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HPV Worry
Hi Doctors,
A little background... I had an abnormal pap in 2007 and my dr did a colposcopy and found low grade mild dysplasia. I don't think she tested for HPV. I repeated the pap soon after and it was normal, so I went back to having yearly paps, which have all been normal since. I worry, however, because I have had three partners since then and have had unprotected sex with all of them. But during this time I never had another abnormal pap, so I didn't worry about HPV. But I recently read that you can still have HPV, even high risk, even when your paps are normal. How often does that really happen? I don't believe my doctor has ever tested me for HPV because she didn't really think it was necessary. I am getting married in a couple of months to the most wonderful man in the world, and we have already had unprotected sex, so if I have HPV, he has already been exposed. I worry so much about him developing cancer (especially oral), since I know that it will be my fault if he does--I'm his one and only partner, he has had ex-girlfriends in the past but all he did was kiss them. I am scheduled for my yearly pap in about a month (can't go sooner because of insurance) - should I have my doc test me for HPV? What do you think the chances are that I have it? I know it's hard to say. But any advice or reassurance would really help, because I've been worrying about this nonstop. I haven't had any symptoms except some minor, occasional itching that I think is due to a yeast infection (HPV doesn't cause any such symptoms anyway, right?)
Thank you so much in advance for any help you can give!
A little background... I had an abnormal pap in 2007 and my dr did a colposcopy and found low grade mild dysplasia. I don't think she tested for HPV. I repeated the pap soon after and it was normal, so I went back to having yearly paps, which have all been normal since. I worry, however, because I have had three partners since then and have had unprotected sex with all of them. But during this time I never had another abnormal pap, so I didn't worry about HPV. But I recently read that you can still have HPV, even high risk, even when your paps are normal. How often does that really happen? I don't believe my doctor has ever tested me for HPV because she didn't really think it was necessary. I am getting married in a couple of months to the most wonderful man in the world, and we have already had unprotected sex, so if I have HPV, he has already been exposed. I worry so much about him developing cancer (especially oral), since I know that it will be my fault if he does--I'm his one and only partner, he has had ex-girlfriends in the past but all he did was kiss them. I am scheduled for my yearly pap in about a month (can't go sooner because of insurance) - should I have my doc test me for HPV? What do you think the chances are that I have it? I know it's hard to say. But any advice or reassurance would really help, because I've been worrying about this nonstop. I haven't had any symptoms except some minor, occasional itching that I think is due to a yeast infection (HPV doesn't cause any such symptoms anyway, right?)
Thank you so much in advance for any help you can give!
MEDICAL PROFESSIONAL
If you were my patient, I would advise against HPV testing. Why look for information you neither need nor want to know?
The risk of serious health outcomes from HPV in men is very low -- a lot lower than in women.
That said, I'm sorry to hear your partner's "reaction would not be good" if you had an HPV test that returned positive. If he's a kind and loving soul, then with the information I have provided he really shouldn't be at all upset. (This assumes, of course, that you have been honest with him about your past sexual partnerships....)
Anyway, good luck with it. HPV really isn't worth so much angst! It's just an insignificant bit of DNA (with a protein coating) that happens to exploit human intimacy for its own existance. Don't let such a trivial thing interfere with love, romance, and commitment.
The risk of serious health outcomes from HPV in men is very low -- a lot lower than in women.
That said, I'm sorry to hear your partner's "reaction would not be good" if you had an HPV test that returned positive. If he's a kind and loving soul, then with the information I have provided he really shouldn't be at all upset. (This assumes, of course, that you have been honest with him about your past sexual partnerships....)
Anyway, good luck with it. HPV really isn't worth so much angst! It's just an insignificant bit of DNA (with a protein coating) that happens to exploit human intimacy for its own existance. Don't let such a trivial thing interfere with love, romance, and commitment.
Dr. Handsfield,
Thank you for your response! Your comments are reassuring. I have been worrying about HPV, off an on, for a long time. I'm actually more concerned for my future husband's health than mine. I try to reassure myself by reminding myself that he doesn't smoke or drink and that his overall risk is low because he's only had one partner (me), who may or may not have an active infection. I read that the risk is only high if there are multiple partners involved. (I actually read a lot about HPV--at this point I'm just really confused by all of it.) I just fear what would happen if I do get tested and it comes back positive--I know his reaction would not be good. I don't want to put that kind of stress on either of us that soon before our wedding. On the other hand, if it comes back negative, I'll be very relieved. If I do get tested and it comes back negative, then my fiance is not at risk then, right? I'm not sure what to do...
