A Woman's Guide to HPV: When the Virus Doesn't Go Away

The human papillomavirus (HPV) is highly contagious: Nearly 80 percent of men and women who are sexually active will become infected with at least one strain of HPV in their lifetime. On the bright side, though, most forms of HPV will clear on their own—in fact, you might have no idea you've ever been infected with HPV unless you had signs of genital warts or an abnormal pap smear.

But HPV doesn't always go away so easily. If your HPV is lingering, get the facts so you know what to expect.

The type of HPV you have will affect your treatment

It's important to understand there are different strains of HPV. Some will do little else to your health besides producing genital warts; others can cause cancer.

If you find out you have a strain of HPV that causes genital warts and your body doesn't naturally clear them on its own, you may need to see your doctor so those warts can be treated or removed completely. In 70 to 80 percent of cases of HPV genital warts, there's no recurrence. However, if genital warts do recur, you'll typically notice them again within a few months, but each case is different so keep a close eye regardless. Any persistent genital warts can always be treated again.

However, if you have an HPV strain that can lead to cancer, there won't be a physical warning, like experiencing genital warts. Instead, you'll learn of an infection through a Pap test or HPV test; in women, this is done at the cervix, but for men, no HPV test has yet been approved. You can, however, still receive an anal Pap test regardless of gender.

If a woman's Pap results come back abnormal, she will need to take further steps.

Additional pap smears

If your results indicate low-grade squamous intraepithelial lesions (LSILs)—usually caused by HPV—your doctor might simply want to monitor the cells through additional Pap smears over time.

It is possible to receive an abnormal result on a Pap test even if you don't have HPV, so a second test if that is the case is typically the first course of action. Your doctor might schedule a new test within a few weeks or months.

If abnormal results continue or worsen, you'll move on to additional treatment methods.

Colposcopy

A colposcopy is a procedure in which your doctor uses a speculum to open up the vaginal passage and a colposcope to view your cervix. The colposcope has both a light and a magnifying glass so the doctor can have a clear view of your cervix. Photographs may also be taken during the colposcopy for analysis.

This procedure can typically be done in an exam room at your doctor's office. If a biopsy of your cervix is needed, your physician will remove some tissue from it to be examined at a laboratory. You can expect the biopsy procedure to pinch or feel uncomfortable for a few seconds.

HPV cervical treatments

If the colposcopy comes back positive for HPV, particularly with high-grade cells, your doctor will discuss a few options with you, including:

• LEEP (loop electrosurgical excision procedure) to remove the infected areas of the cervix
• Cryosurgery to freeze and remove the infected areas
• Surgical removal of the infected areas
• Cold-knife conization to remove a cone-shaped sliver of the cervix

Get regular screenings

Courses of treatment for persistent HPV vary greatly depending on the grade and strain of the virus you carry. If tests reveal abnormal cells in your cervix, it's important to continue regular Pap smear tests to monitor your status and detect any precancerous cells that require immediate treatment.