Human papillomavirus (HPV) is a very common virus that can infect both males and females. There are over 100 types of HPV, with around 40 types that can infect the genital areas. HPV is generally transmitted through sexual contact. Many people who become infected with HPV do not experience any symptoms or health problems. However, some HPV types can cause changes in the body that lead to health issues.
Does HPV always cause symptoms?
No, HPV does not always cause noticeable symptoms. In fact, the majority of people infected with HPV have no symptoms at all. Estimates indicate that around 70% of HPV infections clear up on their own within 1-2 years without causing any health problems. This is because your immune system is often able to fight off HPV naturally.
However, sometimes HPV infections persist and can lead to cell changes in the body over time. HPV types that persist are more likely to cause symptoms. But even with persistent infection, symptoms may not appear for years or even decades after initial infection.
What are the symptoms of HPV?
There are a few main ways that HPV symptoms can appear:
Genital warts
Some types of HPV cause genital warts to grow in the anal and genital areas. Genital warts appear as small bumps or groups of bumps in the genital region. They are usually painless but can cause itching. Genital warts are a very visible sign of HPV infection. However, not everyone with genital HPV will develop genital warts.
Cell changes
Other HPV types can cause changes to the cells in the body over many years or decades. This includes cell changes that can lead to cancer. For example, some HPV types are linked to cancers of the cervix, vagina, vulva, penis, anus, mouth, and throat.
These cell changes themselves do not cause symptoms in the early stages. It is only later on when the abnormal cell growth becomes more advanced that symptoms may appear. For cancers linked to HPV, this includes symptoms like:
- Abnormal vaginal bleeding between periods or after sex
- Bleeding or pain with bowel movements
- Sores or growths in the genital or anal areas
- Chronic hoarseness or sore throat
- Unexplained weight loss
- Fatigue
Keep in mind that these types of cancer symptoms only appear once the cell changes have progressed to serious abnormalities or cancer. They do not occur during initial HPV infection or from mild cell changes.
Does having HPV always mean you will feel sick?
No, having HPV does not necessarily mean you will feel sick or unwell. As mentioned earlier, many people have HPV infections that their immune system clears without any symptoms. And even those with persistent HPV infections can go years or decades without any signs or symptoms before any abnormalities appear.
However, some people do experience symptoms either from genital warts or the later stages of cell changes that lead to cancer. The types of symptoms that can occur include:
Genital warts symptoms
- Itching, burning or tenderness around visible warts
- Pain during sex
- Bleeding after sex
- Wart odor
- Discomfort when urinating if warts are present near urethra opening
Cancer symptoms
- Abnormal vaginal bleeding between periods or after intercourse
- Watery or bloody discharge from the vagina
- Pain during sex
- Pelvic or back pain
- Bleeding from the rectum
- Painful bowel movements
- Difficulty swallowing
- Chronic sore throat or hoarseness
- Unexplained weight loss
- Fatigue
- Enlarged lymph nodes
Keep in mind these types of cancer symptoms only tend to appear once precancerous cell changes become more serious. Early mild cell changes from HPV do not cause symptoms.
What factors affect whether HPV causes symptoms?
Several factors influence whether an HPV infection will cause noticeable symptoms or health problems:
HPV type
Only certain HPV types lead to health issues. HPV types 6 and 11 cause over 90% of all genital warts cases. And about a dozen HPV types are considered high-risk for leading to cancers. Other HPV types have not been linked to any visible symptoms or cell abnormalities.
Immune system health
A strong immune system greatly lowers your risk of having persistent HPV that leads to symptoms. People with weakened immunity from conditions like HIV are at higher risk of symptomatic HPV infections.
Age
Younger people’s immune systems are better able to clear acute HPV infections. Persistent infections and cell changes are more likely to happen as people get older.
Overall health
Those with other health conditions or lifestyle factors like smoking that can impair immunity may have a harder time clearing HPV. This makes them more prone to persistent HPV that leads to symptoms.
HPV screening
Getting regular gynecological exams and Pap smears in women and anal Pap smears in some men can detect precancerous cell changes early before they become symptomatic. Early detection and treatment helps prevent progression to more serious issues.
How long can HPV infections cause symptoms?
For those who do experience symptoms from HPV, how long symptoms last depends on the specific symptom:
Genital warts
The time genital warts are present can vary. Without treatment, visible warts may go away on their own or persist for years at a time. They may also reappear later after disappearing.
With treatment, genital warts can be removed through methods like medications, surgery, freezing or burning. Often genital warts can be successfully removed, but there is still a chance of recurrence.
Cell changes
Abnormal cell changes from HPV develop slowly over many years, often decades. Mild cell changes often don’t lead to any symptoms at first. It’s only once they become more serious that symptoms of precancer or cancer appear.
Early detection and treatment of precancerous changes can prevent progression to cancer. But if cancer does develop, symptoms may be ongoing with treatment until it is cured.
What health issues are caused by HPV?