Thank you for your response! Your comments are reassuring. I have been worrying about HPV, off an on, for a long time. I'm actually more concerned for my future husband's health than mine. I try to reassure myself by reminding myself that he doesn't smoke or drink and that his overall risk is low because he's only had one partner (me), who may or may not have an active infection. I read that the risk is only high if there are multiple partners involved. (I actually read a lot about HPV--at this point I'm just really confused by all of it.) I just fear what would happen if I do get tested and it comes back positive--I know his reaction would not be good. I don't want to put that kind of stress on either of us that soon before our wedding. On the other hand, if it comes back negative, I'll be very relieved. If I do get tested and it comes back negative, then my fiance is not at risk then, right? I'm not sure what to do...
MEDICAL PROFESSIONAL
Welcome back to the forum. I reviewed your discussion with Dr. Hook a year and a half ago. I'm sorry to hear you continue to remain so concerned about HPV. It really isn't necessary.
First, at your age, new HPV infections are uncommon; that's the main reason the anti-HPV vaccines are not normally recommended after age 26. By then most sexually active people are statistically unlikely to be exposed to new infections and others have already been infected by some or all the HPV types covered by the vaccine (and resistant to new infections with them). So the chance is low you have acquired a new HPV infection from your last few partners.
Second, I hope you can come to understand that having HPV is normal. It isn't desired, but it's unavoidable: nearly all sexually active people are infected at one time or another; at any point in time, up to half of all people age 15-25 have genital area HPV infections. You have already had at least one HPV infection yourself. (Nothing else causes cervical dysplasia.) Fortunately, the large majority of infections never cause health problems and are cleared up by the immune system.
Third, although past HPV infections indeed can recur, usually they do not. And when they do, they rarely are apparent or cause any new health problem.
Here is a link to a thread that goes into more detail about all these issues, and others -- and as you will see, in turn it contains links to still other threads.
http://www.medhelp.org/posts/STDs/HPV-concerns/show/1819004
For all those reasons, I would advise you to do your best to stop worrying about something that is a) unlikely, b) would probably not cause harm to either you or your new or future sex partners, and c) you can't do anything about. Just follow your doctor's advice about whether or not to have an HPV test when you have your next pap smear. (Actually, it may be you don't need any more paps. The latest recommendations are that beyond age 30, once 3 paps in a row have been normal, no futher ones are needed.) As for potential health outcomes in your husband, the chance of that is extremely low -- including little or no risk of oral cancer. All these and more are discussed in the other threads linked above.
So my bottom line advice is to do your best to stop worrying about HPV, and go forward with your new sexual relationship without worry and without special precautions against HPV.
Let me know if anything remains unclear after you have absorbed all this and have read the other discussions.
Best wishes-- HHH, MD
First, at your age, new HPV infections are uncommon; that's the main reason the anti-HPV vaccines are not normally recommended after age 26. By then most sexually active people are statistically unlikely to be exposed to new infections and others have already been infected by some or all the HPV types covered by the vaccine (and resistant to new infections with them). So the chance is low you have acquired a new HPV infection from your last few partners.
Second, I hope you can come to understand that having HPV is normal. It isn't desired, but it's unavoidable: nearly all sexually active people are infected at one time or another; at any point in time, up to half of all people age 15-25 have genital area HPV infections. You have already had at least one HPV infection yourself. (Nothing else causes cervical dysplasia.) Fortunately, the large majority of infections never cause health problems and are cleared up by the immune system.
Third, although past HPV infections indeed can recur, usually they do not. And when they do, they rarely are apparent or cause any new health problem.
Here is a link to a thread that goes into more detail about all these issues, and others -- and as you will see, in turn it contains links to still other threads.
http://www.medhelp.org/posts/STDs/HPV-concerns/show/1819004
For all those reasons, I would advise you to do your best to stop worrying about something that is a) unlikely, b) would probably not cause harm to either you or your new or future sex partners, and c) you can't do anything about. Just follow your doctor's advice about whether or not to have an HPV test when you have your next pap smear. (Actually, it may be you don't need any more paps. The latest recommendations are that beyond age 30, once 3 paps in a row have been normal, no futher ones are needed.) As for potential health outcomes in your husband, the chance of that is extremely low -- including little or no risk of oral cancer. All these and more are discussed in the other threads linked above.
So my bottom line advice is to do your best to stop worrying about HPV, and go forward with your new sexual relationship without worry and without special precautions against HPV.
Let me know if anything remains unclear after you have absorbed all this and have read the other discussions.
Best wishes-- HHH, MD
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