STDs Expert Forum
HPV questions and concerns
About This Forum:

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 questions and concerns

I was just diagnosed with HPV, with mild dyplasia. I get my biopsy results next week. I don't check myself out there often so when you find out something is wrong you tend to focus on that area more. I have a small group of several lesions (I think the speculum covered them when he examined me) that look like skin tabs in my vaginal opening. No pain, itching or discomfort. I go back this week. The nurse said I have both low and high risk HPV but they don't know my numbers. They only test for the type that causes cancer. I have heavy mucus discharge for a few days and that might be post ovulation. There is little odor, it is clear or milky and seems to be reducing. I have been having superficial mucoceles in my lower inner gum for 3.5 months. Never more than one at a time but always have one in some stage. No pain, It grows until it pops and repeat, stops but come up in another spot. I had an oral herpes test that was negative. I have had oral sex, giving and receiving, french kissed before and after oral sex, while I was not aware I have HPV. I don't smoke but I did for 10 years, I quit 15 years ago. I am 40 year old female. I have never had any other STD. My only other health issues PCOS, Hypothyroidism and Psoriasis.

Questions:
1. If I am told I have high and low risk HPV, doesn't that mean I am at risk for warts?
2. Is there any link between oral mucoceles, HPV or any other STD?
3. Will vaginal warts or warts on the penis cause oral risks? If so, how great is that risk. Once warts are treated will the risk still be there in the future?
4. Does Psoriasis being an immune system issue put me a higher risk for getting STD's? I know that having HPV now does.
5. Once I get my HPV cell changes out of my system am I at a greater risk for getting other HPV types? I know clearing it from my system means I still have it for the rest of my life. :( Will getting new types when you already have cell change history cause cell changes to be more likely?

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Welcome to the Forum.  Getting a diagnosis of HPV typically raises many, many questions.  I will try to address some of your questions here but I would suggest you also seek information at the excellent web site of the American Social Health Association (ASHA) (disclosure, I am a former Board member of ASHA and Dr. Handsfield is currently on the ASHA Board).

For better or worse, at present HPV is a "fact of life" and most people have it or will have it at some point in the future.  Despite this fact, only a tiny minority of persons with HPV get the consequences of infection (primarily women and primarily cancer and pre-cancerous lesions).  HPV is the most commonly acquired STD.  Over 85% of sexually active women will have HPV infection at some time in their lives.  The figure for men is less well studied but similar.   There are many (over 100) different types of HPV- some (this "high risk" types) are occasionally associated with genital tract cancers while others (so-called "low risk types") tend to cause visible warts but are almost never associated with cancer.  In some HPV will cause genital warts, in others HPV will not cause warts but may lead to changes in PAP smears.  In nearly everyone who gets HPV, warts or otherwise, the infections will resolve by themselves without therapy in 8-24 months.  In a very small minority of women, HPV infection can persist and lead to the pre-cancerous lesions that PAP smears detect and which can then be treated.  With this as background, let's address your questions:

1.  The low risk types tend to cause warts while the higher risk types typically do not.  the small "skin tags" you see on your vulva/vaginal opening could be normal or they could be warts.  I would urge you not to even guess and to have your doctor take a look.
2.  I know of no relationship between HPV and mucoceles.
3.  HPV is rarely transmitted through oral sex and when it does there is typically no problems which follow. Very, very rarely HPV is associated with oral cancers but this occurs in smokers (not former smokers like you) and would typically be detected during routine dental exams.
4.  No psoriasis does not put you at increase risk for STD. Further, there is no GOOD data that suggest that having HPV does either.
5.  Having had HPV has not impact on your risk for future HPV.

I hope my comments are helpful.  Check out the ASHA web site.  EWH
19 Comments
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1609501_tn?1299205202
Thank you for your time and response.

I have read everything I could concerning HPV on Ashastd. I appreciate both WebMD and Ashastd because so much of the internet sites will just cause huge fears and stress.

I have an appt. on Monday to review what I am concerned are warts. I will also be getting my labs this week. I will post those results. I have found that the doc and nurses responses to so many of my questions just left me confused and so I felt you could give me a more clear understanding. There are no support groups in my area but I plan to see a therapist to help with just the stress and anxiety of this.

I have read one site that was trying to link mucoceles to HIV (not HPV) and frankly that scared me. I have no symptoms of HIV, I had a 3 month post negative test result. As well as for all other STD's except Hep and I get those results this coming week. I plan to retest at 6 months because I have been told HIV can show up after 3 months. Feel free to give me your view on that. :)

Thank you for your work here to help educate and reduce fears of STD's.
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1609501_tn?1299205202
2 additional questions.

1. So if warts are present vaginal or on the penis it is safe to have oral sex without fear of getting oral issues?

2. Once you have HPV but no longer have cell changes or warts present, can you have a sexual relationship with a new lover who to their knowledge doesn't have HPV without worry that you will give them HPV. If they know that you have a history of HPV and they are willing to take the risk.?
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300980_tn?1194933000
Glad I could help.

