How are genital warts diagnosed?

Genital warts are fairly common; approximately 500,000 new cases of genital warts are diagnosed each year in the U.S. A typical appearance of a genital wart may prompt the physician to treat without further testing, especially in someone who has had prior outbreaks of genital warts. Genital warts usually appear as small, fleshy, raised bumps, but they sometimes can be extensive and have a cauliflower-like appearance. They may occur on any sexually-exposed area. Over 90% of genital warts are caused by HPV-6 and HPV-11, the so-called "low risk" HPV types.

What HPV is...

Human papilloma viruses are known as HPV. They can affect the skin and the moist membranes that line parts of the body, including

* The lining of the mouth and throat
* The cervix
* The anus

There are more than 100 different types (or ‘strains’) of human papilloma virus (HPV). Each type has a different number. HPV is common. About 3 out of 4 people (75%) have the virus at some time in their lives. For most people it causes no symptoms and goes away on its own. It is much more common in young people, probably because we develop immunity to the virus as we get older.Some types of HPV can cause changes in the cells of the cervix or the lining of the mouth and throat. They are known as high risk HPVs. Doctors call these changes in cells ‘dysplasia’. The changed cells have an increased risk of becoming cancerous.Other types of HPV can cause warts and verrucas. These types of HPV are sometimes called the ‘wart virus’ or ‘genital wart virus’ and they include types 6 and 11. Warts and verrucas are most common on the hands and feet, in the genital area and around the anus. But they can be on any part of the body. Types of HPV that cause warts and verrucas do not usually cause cell changes that may develop into cancer. They are called low risk HPVs.

HPV and cervical cancer

Some types of HPV can increase the risk of developing cervical cancer, particularly types 16, 18, 31, 33 and 45. They are called high risk types. Almost all women with cervical cancer have at least one of these types of HPV in the cells of their cervix.Of the different types of HPV, types 16 and 18 cause about 7 out of 10 (70%) cancers of the cervix. The other types cause most of the remaining 30% of cervical cancers. Do remember that most women with high risk HPV don’t develop cervical cancer. We know from research that other factors affect whether you develop a cancer, such as how well your immune system is working or whether you smoke. Women who smoke and have a high risk type of HPV infection are more likely to go on to get cervical cancer.Remember that regular cervical screening will pick up abnormal cervical cells before they become cancerous. So even if you have HPV and smoke, you can prevent cervical cancer if you go for screening when you are invited.People with low immunity also have an increased risk of cervical cancer. Your immunity may be low because you take certain medicines for another condition, or because you have an illness that affects your immunity, such as HIV AIDS. If you have low immunity, it is particularly important to have regular cervical screening.

How you get HPV

Types of HPV that affect the skin can be passed on by skin contact with an affected person. The types of HPV that affect the mouth and throat can be passed on through kissing.Genital HPV is usually spread through intimate, skin to skin, contact during sex.You can have the genital HPV virus for years and not have any sign of it. So it isn’t unusual to have a long term partner and then be told you have the virus after medical tests such as cervical screening. Many people then worry that their partner has been unfaithful, or will think they have been unfaithful. But finding out you have HPV doesn’t necessarily mean that you or your partner have been unfaithful. There is no way of knowing how long you have had the virus. It could be weeks, months or years.

HPV Virus in Men

Much of the information about HPV virus (human papillomavirus) centers on women, since having the virus increases their risk of getting cervical cancer. But HPV virus in men can cause health problems, too. So it's important for men to understand how to reduce the risks of HPV infection. It can increase a man's risk of getting genital cancers, although these cancers are not common. HPV can also cause genital warts in men, just as in women.More than half of men who are sexually active in the United States will have HPV at some time in their life. Often, a man will clear the virus on his own, with no health problems.

Risks of HPV Virus in Men

Some of the 30 or so types of HPV associated with genital cancers can lead to cancer of the anus or penis in men. Both of these cancer types are rare. In those with a healthy immune system, they are even rarer. About 1,530 men in the U.S. were diagnosed with cancer of the penis in 2006, according to American Cancer Society estimates. About 1,910 men got a diagnosis of anal cancer.The risk of anal cancer is about 17 times higher in sexually active gay and bisexual men than in men who have sex only with women. Men who have HIV (human immunodeficiency virus) are also at higher risk of getting this cancer.Other types of HPV virus rarely cause cancer in men, but they do cause genital warts. At a given point in time, about 1% of sexually active men in the U.S. will have genital warts.

Male HPV: The Symptoms

The types of high-risk HPV that can cause cancer rarely present any symptoms in men or in women. Genital warts are the first symptom you may see with low-risk HPV strains that cause warts but not cancer.

Tests for HPV Virus in Men

To diagnose genital warts in men, the doctor will visually check a man's genital area to see if warts are present. Some doctors will apply a vinegar solution to help identify warts that aren't raised and visible. But the test is not foolproof. Sometimes normal skin is mistakenly identified as a wart.There is no routine test for men to check for high-risk HPV strains that can cause cancer. However, some doctors are urging anal Pap tests for gay and bisexual men, who are at higher risk of anal cancer caused by HPV. In an anal Pap test, the doctor collects cells from the anus, and then has them checked for abnormalities in a lab.

Treatments for HPV

There is no treatment for asymptomatic HPV infection. Instead, doctors treat the health problems that are caused by the HPV virus.When genital warts appear, a variety of treatments can be used. The patient can apply prescription creams at home. Or a doctor can surgically remove or freeze off the warts.Early treatment of warts is discouraged by some doctors because genital warts can go away on their own. It can also take time for all warts to appear. So a person who treats warts as soon as they appear may need another treatment later on.Anal cancer can be treated with radiation, chemotherapy, and surgery. The specific treatments depend on the stage of cancer - how big the tumor is and how far the cancer has spread.

HPV Vaccine for Men?

The HPV vaccine Gardasil, approved for use in women in 2006, is not yet approved for men. Studies are still being done to determine if the vaccine works in males. Eventually, public health experts say, boys and men may be vaccinated.

How to Manage HPV in a Relationship

If a man's long-term sexual partner has HPV, chances are good HPV transmission has already occurred and he also has it. HPV in men may clear from the body more easily than in women. Women, in general, often clear the virus in two years or less.The HPV types associated with cervical cancer usually do not cause health problems for a heterosexual man having sex with an HPV-infected woman.If a partner has HPV, it does not necessarily mean they have had sex with someone else recently. The virus can lay dormant in the body for years without causing noticeable symptoms.

How to Prevent Transmission of HPV

Abstinence is the only sure way to prevent HPV transmission. Risk of transmission can be lowered if a person has sex only with one person who is not infected and who is monogamous.To lower the risk of HPV transmission, men can also limit the number of sex partners and pick partners who have had few or no partners in the past.Condoms can provide some protection against HPV transmission. But they aren't 100% effective, since HPV is transmitted primarily by skin-to-skin contact. The virus can still infect the skin uncovered by the condom.In a recent study of young women who had just become sexually active, those whose partners used a condom each time they had sex were 70% less likely to get an HPV infection than were women whose partners used a condom less than 5% of the time.