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STDs  (Expert Forum)
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pleae help me put this behind me !!!
Answered by
University of Washington Seattle - WA
Welcome to the STD Forum, which 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.

pleae help me put this behind me !!!

by Please Help Me - Really Depressed, Oct 03, 2006 12:00AM
Tags: anal, Life, warts, worry

I like the others here are grateful that we have access to this website, a wonderful service provided by you and other doctors.

My question is about  HPV.  I was diagnosed with anal warts, and was referred to a proctologist. I told him I have never engaged in any anal sex and was 100% heterosexual, he said that it doesn't have to be transmitted by anal sex at all and to leave the question where they came from aside and treat them. He told me I had some inside me (about 2cm) and to use podophyllin for the outside ones, but leave the ones inside, and to see him six weeks later for a follow up. Since most of them had already started to go away on their own even before I saw the proctologist, I decided to wait it out and see if the rest would clear up and they did and I assumed that any inside ones probably did too, and didn't bother seeing the proctologist for a follow up based on this, and went on with my life.

A little while back, I was just curious and was looking down there and saw a few bumps inside and saw several doctors about this to make sure they were not the internal warts that the proctologist mentioned before. I even saw the proctologist himself again and he said, anal warts are not my problem everyone is different stop checking for things and move on with life. Having not being told what these bumps were other than everyone is different I went to several other doctors and they all said its normal, part of me, just tags and folds etc.


1. What are the chances of recurrences, this what I am afraid of not sure why. The last doctor I saw, told me when I did have them I had them not knowing what they were I let them follow their course of action to grow in size and number, and since they went away on their own and have been for that long I don't have anything to worry about?

2. You said before you don't even do an internal exam in people with anal warts, all the several doctors that I saw didn't mention anything about future exams including the proctologist. Only one doctor said It’s a good idea to come back in a year for a rectal exam since I had them in the past. Other websites I read about say its crucial to follow up for at least 3-6 months after all visible warts disappear. What is your say on this?

3. It has been over a year since they all went away on their own, my current fiancé who I have been with for over 2 years doesn't have any visible warts (she was checked by her doctor thoroughly) and just recently got back a normal pap test, do you think I need to worry about reoccurrences or any future problems? Is it possible that HPV is totally out of my system?

4. You said that most people will clear the HPV infection in 6-12 months. Does that mean totally uproot it from the body or just suppress it to low levels and to never reoccur again, all in all do I have to worry about reoccurrences?

I just want to put this behind me, its effecting my relationship and personal life.

Thanks for all your input doc.

by H. Hunter Handsfield, M.D., Oct 03, 2006 12:00AM
"Help me put this behind me":  That's exactly where it is now--and I'm talking about the course of your infection, not your anatomy!

Anal warts indeed occur in heterosexual men.  I disagree with your proctologist's assessment that anal warts aren't sexually acquired; almost certainly they are, through anal area contamination with a partner's genital secretions.  But other than that, you have been given entirely accurate information.  In other words, I cannot add to what you were told:  "...the proctologist himself...said, anal warts are not my problem everyone is different stop checking for things and move on with life. Having not being told what these bumps were other than everyone is different I went to several other doctors and they all said its normal, part of me, just tags and folds etc."

1) Genital area warts typically do not recur once they clear up.  I am unaware of any different data specifically for anal warts.

2) I am unaware of specific guidelines by any public health authorities or professional societies for follow-up of anorectal warts, especially in heterosexual men.  In my STD clinic, we do not advise routine periodic exams for such patients.  (We advise gay men to have periodic anorectal examinations, because of the risk of anal cancer.  But we do that regardless of a history of anal warts.  The low-risk HPV types that cause warts do not lead to anal cancer, so there is no reason to suspect you are at risk for that uncommon outcome.)

3 and 4) There is no guarantee that HPV is "totally out of your system".  Some experts believe that all HPV infections persist, but at an undectable (and non-transmissible) level.  Others believe most infections entirely go away.  What is known for sure is that most people's infections resolve, as measured by the most sensitive tests available.  But since the health consequences of HPV generally are trivial, most experts advise people like you--and your sex partner(s)--to just ignore the problem and not worry about it.

Your concerns are understandable but not really justifiable.  With rare exceptions, both genital/anal warts, and even infection with the high-risk (cancer-causing) types of HPV, are trivial inconveniences, not serious health risks.  If this continues to affect your relationship and personal life, despite your proctologist's strongly expressed reassurance as well as mine, then you need to seek counseling about it.  But truly, you're making too much of this.

Good luck--  HHH, MD
Member Comments (3)

by Please Help Me - Really Depressed, Oct 03, 2006 12:00AM
To: Dr. HHH
Thanks so much for your re-assurance.

A few closing questions please.

You said.

Genital area warts typically do not recur once they clear up. I am unaware of any different data specifically for anal warts.

1. Is that true for genital/anal warts that go away on their own and have for quite some time and ones that needed treatment to be resolved.


2. so basically in a nutshell, i had them just like millions of others, don't need to worry about reoccurences and no need for future exams and should just totally put this out of my mind both physically and mentally. do yo agree with this?

Thanks again so much, You can have my promise that this will be my last post.

God Bless.

by H. Hunter Handsfield, M.D., Oct 04, 2006 12:00AM
1) I don't understand the question.

2) I agree.

HHH, MD
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