The main health problems caused by HPV include:
1. Genital warts
Genital warts affect around 1% of sexually active adults. They appear as small bumps in the moist tissues of the genitals. They can be small or cluster together to form larger warts. While benign, genital warts can cause discomfort and also emotional distress.
2. Cancers
About a dozen HPV types are considered high-risk for leading to cancers over time when they persist. These include:
- Cervical cancer
- Anal cancer
- Vulvar cancer
- Vaginal cancer
- Penile cancer
- Oropharyngeal cancers (mouth and throat)
Cervical cancer is the most common HPV-related cancer. HPV is linked to over 90% of anal and cervical cancers, about 70% of vaginal and vulvar cancers, and 60% of penile cancers.
HPV cancers often don’t have symptoms until the late stages. That’s why regular cervical and anal cancer screening is important to detect precancerous changes before cancer develops.
3. Recurrent respiratory papillomatosis (RRP)
RRP is a rare condition where wart-like growths caused by HPV develop in the airways. This can cause breathing problems or changes in voice. RRP often requires ongoing surgery to remove growths as they reoccur.
Who is most at risk of HPV health issues?
While HPV is very common, only a small percentage of those infected experience significant health problems. Risk factors that make health issues from HPV more likely include:
- Weakened immune system (e.g. HIV infection)
- Smoking
- Multiple sexual partners
- Starting sexual activity at younger age
- Older age (over 30)
- Other genital infections
- Long-term oral contraceptive use
The populations most susceptible to health issues from HPV are:
- Younger women – at high risk of developing cervical cell changes
- Younger men – at high risk of genital warts
- Older women – at higher risk of cervical, vulvar, and vaginal cancer
- Men having sex with men – increased anal cancer risk
- People with HIV or other immune deficiencies
How is HPV diagnosed?
HPV testing is recommended along with a Pap smear for cervical cancer screening in women starting at age 30. HPV DNA testing detects HPV infection, but not what type. A positive HPV test means you may have a type that can cause cancer. Further testing like a colposcopy would be done.
There is no approved HPV test for men. An anal Pap smear is sometimes used to check for anal cancer risk in men who have sex with men.
Genital warts are diagnosed by visual inspection. Cancers are diagnosed by exams and imaging tests like scopes inserted in the body.
Is HPV the only cause of these symptoms?
No, while HPV is a major cause of genital warts and cervical cancer, other factors can also sometimes be involved.
Genital warts – Other strains of the human papillomavirus not included in the HPV types can also rarely cause genital warts. Very rarely, genital warts may be caused by other viruses including the virus that causes molluscum contagiosum.
Cervical cancer – Most cases are linked to HPV, but not all. Other potential causes include having a weakened immune system, smoking, using oral contraceptives for five or more years, giving birth to three or more children, and exposure to the drug DES.
Other cancers – HPV is the leading cause of many cancers (vulvar, vaginal, penile, anal, oropharyngeal). But some cases can also be caused by other factors like poor genital hygiene, having multiple sex partners, smoking, or immune system problems.
Can HPV symptoms appear without sexual contact?
HPV is mainly spread through sexual contact with an infected partner. However, HPV symptoms like genital warts and cancers rarely may occur without having sex.
Non-sexual ways HPV can spread include:
- Mother to newborn during childbirth
- Hand to genital contact
- Spread between close household contacts
- Spread through surfaces like bathroom fixtures or sex toys
So it is possible, though rare, to develop HPV-related health issues without sexual contact as the virus can spread through other kinds of close contact.
How is HPV treated?
There is no treatment for the HPV virus itself. However, the problems it causes can be treated:
- Genital warts – Treated with prescription medications, surgery, freezing, or burning.
- Cervical dysplasia – Mild changes often clear on their own. More advanced changes can be monitored or treated with surgery.
- Cancers – Treated with surgery, chemotherapy, radiation, or immunotherapy based on the cancer type and stage.
Even with treatment for symptoms, HPV can sometimes persist and cause recurring issues like genital warts or precancerous cell changes.
What helps prevent or manage HPV?
Steps that can help lower your risk of symptomatic HPV or detect issues early include:
- HPV vaccination – Prevents infection from up to 9 high-risk HPV types.
- Condom use – Provides some protection against HPV transmission.
- Limiting sexual partners – Reduces chances of exposure to HPV.
- Don’t smoke – Smoking impairs immunity against HPV.
- Pap smears – Allow early detection and treatment of cervical cell changes.
- HPV DNA testing – Identifies high-risk HPV so any cell changes can be monitored.
- Anal Pap smears – Can detect anal cancer precursors in high-risk groups like men who have sex with men.
Even with precautions, HPV exposure is hard to avoid completely. But steps like screening/testing allow early detection before serious health problems can develop.
Conclusion
Many people infected with HPV never experience any health issues from it. But in some, HPV can cause symptoms like genital warts and cell changes that may progress to cancer. How likely you are to feel unwell depends on the HPV type, your own immune health, and screening/testing. Getting vaccinated, using protection, and undergoing regular screening exams can help minimize your risk of HPV health problems.