People who have sex tend to have a few things in common: They like to feel good, they’ve dealt with a sex stain or two in their lives, and they’ve been exposed to HPV, or human papillomavirus. Around 79 million people in the United States have HPV, making it the most common STI in the nation, according to the Centers for Disease Control and Prevention (CDC).
There are a few ways you might discover you have HPV (or that might make doctors pretty sure you have it). Maybe you went in for a routine Pap or HPV test and your doctor called with some unexpected results. Or perhaps you got the news after finding some unusual bumps around your vagina that turned out to be genital warts. Either way, an HPV diagnosis can lead to a slew of confusing questions: How did you get it? Why did you get it? Is it dangerous? And…wait. Does this mean you have to stop having sex for some undetermined period of time?
To give you some clarity, we asked a few HPV experts to answer these questions. The most important thing to remember as you read: Having HPV doesn’t mean you’re a bad person or somehow “tainted,” Kristina A. Butler, M.D., a gynecologic oncologist at the Mayo Clinic in Arizona, tells SELF. It simply means you have a communicable disease that literally millions of other people have, too. And, depending on the circumstances, it might not even change your sex life much. It all comes down to the specifics of your situation. Keep reading to see what we mean.
The ubiquity of HPV
“The only way to fully avoid HPV is to never be sexually active,” Grace Lau, M.D., a gynecologist who specializes in HPV at NYU Langone, tells SELF. Welp. As Dr. Lau explains and as you may relate to, that’s just not realistic for many people. But because HPV spreads through skin-to-skin contact during vaginal, oral, or anal sex with someone who has the infection—even if they don’t have any symptoms—it’s hard to fully protect yourself. Unlike STIs such as chlamydia and gonorrhea, you don’t need to come into contact with bodily fluids like vaginal secretions or semen in order to get HPV.
Using latex condoms and dental dams can reduce your risk, but the infection could be on a part of the genitals that these barriers don’t fully cover. There’s a good chance that some of your uncovered parts will touch some of your partner’s—that’s kind of how the whole thing works. There’s also the chance that one of you could touch the other’s genitals and then your own.
Along with HPV’s ability to pass through skin-to-skin contact, another reason it’s so prevalent is that it actually isn’t one virus at all. HPV is a group of more than 150 related viruses, according to the CDC. Each one gets a different number, which is called its HPV type or strain.
Unfortunately, while anyone can get HPV, not everyone can easily test for it. There is currently no HPV test specifically for people with penises approved by the Food and Drug Administration (FDA), and it’s not possible to perform any of the approved tests for HPV on people with penises. Right now, the only way people who have penises can get diagnosed with HPV is when genital warts show up around the penis, scrotum, anus, or groin, according to the Cleveland Clinic.
Even though HPV can cause cancer in body parts like the throat and anus, there’s not yet recommended routine screening for those areas, either, the CDC explains. Testing limitations are part of the reason why so many people with HPV don’t know they have it and may be passing it along to other people.
Dealing with an HPV diagnosis
We know this is easier said than done, but try not to freak out if you find out you have HPV. The vast majority of the time, HPV doesn’t cause any harm. When a person gets HPV, their body will produce antibodies that are often able to completely fight off the virus, Dr. Lau explains. Pretty cool, right?
There is currently no cure for HPV infections, so finding out you have it might feel a little anticlimactic. Essentially all you can do is wait for your body to do its thing and stay up-to-date on your suggested Pap tests to keep an eye out for anything else. Keep in mind, the vast majority of HPV cases will go away on their own. According to the CDC, more than 90 percent of new HPV infections will clear from a person’s body within two years. And this typically happens in the first six months post-infection.
However, it’s also possible in some cases for HPV to stick around, cause symptoms, or cause cellular changes that can lead to cancer. Some HPV strains, like types 6 and 11, are categorized as low-risk, meaning they can either resolve on their own or possibly cause genital warts (which can be annoying but aren’t dangerous for your health), according to the U.S. National Library of Medicine. High-risk HPV strains, such as types 16 and 18, can also resolve on their own. In other cases, they may lead to cervical cancer (HPV is actually the most common cause of this illness), anal cancer, some types of oral and throat cancers, vulvar cancer, vaginal cancer, and penile cancer.
