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Human papillomavirus (HPV) refers to a group of viruses.

More than 100 types of HPV exist, and at least 40 of them are spread through sexual contact. There are both lower and higher risk types.

Although HPV typically doesn’t cause any symptoms, some types can cause genital warts. Some types can also lead to certain cancers if left untreated.

Read on to learn about the vaccine and other ways to reduce your risk, how to get a diagnosis, what to expect from treatment, and more.

HPV is the most common sexually transmitted infection (STI) in the United States.

According to the Centers for Disease Control and Prevention (CDC), approximately 42 million Americans are living with an active HPV infection. As many as 13 million Americans newly acquire HPV each year.

Most people who are sexually active — regardless of anatomy or gender — and are unvaccinated will contract at least one form of HPV in their lifetime.

HPV is a virus, like the common cold or flu, that has many different variations.

Some forms of HPV can cause papillomas (warts), which is how the virus got its name.

HPV is primarily transmitted through skin-to-skin contact. In most cases, this refers to genital touching or intercourse.

This includes:

  • vulva to vulva
  • vulva to penis
  • vagina to penis
  • penis to anus
  • fingers to vagina
  • fingers to penis
  • fingers to anus

HPV can also be transmitted through oral sex. This includes:

  • mouth to vulva
  • mouth to vagina
  • mouth to penis
  • mouth to testicles
  • mouth to perineum (between the genitals and anus)
  • mouth to anus

Generally speaking, any genital or anal contact can transmit HPV, even if no symptoms are present.

In rare cases, HPV can be transmitted from a birthing parent to a baby during vaginal delivery.

Overall, it’s unlikely that genital HPV — with or without warts — will cause complications during pregnancy or delivery.

HPV affects everyone. However, certain situations only affect individuals who have a penis.

For example, those who act as the receiving partner in penis-in-anus sex are more likely to develop HPV than those who have penis-in-vagina sex only.

Check out our comprehensive guide to learn more about HPV in penis owners.

HPV is often asymptomatic. Because of this, most people don’t know that they’ve developed the virus.

In many cases, the virus will clear up spontaneously, so you may never know that you experienced it at all.

When symptoms do occur, they usually appear in the form of genital warts. You may notice a single bump or a group of bumps.

These bumps may be:

  • itchy
  • the color of your skin or white
  • raised or flat
  • cauliflower-shaped
  • about the size of a pin head (1 millimeter) to about the size of a cheerio (1 centimeter)

Not all genital bumps are warts, so it’s important to see a doctor or other healthcare professional (HCP) for diagnosis. They can determine the underlying cause and advise you on any next steps.

The only sure-fire way to know if you’ve developed HPV is to consult a doctor or other HCP.

If you have warts or other genital sores, a clinician may use a scalpel to take a small skin cell sample (biopsy) from the affected area.

If you aren’t experiencing symptoms, the diagnostic process typically begins with an abnormal Pap smear or Pap test result.

A clinician may order a second Pap smear to confirm the original results, or move straight to a cervical HPV test when this happens.

To do this, they’ll collect another cervical cell sample — only this time, they’ll have a lab technician test for the presence of HPV.

If the technician detects a type that may be cancerous, a clinician may perform a colposcopy to look for lesions and other abnormalities on the cervix.

What about oral or anal HPV?

There isn’t a specific test available to test for oral HPV, but a doctor or other HCP can perform a biopsy on any lesions that appear in the mouth or throat to determine if they’re cancerous.

An HCP is unlikely to perform an anal Pap smear unless you develop anal warts or other unusual symptoms.

A Pap smear doesn’t test for HPV. It can only detect the presence of abnormal cells.

In many cases, an abnormal result stems from:

  • a poor tissue sample
  • current spotting or menstruation
  • recent use of (often unnecessary) feminine hygiene products
  • recent penis-in-vagina sex

An abnormal result can also signify other STIs, including genital herpes and trichomoniasis.

An HPV test, on the other hand, can detect the presence of HPV. It can also identify which strains are present.

No, the HPV test isn’t usually included in a standard STI screening.

If you’re under the age of 30, a clinician typically won’t recommend an HPV test unless you have an unusual Pap smear result.

If you’re between the age of 30 and 65, clinicians recommend the following:

  • Pap test every 3 years
  • HPV test every 5 years
  • Pap and HPV test together every 5 years

HPV doesn’t have a cure, but many types will go away on their own.

According to the CDC, more than 90 percent of new HPV infections, including those caused by higher risk strains, clear or become undetectable within 2 years of contracting the virus.

In many cases, the virus clears or becomes undetectable within 6 months.

If the virus doesn’t clear, a clinician will work with you to treat any cervical cell changes or HPV-related warts.

If you have genital warts, chances are they’ll go away on their own.

If they don’t, a doctor or other HCP may recommend one or more of the following:

  • imiquimod (Aldara), a topical cream that boosts your immune system’s ability to fight off the infection
  • sinecatechins (Veregen), a topical cream that treats genital and anal warts
  • podophyllin and podofilox (Condylox), a topical plant-based resin that destroys genital wart tissue
  • trichloroacetic acid (TCA), a chemical treatment that burns off internal and external genital warts

They may recommend surgery to remove warts that are larger or unresponsive to medication. This can include:

If HPV has caused cancer in the body, the recommended treatment will depend on how much cancer has spread. For example, if the cancer is in its earliest stages, they may be able to remove the cancerous lesion.

