Can HPV sometimes cause pain?

[jann20]

I received a diagnosis about 15 years ago of cervical dysplasia, and at the time an ulcerated area was also biopsied and was found to be a wart.  What initially prompted my doctor's visit was vaginal burning and rawness.  Once the wart and dysplasia were discovered and treated, I expected the burning/rawness to go away.  But they never really have.  Is it possible or have you ever encountered a case where HPV caused these additional symptoms?   Also, since there were both dysplasia and a wart, does that mean that more than one strain was present, or can a single strain cause both dysplasia and warts?  

[H. Hunter Handsfield, M.D.]

Responding first to the title you selected for your question, before I read the question itself:  No.  HPV infections are painless.

Now having read the question:  The usual cause of vulvar burning and "rawness", especially lasting 15 or more years, is called idiopathic vulvodynia.  The cause is unknown.  There have been theories about a possible role for HPV, but they have never panned out in any research studies.  I assume you have been seeing a gynecologist about this over the years -- what does s/he say about it?

The "low-risk" HPV types, i.e. the ones that cause warts, can cause dysplasia -- although those dysplasia cases generally do not progress to cancer, even if untreated.  But at this point, 15 years later, there is no way to know whether you were infected with one HPV strain or more than one.

Bottom line:  If your sexual lifestyle has not kept you at risk for additional HPV exposurs, you can safely assume your old HPV infection is long gone and that something else (vulvodynia?) is the cause of your ongoing genital discomfort.  Discuss it with your gynecologist then follow his or her lead about possible causes and treatments.

Best wishes--  HHH, MD