as per Forum guidelines, this thread will now be closed without further responses. Please don’t worry. EWH
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