Your Sex Life When Living With Genital Warts

Key Points

• Ninety percent of genital warts are caused by two strains of the world's leading STI: human papillomavirus (HPV).
• Genital warts generally appear six to 10 months after an HPV infection, and a flare-up may last several months before disappearing.
• It may take months or years for your body to clear an HPV infection, during which time you may experience one or more flare-ups of genital warts.

Have you spotted a fleshy growth or bump on or near your genitals?

Also known as anogenital warts or condyloma acuminatum, genital warts are a common skin condition named for the body areas on which they commonly appear.

"In women, genital warts typically involve the area around the opening of the vagina. However, they may also occur inside the vagina and on the cervix," said Aldene Zeno, M.D., a Los Angeles-based urogynecologist and women's health specialist and the founder of Essence Health and Urogynecology. "In men, they tend to occur on the penile shaft or under the foreskin."

Up to 90 percent of genital warts are caused by two strains of the world's leading sexually transmitted infection (STI), the human papillomavirus (HPV), according to the Centers for Disease Control and Prevention (CDC).

Most HPV infections are contracted through sexual contact, which includes but isn't limited to penetrative sex, according to Daniel Atkinson, M.D., a United Kingdom-based physician specializing in sexual and reproductive health.

"Anyone can get genital warts if they've had skin-to-skin contact with someone who has a strain of HPV that causes them," said Atkinson, who is the general practice clinical lead at online healthcare provider Treated. "This could be through vaginal or anal sexual intercourse, sharing sex toys, or if HPV has spread to other areas of the body and there's been contact with the affected skin."

Genital warts generally appear six to 10 months after an HPV infection. A flare-up may last several months before disappearing, during which time warts may change their shape and color.

"When they do appear, you'll first notice them as a slight skin color change, which then develops into a raised or flat growth," Atkinson said. "They can then spread and grow if left untreated, if you scratch them or if you have a weakened immune system. Your immune system will fight the wart cells, and after a time, the warts may clear up, but you'll usually need a topical wart treatment to help this process along."

Myths and misconceptions about genital warts

Genital warts are often misunderstood, and stigmas and misconceptions about the common skin condition abound. Let's debunk the four most common misconceptions Zeno and Atkinson hear from their patients.

Myth: I can't get genital warts if I'm monogamous. If I do, that means my partner must be cheating on me.

"Even though genital warts may be more common among people with multiple sexual partners and those who do not use barrier methods, it is possible to get genital warts in a monogamous relationship," Zeno said. "Someone may have been previously exposed, and despite not having symptoms, they can transmit it to you. The virus can stay dormant in the tissues, sometimes—though not commonly—for years even, without someone having symptoms."

Myth: I can't get warts from oral sex.

"Lots of people don't realize that HPV can be transmitted through oral sex," Atkinson said. "HPV can cause warts in and around the mouth, so if you or your partner is prone to genital warts, you should avoid oral sex if either of you is having a flare."

Myth: Genital warts are a sign of cancer.

"Because they're caused by the same group of viruses, there's some confusion that genital warts are a sign of cancer. This isn't true, as warts are considered benign," Atkinson said. "The HPV strains that cause genital warts are not the same strains that cause cervical cancer."

Myth: If I have genital warts, I know I have HPV so I don't need testing.

"If you have genital warts, it's possible you might have picked up another strain of HPV that causes cervical cancer or another STI at the same time, so it's best to do a full checkup at a sexual health clinic," Atkinson said.

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How can you manage genital warts?

It may take months or years for your body to clear your HPV infection—you may experience one or more flare-ups of genital warts during this time—so incremental, healthy changes every day make a big difference in managing your genital warts long-term.

"Being proactive in your lifestyle and health can help you keep on top of HPV and prevent you from getting warts again," Atkinson said.

He shared a few healthy techniques that may prevent future flares of genital warts and help you best manage the condition over time:

• Avoid sex while you're using medication for genital warts.
• Get vaccinated for HPV. The CDC recommends all children receive the HPV vaccination at age 11 or 12, as well as adults younger than 27 who didn't receive the vaccine as children. If you're 27 to 45, it's recommended you speak with your doctor about the vaccine's potential benefits, as many adults may have been previously exposed to multiple strains of HPV by this age.
• Practice safe sex. "Using condoms when having sex can help stop the spread—but not always," Atkinson said. "If your warts are in a place not protected by a condom, it's best to avoid contact."
• Protect your immune system. Atkinson recommended getting plenty of sleep, exercising, reducing alcohol and not smoking.
• Get regular checkups. This is especially true when you're sexually active.
• Wash or cover sex toys with a barrier. If you're going to share them with a partner, this is vital.

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Do genital warts mean I can't have sex?

Just because you've been diagnosed with genital warts does not mean you have to remain celibate. Atkinson acknowledged that the condition has been linked to sexual dysfunction and anxiety, but he noted that many people with genital warts continue to enjoy sex. All it requires is a willingness to communicate openly and honestly with your doctor and your sexual partners.

"Some studies have shown a small increase in experiencing sexual dysfunction among both women and men with genital warts," Atkinson said. "This can be due to anxiety, stress or embarrassment due to the nature of genital warts. If you're honest and have good, open communication with your sexual partner, this can help with any anxieties you might have before sex."

Talk to a sexual health professional for answers to any questions or concerns you may have.

He added that conscientiousness around the timing of the conversation and a willingness to open up about your sexual history may lend themselves to a productive conversation when you tell your partner you have genital warts.

"If you suspect you have HPV or have genital warts, it's important you tell your partner before any intimate contact to stop the spread of the virus," Atkinson said. "Being honest with your sexual partner about your sexual history might seem like a daunting prospect, but being open will make things easier in the long run. Most people tend to be more understanding than you'd think."

Prepare yourself for this important conversation with your partner by arming yourself with all the medical knowledge available.

"First, confirm your genital warts diagnosis with your clinician and become informed about the nature of the infection, as well as the treatment and expected timeline for your recovery," Zeno said. "That way, hopefully, you will feel more empowered to discuss this benign, common condition without judgment. Emphasize that it may be a good time for your partner to have a pelvic health checkup."

No matter what reaction you encounter from your partner, Atkinson said, keep in mind that you are not alone in having genital warts. The skin condition says nothing about who you are or the choices you have made.

"Genital warts are a very common STI," Atkinson said. "It's estimated that over half of sexually active people, 15 to 49 years old, have had genital warts and at least 80 percent of all adults will be infected with an HPV infection at some point."

Genital warts present no reason to be embarrassed or ashamed talking about it.

"Having genital warts doesn't necessarily mean someone has had lots of unprotected sex," Atkinson said. "It's just a very easily contagious infection."