Chemotherapy or radiation may also be used to kill the cancerous cells.

In some cases, genital warts that are left untreated will go away on their own. In others, the warts may stay the same or grow in size or number.

If a clinician detects abnormal cells, you should follow their recommendations for additional testing or treatment to remove the cells.

Changes that are left unmonitored or untreated may become cancerous.

Having HPV won’t affect your ability to conceive. However, certain treatments for HPV might.

This includes:

These procedures are used to remove abnormal tissue. Cell removal can change your cervical mucus production or cause the cervical opening to narrow (stenosis).

These changes may make it more difficult for sperm to fertilize an egg.

If you’re already pregnant, HPV shouldn’t affect your pregnancy. Transmitting the virus or genital warts is unlikely during pregnancy or delivery.

In rare cases, if genital warts are large or widely spread, they may block the vaginal canal or otherwise complicate a vaginal delivery.

If this happens, your clinician will likely recommend a cesarean delivery.

Having HPV doesn’t mean you’ll develop cancer. Often, the condition will clear without ever causing genital warts or other complications.

If a clinician detects abnormal cells, they can perform an HPV test to determine whether you developed HPV and, if you have, whether it’s a higher risk strain.

Data from 2014 to 2018 suggests that approximately 46,143 HPV-related cancers occur in the United States each year. Of these, almost 26,000 occurred among vulva owners.

Researchers found that cervical cancer is the most common HPV-related cancer among individuals who have a vulva and vagina.

Yes, and this can happen in several ways. For example:

  • You may have multiple strains of HPV at once.
  • You may clear one type of HPV and develop the same type later on.
  • You may clear one type of HPV and develop a different type later on.

It’s important to note that clearing the virus once without treatment doesn’t mean you’ll be able to do so a second time.

Your body may respond to the same strain differently at different times in your life.

To help reduce your risk of contracting HPV, you can:

  • Get the HPV vaccine. The HPV vaccine helps prevent strains known to cause warts or become cancerous. Although it’s most often recommended for adolescents who haven’t engaged in sexual activity, anyone of any age can benefit from the HPV vaccine.
  • Use a condom or other barrier method correctly and consistently. Condoms and other barrier methods don’t provide complete protection against HPV and other STIs, but correct use during oral, vaginal, and anal sex can dramatically decrease your risk.
  • Avoid douching. Douching removes bacteria from the vagina that can help keep HPV and other STIs at bay.

The HPV vaccine helps prevent strains known to cause genital, anal, or oral warts and certain cancers.

The Food and Drug Administration (FDA) has approved three HPV vaccines:

  • Cervarix
  • Gardasil
  • Gardasil 9

While the FDA has approved all three, only Gardasil 9 (9vHPV) is distributed in the United States at this time. The vaccine involves a series of two or three shots administered over 6 months.

You must receive the full course of medication in order to fully benefit from the vaccine.

Most doctors recommend getting the HPV vaccine around age 11 or 12 or before becoming sexually active. However, you may still receive some benefits after becoming sexually active.

The FDA has approved the HPV vaccine for adults up to age 45.

If you’re over age 45 and wondering if you may benefit from the HPV vaccine, consult a doctor or other HCP.

Can the HPV vaccine protect against all strains?

The vaccine protects against HPV strains associated with warts and cancer.

Each of the three vaccine types provides different levels of protection:

  • Cervarix protects against HPV types 16 and 18.
  • Gardisil protects against HPV types 6, 11, 16, and 18.
  • Gardisil 9 protects against HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58.

HPV types 16 and 18 are responsible for approximately 70 percent of all cervical cancers.

HPV types 31, 33, 45, 52, and 58 are responsible for 20 percent of all cervical cancers.

HPV types 6 and 11 aren’t cancerous, but they can cause genital, anal, or oral warts.

Gardasil 9 protects against all higher risk HPV strains and is the only recommended HPV vaccine in the United States.

The vaccine plays an important role in preventing HPV, but it doesn’t protect against every possible strain. Using a condom with oral, vaginal, and anal sex can provide additional protection.

How do you get the HPV vaccine?

If you have a primary care doctor or other HCP, talk with them about the vaccine. The vaccine is also available at most health departments and health clinics.

The vaccine costs about $196 per dose, so it may cost as much as $588 to receive the full course of medication.

If you have health insurance, the vaccine is fully covered as preventive care until age 26.

If you’re over the age of 26 or without insurance, ask a clinician if they have any patient assistance programs available.

You may be able to get the vaccine at no cost or at a reduced cost.

Although HPV is usually asymptomatic, certain strains can cause warts or become cancerous. According to the CDC, the vaccine can prevent most HPV-related cancers from ever occurring.

If you have questions about HPV or getting vaccinated, talk with a healthcare professional. They can discuss your risk for developing HPV and confirm whether you were vaccinated earlier in life or if you could benefit from it now.