Questions about HPV

[Baseball28]

I have been in a relationship with my girlfriend for 3 years.  I am a male. We began having sexual relations 2 years ago.  Before we became intimate I got tested for chlamydia, gonorrhea, syphillus, HIV, and herpes.  All test came out negative.  Now last week she went to the gyno and had a Pap smear and it came back abnormal.  A year ago her Pap smear also came back abnormal and she followed up with a colopscopy and the gyno said the cervix looked normal so she just repeated the Pap smear and it came back normal.  Now her Pap smear came back abnormal again.  I started freaking out because the doctor told her its most likely HPV I am her only partner so obviously I feel horrible and guilty.  I have never had any symptoms and from my knowledge men cannot get tested for HPV so I don't know how I could of prevented this.  She also has the gardasil vaccine which I heard covers 2 strains that cause 75% of cervical cancers and 2 strains that cause 90% of genital warts. I guess my question is how do I deal with this.  I have read that HPV strains that cause genital warts are different from those that cause cervical cancer but then some sources say that genital warts turn into cancer as well.  I want some clarification.  Do strains that cause genital warts causes abnormal paps or just the ones that cause cervical cancer, or is it both? Thank god the Dr told her this does not mean I have been cheating.  She told her I could of given it to her from the beginning of our relationship.  She is going for a follow up colopscopy next week.  I hope everything is ok.  I feel that I basically have her cervical cancer because if she does have pre-cancerous cells she will probably need to undergo treatment and I cannot believe I have put her through this.  Is there a chance that she clears the infection on her own and her paps become normal again without treatment? Thank you

[Edward W Hook, MD]

Thanks for the F/U.  EWH

[Baseball28]

Thanks a lot Dr. My girlfriend is 22 years old and she had the 3 doses of the gardasil vaccine which is leading me to believe I gave her a strain which is not covered

[Edward W Hook, MD]

Sorry, I missed your earlier follow-up.  We do allow a limited number of related follow-up questions.  At this time, if you do not have external warts, there is little risk that she will develop external warts.  

Most o f the HPV types that cause abnormal PAP smears do not cause genital warts or other visible abnormalities.  

No, you will not make things worse by continuuing to have sex, including changing her risk for external warts or further PAP smear abnormalities.  

Your questions raise some other questions from me- how old is your GF?  Has she had the HPV vaccine (she should).

You are asking good questions.  I might suggest you go the ASHA (Americal Sexual Health Association) web site and read ther about HPV infections- the site is excellent and very informative.

I hope these comments are helpful. EWH

[Baseball28]

Hey doc do I have to pay and repost for follow up questions?

[Baseball28]

Thanks Dr for the quick response.  I have a couple follow up questions and that will be it. I just want to have a general understanding because HPV never crossed my mind when I thought about sex until now and I wish I would of been better informed about it previously.

1) Since my gf's Pap smear is already abnormal, can I assume she's been infected for a while and that the symptoms she will develop (abnormal pap) have already developed.  In other words, she does not have external genital warts (per self inspection and pelvic exam).  Is there a chance although her pap is already abnormal that she can still develop External genital warts or they would of been present at the time her pap was abnormal? Without the presence of genital warts, but an abnormal pap, Could this mean she has internal warts or a strain of HPV that doesn't cause genital warts but just causes cervical cancer? I am her only lifetime partner so obviously I gave it to her, if she is already infected can I make her situation worse by continuing unprotected sex? For instance, recurrent infections or possible external warts in the future?  Thank you very much

[Edward W Hook, MD]

Welcome to the Forum.  Just to be clear, are you saying your GF has never had sex with another person or that you are monogamous since you became a couple?  The reason I ask is that most women (and men) who have had sex have HPV.  This may lead to abnormal PAP smears but that by no means indicates that she is going to develop cervical cancer.  Most women who develop abnormal PAP smears due to HPV resolve the abnormalities with no treatment at all.

Do strains that cause genital warts causes abnormal paps or just the ones that cause cervical cancer, or is it both?

Yes the HPV that causes genital warts can cause abnormal PAP smears but these abnormalities almost never progress to cancer.  

My advice is not to worry and don't worry that you have done something irreparable.  Her PAP smear will almost certainly become normal without therapy,  Even if it persists, there is little reason for concern- if it persists, infections of this sort are easily treated.  EWH