Having sex when you know you have HPV
It might seem highly irresponsible to even consider having sex when you know you have an STI. But, as we mentioned, HPV is pretty much everywhere. It’s so prevalent that it really makes more sense for people to assume anyone they’re having sex with has this virus than the reverse.
Depending on your unique situation, it might make sense to tell your current or previous partners what you’re dealing with. And in some cases, you might be advised to abstain from sex for a while. As you can tell, this is a really tricky issue, so talking to your provider can be a huge help. In the meantime, here are some things to consider if you’re trying to figure out what to do about your sex life after an HPV diagnosis.
If you’re under 30 and have an abnormal Pap result:
Age is actually a pretty important factor with HPV. If you’re under 30, your body is more likely to clear HPV on its own. This is why HPV tests actually aren’t recommended for people under 30. “We don’t routinely test anyone under 30 [for HPV] because we know the virus is common at that age, and we also know that it often goes away without causing problems,” Dara Matseoane-Peterssen, M.D., director of NewYork-Presbyterian/The Allen Hospital’s Ob/Gyn Division, tells SELF.
So, how would you even know you have HPV then if you’re under 30? Maybe you had an abnormal Pap test result. A lot of things can cause an abnormal Pap (and false results are also possible). But the main cause of an abnormal Pap is known as ASCUS, which stands for this mouthful of a medical term: atypical squamous cells of undetermined significance. This indicates unusual cellular changes, typically due to HPV, according to the American College of Obstetricians and Gynecologists (ACOG). More advanced cervical cell changes known as cervical dysplasia can also cause abnormal Pap tests. Cervical dysplasia can happen due to HPV, precancer, or cancer, and as such is graded from mild to severe, ACOG explains.
Depending on the type of Pap you get, your doctor may or may not know exactly which strain of HPV you have. Conventional Paps (meaning the doctor puts the cells from your cervix on a glass slide) only reveal cellular changes, not the presence of HPV, the Mayo Clinic explains. Newer Pap technology uses liquid to preserve the sample but can show the presence of high-risk HPV types, according to the Mayo Clinic. Doctors can also perform what’s known as reflex HPV testing on a conventional Pap sample to reveal high-risk HPV.
But, again, if you’re under 30, your health team is probably not going to be very concerned about the actual strain of HPV you have, since your body is very likely to clear the infection.
For instance, if you’re 22 and a Pap indicated ASCUS, your doctor will probably suggest watchful waiting, meaning you’d schedule a follow-up in a year or so to see if your HPV has cleared, Dr. Lau says. There’s really no point in abstaining from sex in this period out of a fear that you’ll spread HPV, Dr. Lau says. The risk of getting exposed to HPV is just part of having sex these days. “I think abstaining is not the answer,” Dr. Lau tells SELF. (Depending on your relationship status, it might make sense to be extra diligent about having the safest sex possible—we’ll dive into that bit more below.)
If you’re over 30 and test positive for HPV:
Once you turn 30, the recommendation from the U.S. Preventive Services Task Force is to get an HPV test at least once every three years or a combined Pap and HPV test at least once every five years. (The latter is called co-testing.) Doctors start looking for the presence of high-risk HPV once you’re 30 because that could indicate a more stubborn infection that your body is having trouble clearing. Still, it typically takes more than 10 years for cell changes to become cancer, according to the American Cancer Society.
Just like there are different types of Paps, there are also different HPV tests, which can affect the level of detail of your results. Some only check for the presence of high-risk HPV while some can detect all types of HPV, according to the National Cancer Institute. Some tests even look specifically for HPV types 16 and 18, which lead to the most cases of cervical cancer.
Because of the variety in HPV tests out there, it can be good to ask your doctor for clarification no matter your HPV test result. If they say you’re negative, does that mean for all types of HPV, or was the test only looking for high-risk strains? Same goes if the test was positive. And if you co-tested, what do your results mean in conjunction with your Pap?
If, for instance, you’re 30 or older and test positive for a low-risk strain of HPV with no abnormal Pap result, your doctor will probably just suggest more watchful waiting. And there’s no real reason to abstain from sex in the meantime.
