Living With HPV

Having HPV, the human papillomavirus, is nothing to be ashamed of. In fact, 80 percent of sexually active adults will get HPV at some point in their life. According to the CDC, 42 percent of Americans ages 18 to 59 have at least one type of genital HPV, making it the cause of the most common sexually transmitted infection (STI).

The peak time for acquiring HPV is soon after becoming sexually active. Vaginal or anal penetration is not required for transmission, as skin-to-skin genital contact can spread the virus, as well. HPV can also be passed through oral sex, although this form of transmission is not as common. There are two common ways to learn whether you have HPV:

1. You are diagnosed with genital warts.

2. If you are female, the results of your Pap test are abnormal, and you screen positive for HPV.

There are more than 100 types of HPV, most of which cause few issues and generally clear up within a year or two. But at least 14 types of HPV are known to cause cancer, with cancer of the cervix—the end of the uterus that provides a passage between the uterus and the vagina—being the most common cancer related to HPV. Almost all cervical cancer cases are due to an HPV infection. In addition to cervical cancer, anal, penile and oropharyngeal (cancer of the middle part of the throat behind the tongue) cancers have been linked to high-risk strains of HPV.

Physical effects of HPV

Warts are the most common sign of HPV, including common warts and/or genital warts.

Genital warts can appear within weeks after contact with an infected partner. On women, they usually appear on the vulva, while they show up on a man's penis and scrotum. They typically look like small bumps or groups of bumps in the genital area, and they may vary in size and be raised, flat or cauliflower-shaped.

If you have warts you believe may be related to HPV, you should see your doctor about treatment as soon as possible. In addition, you should mind the following guidelines:

• Wash your hands immediately after touching your warts.
• Contact your doctor if your warts do not improve after a few weeks of treatment.
• Don’t pick at, pull, cut or scrape the warts.
• Try not to let other parts of the body come in contact with the warts.

Two types of HPV—6 and 11—cause most cases of genital warts, but they are described as low-risk strains because they don’t lead to cancer. The high-risk strains are 16 and 18, which can cause cervical cancer in women. Cervical cancer may take five to 20 years to develop, and many people, until it is in its advanced stages, don't experience symptoms, which include: vaginal pain; bleeding between periods; vaginal bleeding after sex; pelvic pain during sex; bloody, watery and foul-smelling vaginal discharge; weight loss, fatigue or a single swollen leg.

Other types of cancer associated with HPV include:

• Penile cancer (cancer of the penis): Symptoms include changes in the skin color of the penis, painful sores on the penis and small crusty bumps on the penis.
• Vulvar cancer (cancer of the vulva): Symptoms include changes in the color and thickness of the skin of the vulva or a lump in the area. Chronic pain and itching are other common symptoms.
• Anal cancer (cancer of the anus): Symptoms include bleeding from the anus or rectum, pain in the anal area, itching, changes in bowel habits and unusual discharges from the anus.
• Throat cancer: Symptoms include sore throat, ear pain, coughing, difficulty swallowing or breathing, a lump or sore that does not heal and weight loss.

Psychological effects

Another part of living with HPV is accepting its effects on your mental health. Shame, anger, anxiety and depression are some of the feelings frequently reported by people following an HPV diagnosis. Research indicates that concerns over sexual transmission contribute to these feelings, as does the difficulty in knowing where an infection might have come from. Testing for HPV and waiting for results can also cause anxiety.

In a study published in BMC Women’s Health, women spoke about fears of testing HPV-positive and the potential implications for their health and relationships. They discussed feelings of anger and blame within relationships if they tested positive, including over how the virus was contracted. They also expressed concern and embarrassment regarding talking to a partner about being HPV tested or revealing they had the virus, due to its sexually transmittable nature.

Another study from the American Academy of Pediatrics found that stress has a strong effect on a woman’s ability to fight HPV. Every six months, the 333 participants were tested for HPV. In the 11th year of the study, the women were asked to fill out a questionnaire about their stress levels, coping strategies and whether they suffered from depression. The researchers found that women who smoked, did drugs or drank alcohol as a means of coping with stress were more likely to still be infected with HPV. The women who said they were depressed or had high levels of stress also still had an active infection.

Sex & relationships

Sexually active partners generally share HPV until the immune response suppresses the infection. When the infection goes away, the immune system will acknowledge that type of strain going forward and prevent a new infection of the same type from happening again. However, becoming immune to one type may not protect you from getting the virus again if you are exposed to another type.

If you have HPV, you need to let your partner know. Communication is key in a relationship that involves the human papillomavirus. If you are concerned about fielding questions from your partner, you may want to invite them to join you at one of your doctor’s appointments, so your physician can help explain HPV to them.

Don’t feel the need to apologize for your HPV diagnosis. Remember that it’s an extremely common STI. Having HPV does not mean you did anything wrong. One of the best ways to cope is to develop a thorough understanding of the virus. Make sure you learn as much as you can from reputable sources and avoid myths and misinformation. Direct your partner to trustworthy sources, too.

It might take some time for your partner to process the news once you tell them, but an HPV diagnosis should not mean your relationship is over. HPV is treatable, and many people living with it continue to have happy, healthy sex lives and relationships.

Managing with HPV

The types of HPV that cause cancer and genital warts can be managed but not cured. Genital warts can be removed, but that does not eradicate the virus from the body. HPV vaccines can reduce the risk of HPV in young people, but they cannot neutralize the virus in people that already have HPV.

If you are living with HPV, the following tips will help you lead a healthy and happy life:

• Get checked regularly.
• Use condoms when you have sex.
• Participate in a monogamous relationship with clear communication.
• Exercise, eat a well-balanced diet, keep alcohol consumption in moderation and refrain from smoking.
• Keep your stress level in check, as elevated stress can weaken the immune system and reactivate HPV.
• Recommend the HPV vaccine to male and female friends and family from ages 9 to 26.

If you have been diagnosed with HPV, know that you are one of millions of people managing this virus, and that 4 out of 5 people who are sexually active will have it at some point. And remember that most infections clear out of the body by themselves.

While the risk of cancer is low, it should still be taken seriously. Don’t ignore it after your diagnosis. Your doctor may want you to get a repeat Pap test every six months until the infection is gone, which could take up to two years. Keep in mind that the vast majority of women who get regular Pap smears and follow the doctor’s orders will not develop cervical cancer. If you have further questions about living with HPV, speak with your doctor as soon as you can.