Getting over my Genital Wart Obsession

[That Dude]

Dr. HHH

I posted a question over a month back about an incident that happened almost 6 months ago involving protected sex with a massage parlor sex worker. I would first like to apologize for being such a pest. I understand there a 6 month two question limit and this will be my last question on the subject.

1) I’ve read some experts believe that only 1-2% of the people who are infected with wart-causing HPV ever show symptoms. This site specifically http://www.hpvfaq.com/hpv101.asp.  Are you one of those experts that share this belief? I think I’ve seen you write it could be more toward 5%. What would your take be.

See originally I though that all persons infected with the wart causing strains of HPV got visable warts, I know that’s not true now. But, if its actually only 1 to 2% or even 5% that show symptoms (even with the wart causing stains) that makes me feel a lot better and even stupider for worring so much.


2) If pretty much everybody gets HPV at one point or another and clear is with out even getting symptoms, how could anyone reasonably say if you get HPV you have it for life. That would mean everybody pretty much has it for life. No?

3) Would you in fact say even if you get genital warts all HPV infections eventually go away?
  
Anyway, I think I finally am getting a perspective on Genital Warts. I was so worried before even after all my negative tests that I’d ruined my life since I could never know for sure if I was infected or was gonna get them. I really see how crazy that is now as HPV is pretty much unavoidable unless I was going to be celibate my whole life. I had other stuff written but want to try and be as brief as possible.
Thanks so much.

I would like to take this opportunity also to thank yourself and Dr. Hook for providing this truly invaluable service.

[H. Hunter Handsfield, M.D.]

As you correctly concluded, your last comment, and the one after it, disappeared because I deleted them.  You don't get to ask unlimited questions and clarifications.  This thread is over.

[H. Hunter Handsfield, M.D.]

Genital warts usually appear within a few weeks of infection with HPV 6 or 11, and generally clear up within a year, without treatment.  Although sometimes they persist longer or reappear more than a year later, it is rare. So if you haven't seen warts, you probably weren't infected during your massage parlor event (and in any case, you said the exposure was condom-protected); and if you were, the infection probably is gone by now, or will be soon.  On top of all that, warts are a trivial issue - an inconvenience (and usally a minor one), not a serious health threat.  You have devoted far more worry and energy to warts and HPV that is warranted.

This will be my last comment.

[That Dude]

Thanks Doc,

Your answer to question number one wasn’t exactly what I’d hoped for but it is what it is. You bring the research, info and facts. I respect that. I’m a little surprised how off the site I pointed out was but 1 to 2% did seem pretty low.

I guess what I was trying to get at there was if almost everyone gets HPV at some point, I didn’t understand how some could think genital warts/HPV were a permanent thing. It almost sounds like people who develop warts are just unfortunate to find out that they have HPV while most sexually active people have/have had or will have HPV and just never know because it cleared with out ever showing symptoms. If that makes sense

So my only real question left is say hypothetically, I did get genital warts from my encounter 6 months ago in the future at some point  (I guess I wouldn’t even know for sure it was from her) but anyway would the warts definitely eventually go away, even if it took years. Would it eventually clear just like any other HPV infection. Even if it took say 5,6,7 or more years even. Would the problem not go on forever.

Thanks for the info on the vaccine too. I think I’ll hold off for the time being but will probably recommend to future long-term partners, especially because of what I know about HPV now and the risk it can be for woman and what a breakthrough the vaccine really is. I’m glad it’s available for when/if I have a daughter.

Sorry for the long follow up,  but it’s only one question really. I’m so ready to close the book on all this madness I’ve put myself though for nothing really. I went to a hypnotist today and feel more relaxed and all around better about my self and will continue seeing a psychiatrist I’ve been seeing the last couple months for my guilt and anxiety over what I did. The crazy thing is if warts are just a slightly unpleasant inconvenience, not a significant health risk and definitely not a permanent thing, I really feel like the weight of the world will be off my shoulders.  

I am truly sorry for carrying on here with such a long follow up message but if your can just answer my one last question and hopefully with good news you will pretty much be my hero and let this be my last medhelp STD post ever.

[H. Hunter Handsfield, M.D.]

1) Almost all genital warts are caused by HPV types 6 or 11.  Far more than 1-2% of people with new HPV 6/11 infection get visible warts.  The best research study followed sexually active university women every few months for 3-4 years.  Of those who acqhired HPV 6/11, a majority -- 70-80% as I recall (I didn't go back to look at the data) -- developed warts.  Some of those were internal and would not have been easily noticed by the infected women.  Whether the same data apply men isn't known, but it's a fair bet that well over half develop visible warts.  It is true that many authorities assume and quite lower rates, and I'm quoting only a single study, which always leaves open the possibility of not being widely valid.

2,3) I don't understand just what you're asking.  There are at least 10-15 common HPV types that infect the genitals, and the number approaches 100 if the rare types are included. The large majority of infections clear up on their own, typically within 6-12 months (with some differences between HPV types).  For these reasons, among sexually active people who change partners from time to time, HPV infections probably are coming and going much of the time.  Each infection probably clears up on its own, regardless of what is going on (or went on before) with a different infection.  At any particular point in time, 20-40% of sexually active persons age 20-30 are carrying HPV.

So unless you are unusually lucky, or indeed remain celebate, you can expect to be infected with HPV if you haven't already.  You could reduce that risk if you want to get immunized with Gardasil, the vaccine that protects against 4 of the most common types:  HPV 16 and 18 (which together cause 70% of HPV related cancers) and 6 and 11, i.e. highly effective in preventing genital warts.  Although not yet approved or formally recommended for use in men (and thus not insurance covered and expensive), there is every reason to expect it to be effective.  Consider it, if it would make you get over your concerns.  But those fears are pretty much unjustified.

Best wishes--  HHH, MD