1.  See no. 3 above.  While there are occasional transmissions of HIV through oral sex there are, as I said, quite rare and when they occur are of little consequence.  If you were to get significant HPV infection through oral sex your dentist should pick it up and help you deal with it.  Oral HPV is really is not worth worrying about.

2.  Yes.  Once your HPV is treated, if there are no signs of recurrence at 3-6 months following treatment, there is no need to disclose.

EWH
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1609501_tn?1299205202
It's great to know there is life and sex after HPV!!
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Oh...and I did want to get your view on my 3 months negative for all over STD's. Because of the warnings about some, esp HIV sometimes taking longer (6 months). I just would like to get your view on how accurate that is.
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300980_tn?1194933000
there is no need for further testing for other STDs.  Your 3 month results are definitive and suggestions that you should wait longer for final testing is overly conservative.  This is true for HIV as well as other STDs.  EWH
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1609501_tn?1299205202
YAY!
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I posted pics of the area I am concerned is warts and of the oral mucocele via my profile. I wish there were better (less scary) pics of gential (genital) warts online!
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300980_tn?1194933000
Sorry we do not comment on pictures at this site.  Past experience has shown that the pictures are hard to interpret and can be misleading,  Lesions of any sort should be looked at in person by a trained clinician.  Sorry. EWH
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1609501_tn?1299205202
:) That is ok, thank you for letting me know. I will post all the results of appts/labs I recieve this week. Hopefully these posts will help others in learning about HPV.
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1609501_tn?1299205202
My biopsy shows I have the mildest of the mild stage dyplasia. The vinegar used for the test has caused bacteria vaginosis and I have an rx for that. The doc does think that the bumps are small warts and I start acid treatment a week from today.

I will post here how treatment goes.
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1609501_tn?1299205202
Hello Dr. Hook,

If you are still watching this thread...I have another question. :)

I have the mildest of the mild stage of dyplasia caused by high risk HPV and I have vaginal warts due to low risk HPV. If in most people they never even get symptoms and I have both am I at any higher risk of getting oral symptoms? Before I found out I had HPV (three weeks ago) I know I have given oral sex, recieved oral sex, french kissed before, after both types of oral. After all I have read I understand how low the risks are with oral issues but just wonder if I would be at any higher risk than normal.
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300980_tn?1194933000
Good question.  the fact that you have clinical signs of infection does not make you any more likely than anyone else to have oral infection or to have adverse consequences from it.  Your abnormalities are mild. Most peole with such leisons are not aware of them and do just fine.  I know it's hard but try not to worry.  EWH
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1609501_tn?1299205202
Thank you, yes I am trying my best to educate myself and work through each fear. I will be seeing an ENT for the mucocele issues as I have now had them going on 4 months and plan to have him check me for any other oral issues. My period came today and it is really heavy, dark and painful. I have three more days of  Metronidazole gel for the bacteria vaginosis. I don't know if it is the infection or the HPV (cells/warts) or all causing this. I have noticed my last 3ish periods were a bit different in consistency but not this bad. Hope it improves as I clear these issues out of my system.
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300980_tn?1194933000
I understand you esire to understand.  At the same time, it is now time for this thread to end.  It has gone on far longer than is usual or we are able to do.  I woul suggest the highly informative information available at the web site run by the American Social Health Association.  (Disclosure. Dr. Handsfield and I are both members of the American Social Health Association Board of Directors.)

HPV is not typically associated with abnormal periods.

This concludes this thread.  EWH
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Thank you for all your help.
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1609501_tn?1299205202
Update: I posted a pic today after my first acid treatment for vaginal warts. The lesions turned white and that means they are warts, I had considered a biopsy but after all STD testing only showed I have HPV I figured why. The treatment wasn't painful, I will be having one treatment a week for several weeks then determine if I have new warts and need a different treatment or hopefully this works and my system clears all symptoms.

Dr. Hook I know you are no longer watching this thread but I will continue to post updates in hopes it helps others. I always wonder what happened for people when I read back posts. :)
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1609501_tn?1299205202
ENT update: My doctor has a long career in medicine. He said he had just talked to another doc in the practice about how people would be coming in to see them with fears based on misleading info on the internet. He has not seen any cases other than with children born to moms with HPV and one of those kids had it so bad he died. Still it is very rare. I amused him greatly by being the only woman to ever ask him about oral sex. I would guess in a 30+ career...and I hold that place. He examined my mouth and throat and said there was nothing abnormal except the mucocele and it has improved and I will only go back if I continue to have them to the point that I need something done. I do live in a conservative area, I would have expected him to have seen some oral warts. This was a very good step toward my getting past the fears of learning I have HPV and working on my health.

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H. Hunter Handsfield, M.D.Blank
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