Aa
Multiple hpv strains
Doctors,
I would first like to premise my story and subsequent question with a thank you for providing a positive spin on what has been a completely demoralizing experience up to this point.
I am a 39 year old heterosexual male with ZERO history of anal sexual activity. I was in, what I believed to be a monogamous relationship for over two years. For reasons irrelevant to this discussion I am no longer in a relationship. Approximately 3-4 months after breakup I noticed warts on my buttocks, around my rectum, on my penis, and unfortunately a few were discovered inside my rectum. The warts were treated with various methods and surgery was required to remove the internal warts. Interferon was also injected as a preventative treatment.
I just returned home from a two month checkup with the physician. No warts have returned but I'm anticipating that to change. But what he did mention was that precancerous tissue was also discovered inside my rectum as well.
I've exhaustingly tried to educate myself on this most frustrating disease and thought there was a differentiation between high risk and low risk HPV. Essentially being two separate diseases under the same "catch all" HPV classification. My question is just that. Am I suffering the effects of two HPV strains or is this the consequence of a single strain? I am trying to subscribe to the positive outlook represented on these posts but if I now have the socially debilitating warts HPV and a potentially dangerous cancer causing strain it is becoming increasingly more daunting.
I am truly trying to be objective in my thinking but this has been mentally and socially overwhelming.
Thank you again for your time and your valued responses.
TAE
I would first like to premise my story and subsequent question with a thank you for providing a positive spin on what has been a completely demoralizing experience up to this point.
I am a 39 year old heterosexual male with ZERO history of anal sexual activity. I was in, what I believed to be a monogamous relationship for over two years. For reasons irrelevant to this discussion I am no longer in a relationship. Approximately 3-4 months after breakup I noticed warts on my buttocks, around my rectum, on my penis, and unfortunately a few were discovered inside my rectum. The warts were treated with various methods and surgery was required to remove the internal warts. Interferon was also injected as a preventative treatment.
I just returned home from a two month checkup with the physician. No warts have returned but I'm anticipating that to change. But what he did mention was that precancerous tissue was also discovered inside my rectum as well.
I've exhaustingly tried to educate myself on this most frustrating disease and thought there was a differentiation between high risk and low risk HPV. Essentially being two separate diseases under the same "catch all" HPV classification. My question is just that. Am I suffering the effects of two HPV strains or is this the consequence of a single strain? I am trying to subscribe to the positive outlook represented on these posts but if I now have the socially debilitating warts HPV and a potentially dangerous cancer causing strain it is becoming increasingly more daunting.
I am truly trying to be objective in my thinking but this has been mentally and socially overwhelming.
Thank you again for your time and your valued responses.
TAE
MEDICAL PROFESSIONAL
As I said, I agree you should inform potential partners in the next few months, while your HPV infection probably remains active. Disclose whatever you wish after that, as long as you understand that doing so you probably will not contribute to that person's health or reduce her risk of HPV and its potential consequences. Because HPV is so common, everyone is exposed, often repeatedly; knowing that a particular partner has been infected generally has no bearing on the likelihood of infection. Often the result may be little more than to create alarm, without benefit.
Of course when starting a new sexual relationship, especially one that has promise for the long term, many couples choose to be open about past relationships, STD history, etc. In that spirit, discussing your (past) HPV infection would be entirely reasonable. But that's a relationship issue, not one of disease prevention.
Anyway, I'm glad to be of help. Thanks for your kind words.
Of course when starting a new sexual relationship, especially one that has promise for the long term, many couples choose to be open about past relationships, STD history, etc. In that spirit, discussing your (past) HPV infection would be entirely reasonable. But that's a relationship issue, not one of disease prevention.
Anyway, I'm glad to be of help. Thanks for your kind words.
Dr. Handsfield,
Thank you for your response. Just to clarify. Sounding defensive about not having anal sexual history was not a social commentary but was stated due to the seemingly inexplicable location of my warts and my subsequent frustration.
As for future relationships, I subscribe to the camp that believes in complete disclosure of a potentially contagious medical history, regardless of the time frame. . My symptoms have been quite significant and I most certainly don't want to subject a partner to the physical and emotional anguish I've experienced thus far. Such is my personal choice on this ethical issue and each person needs to decide what is best for them, as you have said.
Hoping to eventually move past this difficult time and your advice certainly aids in this process. Thank you again for providing this valuable forum.
Tae
Thank you for your response. Just to clarify. Sounding defensive about not having anal sexual history was not a social commentary but was stated due to the seemingly inexplicable location of my warts and my subsequent frustration.
