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What are Men to do when there is no Test?
In June of 2005 I had some bumps on my penis which the nurse said may have been HPV. She stated that almost everyone gets them and the HPV strains that do cause warts are not the cancerous types (see also CDC flyer "InsertGW") and after a few weeks they went away and I did not think about them until the battery of commercials about the HPV vaccine came out. In 2007, I began dating a wonderful woman and came out after we had sex and told her about my bumps. We both were tested and her PAP test was normal. I then contacted a woman who I was with in the summer of 2006 (one year after my bumps) and told her that I may be a carrier of HPV. She was tested and said her PAP came back abnormal and that her Dr. said it may have been caused by types 16 or 18. She specifically blamed me for her infection. A few months went by and then my girlfriend stroked my penis before we were about to have sex and felt some bumps and accused me of trying to infect her (The bumps at that time were dry skin but she did not believe me) . My questions are 1) is the statement as the CDC states that wart causing HPV is non-cancerous and therefore less of a risk; and 2) How am I to know if I did pass on type 16 or 18 to my partner in the summer of 2006 if those types of HPV have no symptoms in men; and 3) If men cannot get tested for HPV and even a visual inspection is not a clear diagnosis, what are men to do when a woman feels bumps and accuses a male of having an HPV breakout?
MEDICAL PROFESSIONAL
I should have added that the same testing dilemma applies to women as well as men. There is no test available that reliably detects HPV infection at sites other than the cervix, except for special techniques used in research and much too expensive to routine diagnostic use. The cervical test used in the pap smear misses infections of the labia, vagina, or anal area, and women with normal pap tests cannot assume they don't have a genital HPV infection.
MEDICAL PROFESSIONAL
"What are men to do when there is no test?" For the most part, men and their partners should just sit tight and not worry about it very much. Please see my reply to another question earlier today: http://www.medhelp.org/posts/show/365097.
HPV 16 and 18 are among the most common of all HPV types, but they do not cause warts. It is true that the types of HPV that cause warts, mostly HPV types 6 and 11, do not cause cervical cancer. (Why you doubt the CDC information, by the way??) However, HPV 6/11 infection often causes low-grade pap smear abnormalities which, if left alone, do not progress to cancer.
So, if your penile bumps were warts, they may or may not be related to your partner's abnormal pap smear. That said, my bet is that your problem and hers are unrelated: the timing suggests your warts had cleared up and that most likely you were no longer carrying the virus when you and your new partner first had sex; her problem could just as easily go back to some previous partner.
However, you're never going to know for certain, and it doesn't matter. The appropriate attitude (and the mature attitude) toward HPV is that everybody gets one or more HPV infections somewhere along the line; they are essentially unavoidable; that most infections never cause serious health risks (even the high risk types don't progress to bad disease with appropriate medical care); and that it is foolish for infected couples to try to figure out who was infected first. The blame game is always a loser for both participants.
I think those comments answer questions 1 and 2. As for question 3, there is nothing to be done. Since you and your partner had already had sex, there was no reason to stop once she found the bumps. (It sounds like she needs some education that not all bumps are warts, whether or not they started out that way. But if in doubt, the two of you could go together to a provider who could educate her after examining you.) Anyway, avoiding sex with partners with known HPV doesn't reduce a person's long term risk of catching HPV somewhere along the line. Anybody who ever changes from one sex partner to another from time to time is sure to have sex with one or more people with undiagnosed HPV--and that most commonly involves the high risk types.
You already are aware of the vaccine. Your partner should have it. See my follow-up comment in the same thread I cited above. Also, please see the other websites I suggested in that thread, and read up further on HPV.
Good luck-- HHH, MD
HPV 16 and 18 are among the most common of all HPV types, but they do not cause warts. It is true that the types of HPV that cause warts, mostly HPV types 6 and 11, do not cause cervical cancer. (Why you doubt the CDC information, by the way??) However, HPV 6/11 infection often causes low-grade pap smear abnormalities which, if left alone, do not progress to cancer.
So, if your penile bumps were warts, they may or may not be related to your partner's abnormal pap smear. That said, my bet is that your problem and hers are unrelated: the timing suggests your warts had cleared up and that most likely you were no longer carrying the virus when you and your new partner first had sex; her problem could just as easily go back to some previous partner.
However, you're never going to know for certain, and it doesn't matter. The appropriate attitude (and the mature attitude) toward HPV is that everybody gets one or more HPV infections somewhere along the line; they are essentially unavoidable; that most infections never cause serious health risks (even the high risk types don't progress to bad disease with appropriate medical care); and that it is foolish for infected couples to try to figure out who was infected first. The blame game is always a loser for both participants.
I think those comments answer questions 1 and 2. As for question 3, there is nothing to be done. Since you and your partner had already had sex, there was no reason to stop once she found the bumps. (It sounds like she needs some education that not all bumps are warts, whether or not they started out that way. But if in doubt, the two of you could go together to a provider who could educate her after examining you.) Anyway, avoiding sex with partners with known HPV doesn't reduce a person's long term risk of catching HPV somewhere along the line. Anybody who ever changes from one sex partner to another from time to time is sure to have sex with one or more people with undiagnosed HPV--and that most commonly involves the high risk types.
You already are aware of the vaccine. Your partner should have it. See my follow-up comment in the same thread I cited above. Also, please see the other websites I suggested in that thread, and read up further on HPV.
Good luck-- HHH, MD
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