STDs Expert Forum
HPV concerns
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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HPV concerns

Dear Doctor,
I am a professional female in my 40's.  I had an abnormal pap with moderate to severe dysplasia when I was 30.  I had a procedure in which the cell were "burned" off my cervix. Right after that my HPV test was negative and have been ever since.    What are my chances of transmitting the virus now?  What about oropharyngeal cancer due to HPV?  I was scanning the HPV forum and someone cited a Harvard study stating that type of cancer will be more prevalent in 2020 than cervical cancer.  Do I need to tell future partners of this?  Some doctors say yes and some say no as well as many websites have conflicting information.  I find it all terrifying and wonder if I'll ever have a normal guilt free relationship again.  I feel like I am spending a lot of time worrying about this.  Do you have any information that I could tell a potential partner without freaking them out?  Thank you for your help with this.
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Welcome to the forum.  Thanks for your question.  However, it's not a new one; all the specific concerns you have have been addressed before.  See the following threads as a start; some of them may have links to still other discussions embedded within them.

http://www.medhelp.org/posts/STDs/HPV-Transmission/show/1522088
http://www.medhelp.org/posts/STDs/HPV-without-sex/show/1799277
http://www.medhelp.org/posts/STDs/hpv-QA/show/742564
http://www.medhelp.org/posts/STDs/Oral-HPV-Cancer-Risk/show/1512873
http://www.medhelp.org/posts/STDs/HPV-and-oral-cancer-risk-in-male/show/1181303
http://www.medhelp.org/posts/STDs/Handsfield-6-month-disclosure-guidelines/show/552283
http://www.medhelp.org/posts/STDs/Ethical-Dilemma-about-HPV/show/1744484

As for your specific concerns, you can expect to never again have any problem with the HPV infection responsible for your cervical dysplasia more than 10 years ago -- either in personal health or in transmission to current or future sex partners.  What should you say to sex partners?  From a strict prevention perspective, nothing.  Of course if you are in a committed relationship, or develp a new one, you may decide to discuss this an other health issues.  But this is a relationship issue, not one of disease prevention.

Although the knowledge about certain pharyngeal (throat) cancers and HPV is evolving rapidly, I don't know anybody who believes it will be an especially common cancer in future years -- maybe more frequent than now, but it's currently so rare that this shouldn't raise great alarm.  And due to current and evolving cervical cancer prevention strategies, that disease is now uncommon, at least in its invasive (potentially dangerous) form -- so even if pharyngeal cancers outnumber that problem, it won't necessarily mean that large numbers of persons are at high risk.

So my advice is to try to not worry about all this.  You're among 40 million or more women (as a very rough guess) in the US with the identical medical history.  The vast majority of you will never have any future health problems from your past HPV infections.

Please take a look at the other discussions then let me know if I can clarify anything further.

Regards--  HHH, MD
5 Comments
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I remember from my LEEP report it said moderate to severe dysplasia and also somthing about field to field of condyloma.  (I'm not sure I'm getting this right).  I was never told I had genital warts.  Are all HPV strains considered condyloma??
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This is just an issue of terminology.  Clinicians and patients often use "condyloma" to mean "wart".  Pathologists, who write pap smear reports, mostly use "condyloma" to mean how certain cells look under the microscope.  Most high risk HPV infections that cause dysplasia do not cause lesions that you and I would call a wart or condyloma, but many (maybe mosof them (maybe most) produce changes under the microscope that a pathologist would characterize as condyloma.  Either way, this makes no dfference al all in your past or future health with respect to HPV, or in the chance of transmission to partners.
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So you are saying I did not have genital warts, correct?  Also one other question, would getting the HPV vaccine be a smart thing since I'll hopefully be back in the dating world soon.  Are there any dangers to getting it at my age?  Should future partners get vaccinated to be with me?  I'm assuming from your earlier post that I am no longer contagious.  But the confusing part is that even in your other threads, you say that it is unlikely to be transmitted but it could be transmitted at this stage because science does not have all the answers at this time.  Unfortunately, we live with uncertainty.  That seems to be conflicting to what you told me in this thread.  Please comment.
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"So you are saying I did not have genital warts, correct?" No, I did not say that. I have no way of knowing.  But if you didn't have visible warts in the genital area, most likely you did not have warts.

"would getting the HPV vaccine be a smart thing since I'll hopefully be back in the dating world soon.  Are there any dangers in getting it at my age?"  New HPV infections are rare at your age, regardless of their sexual activity.  Therefore, the vaccines have not been studied beyond age 26, which is why they are not recommended in older women.  But there is no reason to believe immunization would be harmful, except on your pocketbook:  because it isn't recommended at your age, it probably wouldn't be covered by your health insurance and you would pay around $500.

"Unfortunately, we live with uncertainty."  True.

"That seems to be conflicting to what you told me in this thread."  Not true.  

I never said there is no chance of future transmission.  But the low risk is no different than for 90% of all people!  That's the proportion of us that get genital HPV somewhere along the line.  All carry some potential for reactivation in the future -- low risk, but not zero.  That your infection caused an abnormal pap smear and was diagnosed, whereas most infections are asymptomatic, makes no difference.  In other words, your past abnormal pap -- or whether or not you were infected with a wart-causing strain of the virus -- makes absolutely no difference in your health, or that of your future partners, compared with almost all sexually active human beings.

Please do your best to accept the reasoned, science-based reassurance you have had.  This really isn't worth the amount of concern you have expressed.  You should understand that both from my comments here, and if you will carefully read the other threads linked above.

That will end this thread.  Please do your best to move on without worry about HPV.
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