As for future relationships, I subscribe to the camp that believes in complete disclosure of a potentially contagious medical history, regardless of the time frame. . My symptoms have been quite significant and I most certainly don't want to subject a partner to the physical and emotional anguish I've experienced thus far. Such is my personal choice on this ethical issue and each person needs to decide what is best for them, as you have said.
Hoping to eventually move past this difficult time and your advice certainly aids in this process. Thank you again for providing this valuable forum.
Tae
MEDICAL PROFESSIONAL
Welcome to the forum. Thanks for your question.
Sorry to hear of your anal HPV problem and your stress over it. But the bottom line (no pun intended!) is that "this too shall pass"; with propoer care, ultimately this will be a transient unpleasantness in your life, without long terms serious health consequences.
First, you need not be defensive about anal sexual activity. Anal HPV infections, including overt warts and precancerous cellular changes, are not at all rare in heterosexual men with no anal sexual exposure. The precise mechanism of infection isn't clear, but probably usually results from auto-inoculation, i.e. self-transfer of infections acquired genitally.
As you have learned, anal warts can be difficult to treat, especially when they occur internally as well. However, the natural course is ultimate resolution, even if it takes a few months or even a couple of years -- and sometimes surgery with rather painful recovery. But ultimately you can expect the problem to stop recurring.
The distinction between low and high risk HPV is not absolute. Many low risk HPV infections (e.g. HPV 6 and 11, which cause ~90% of anogenital warts) result in apparent pre-cancerous cellular changes. In fact, many women with such changes in their cervix, discovered by pap smear, are not treated at all -- just followed with repeat exams until the problem goes away. In other words, not all "pre-cancerous" changes actually progress to cancer. Most clear up even without treatment.
That said, infection with multiple HPV types is common, so it is possible you are infected with more than one strain, causing both the warts (a "low risk" type) and a "high risk" type causing the cellular changes you are concerned about.
The important thing is to follow your doctor's advice (presumably a proctologist or colon and rectal surgeon) about follow-up examinations. Despite the "pre-cancerous" changes that were seen, you are not necessarily at significant risk for cancer -- but should that develop, treatment is almost always curative if detected early.
As for the "socially debilitating" aspect, try to get beyond feeling that way. The fact is that almost all sexually active people get genital (and often anal) HPV, often several times, and an estimated 25% of the entire population has genital warts at one time or another. I'm not minimizing the social impact, but the fact is that you're not alone and you can expect the problem to resolve. For the next few months, it would be kind to inform potential sex partners of the problem. But once a few months have gone by without recurrence, there will be no need to mention it.
I hope these comments have been helpful. Best wishes--
HHH, MD
Sorry to hear of your anal HPV problem and your stress over it. But the bottom line (no pun intended!) is that "this too shall pass"; with propoer care, ultimately this will be a transient unpleasantness in your life, without long terms serious health consequences.
First, you need not be defensive about anal sexual activity. Anal HPV infections, including overt warts and precancerous cellular changes, are not at all rare in heterosexual men with no anal sexual exposure. The precise mechanism of infection isn't clear, but probably usually results from auto-inoculation, i.e. self-transfer of infections acquired genitally.
As you have learned, anal warts can be difficult to treat, especially when they occur internally as well. However, the natural course is ultimate resolution, even if it takes a few months or even a couple of years -- and sometimes surgery with rather painful recovery. But ultimately you can expect the problem to stop recurring.
The distinction between low and high risk HPV is not absolute. Many low risk HPV infections (e.g. HPV 6 and 11, which cause ~90% of anogenital warts) result in apparent pre-cancerous cellular changes. In fact, many women with such changes in their cervix, discovered by pap smear, are not treated at all -- just followed with repeat exams until the problem goes away. In other words, not all "pre-cancerous" changes actually progress to cancer. Most clear up even without treatment.
That said, infection with multiple HPV types is common, so it is possible you are infected with more than one strain, causing both the warts (a "low risk" type) and a "high risk" type causing the cellular changes you are concerned about.
The important thing is to follow your doctor's advice (presumably a proctologist or colon and rectal surgeon) about follow-up examinations. Despite the "pre-cancerous" changes that were seen, you are not necessarily at significant risk for cancer -- but should that develop, treatment is almost always curative if detected early.
As for the "socially debilitating" aspect, try to get beyond feeling that way. The fact is that almost all sexually active people get genital (and often anal) HPV, often several times, and an estimated 25% of the entire population has genital warts at one time or another. I'm not minimizing the social impact, but the fact is that you're not alone and you can expect the problem to resolve. For the next few months, it would be kind to inform potential sex partners of the problem. But once a few months have gone by without recurrence, there will be no need to mention it.
I hope these comments have been helpful. Best wishes--
HHH, MD
You are reading content posted in the STDs Forum
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