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Genital warts tranmission

Hello I'm a 37 Y.O. male that noticed and was diagnosed with genital warts last week.  

My doctor put acid on them yesterday. Warts started out like razor burn bumps and progresively got worse and ranged in size from a pen point to a little larger (all small).  They are located at the base of my penis and on right side of my scrotum.  I am unsure who I got them from as I came out of a relationship months ago but only had protected sex with her.

Anyhow, I am now dating a different woman and had unprotected sex with her prior to the warts coming out last week.  She had no warts present.  I spoke with her about this and of course, like me, she was upset, but we have since become more informed.  However, I have the following questions because my Doctor is difficult to talk too.

1)  Once the visible warts (mine for now and hers if she gets any) are removed by the treatments how long, in your opinion, would you suggest we wait to have unprotected sex again?  I don't want to keep passing this back and forth.  Once visible warts are gone, if we have protected sex with a condom and limit penetration so as not to rub my infected area on her, would that limit risk of future outbreaks?

2) Again, once the warts are gone, could we have oral sex?  What is the risk of spreading the warts to the mouth / throat?

3) Is there any home wart treatment (over the counter) that I could use rather than going to the doctor for the acid?

I want to avoid passing the warts back and forth between us but at the same time I would like to have some level of a sex life.

Thanks for you help!

1 Responses
239123 tn?1267651214
MEDICAL PROFESSIONAL
Directly to your questions.  They are based on the assumption that the diagnosis of genital warts is correct.

1) There probably is little point in stopping sex with your partner now.  She has already been exposed.  The general advice to couples in which one person has HPV and the other apparently does not (and who have been having sex) is to not worry about it, just keep and eye out for warts and for women to stick with the program of annual pap smears.

Having said that, it is likely that infectiousness declines once the warts are gone, but there are no good data.  It's a good idea to avoid direct genital contact with your warts until they respond to treatment, probably just a couple more weeks.  You might remain somewhat infectious after that, but probably after 6 months there is little chance of transmission.  Condoms reduce the risk somewhat, but in the long run don't make much difference--perhaps especially when warts are in a location that is not consistently covered by condoms.

There is never a problem with "passing warts back and forth".  Once the infection clears up, you and she both will be immune to future infections with your virus.

2) Symptomatic oral HPV is rare.  Probably lots of infections are transmitted to partners' mouths, but they don't get warts.  I wouldn't worry about oral sex.

3) There are several other options for genital wart treatment in addition to "acid" (probably trichloroacetic or bichloroacetic acid), both provider-applied (podophyllin, freezing, laser cautery, others) and patient-applied including podophyllotoxin and imiquimod (trade names Condylox and Aldara, respectively).  They all are equally effective, but some providers are most experienced with one or the other.  If you want to consider other options, you should discuss it directly with your provider.  Perhaps s/he will give you a prescription for Condylox or Aldara.  However, those require treatment for 3-4 weeks, whereas just 1-2 more acid treatments might be all you need.

Bottom line:  Probably it's a good idea to avoid direct sexual contact of the warts themselves with your partner's genital area until the visible lesions are gone, i.e. no vaginal penetration but no other restrictions. Once visible warts are gone, just go back to where you were, with your partner keeping a lookout for warts.  You and she need to look at warts as a somewhat unpleasant inconvenience, but not a significant health problem.

This also is a good time for your partner to ask her own health care provider about getting the HPV vaccine.  It's too late to prevent her getting your infection, but it will prevent future infection with other HPV types, including the two strains that cause most cervical cancer.

Good luck--  HHH, MD
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