If you’re over 30 and test positive for a high-risk strain of HPV but don’t have any cervical cell changes that need treatment, your doctor will probably also suggest watchful waiting. (As Dr. Matseoane-Peterssen explains, unless you were very recently tested for HPV you have no way of knowing if this is a new infection your body will clear or one that’s been around for a bit.) You don’t need to instinctively abstain from sex in this case, but if you’re over 30 with a high-risk strain of HPV, Dr. Matseoane-Peterssen does suggest telling your sexual partners, especially if you have a partner with a cervix who can go get tested. (If they’re over 30, that can give you even more reason to do this, since their body will also be less likely to clear the infection.)
If your partner has a penis and can’t be tested for HPV, it’s still pretty likely that they’ve been exposed to that same strain that you have. Knowing this information may be helpful for them to discuss with their doctor so that they can also be on the lookout for any signs of precancer in the sites that may have been exposed to that same HPV strain (which may be their penis, their throat, or their anus).
If you need treatment for cervical cell changes caused by HPV:
While there is no treatment for HPV itself, there is treatment for the cervical cell changes that can be caused by certain HPV infections. This is why staying on top of your Pap tests is so crucial, because those tests watch for any changes to your cervix that could be treated ASAP. The Pap test will also tell you the level of seriousness of these cervical cell changes, which will determine your next steps for treatment. You can learn more about the possible results here.
Let’s say you’re 32 and you have a positive HPV test combined with a Pap result of low-grade squamous intraepithelial lesion (LSIL), a mild form of cervical dysplasia that is a step up from ASCUS. (It’s also possible—but rarer—to have a level of cervical dysplasia severe enough to need treatment if you’re under 30.) This would likely require treatment, and you may need to abstain from sex for a while after you get that treatment.
Your doctor could recommend a colposcopy (a close exam of your vulva, vagina, and cervix to look for cells that appear cancerous). According to the Mayo Clinic, your doctor may ask you not to have sex a day or two before the procedure for the most accurate exam possible. And if they see anything strange during the colposcopy, they might remove a tissue sample for further testing (biopsy). If you do get a biopsy, it’s recommended that you avoid sex for at least a week afterward, according to the Mayo Clinic, which allows your cervix to heal and lower the chance of infection. If a biopsy discovers abnormal or cancerous cells, your doctor will walk you through your treatment options, which could affect your sex life depending on what you choose. For instance, after undergoing a loop electrical excision procedure (LEEP) to remove abnormal tissue, your doctor may recommend that you abstain from sex for about a month, according to the Cleveland Clinic.
If you have genital warts:
Genital warts offer another example of how HPV-related medical procedures can influence your sex life. These warts are characteristic of low-risk strains of HPV, typically types 6 and 11. They can be raised or flat and sometimes look like cauliflower, the CDC says. Though these warts might go away on their own, they often come back.
If you have any visible genital warts, you should definitely tell your partner before any sexual contact takes place, Dr. Lau says. That gives them a chance to decide if they want to hold off on sex or have it anyway. If you two do choose to move forward with sex, be extra vigilant about protection (and remember that barrier methods can’t fully stop HPV transmission, but they’re better than nothing). Finally, if you want a guarantee that you’re not going to pass genital warts to anyone through sex, consider abstaining and seeing if they fade. Although it’s still possible to spread HPV when the warts are gone, their recession can signal lower viral levels that might make transmission less likely, Dr. Matseoane-Peterssen says.
You might decide to get your warts treated instead of hoping they’ll fade, in which case there are two general options available: topical medications, like a cream that is rubbed on the warts, or some form of removal, like surgery or having them frozen off.
Regardless of your genitalia, your doctor may recommend that you abstain from sex if you’re using medicated creams to treat warts. Some of these treatments can weaken latex and irritate your partner’s skin, according to the Mayo Clinic. And, if you have warts removed, you’ll want to wait until the skin heals to have sex, Dr. Lau says, which will depend on the form of removal you and your doctor choose. “To be clear, treatment can remove warts, but it does not necessarily clear an HPV infection,” Dr. Lau says. “So, even if the warts are gone, there is still risk of HPV transmission.”
If you have a current sexual partner (or partners):
If you’re in a relationship and are just going to keep having monogamous sex, you can be almost certain that your partner has your strain of HPV already, Dr. Matseoane-Peterssen says. Since there’s nothing to protect against, you can basically continue having sex like you always do as long as you’re not getting any further testing or treatment for HPV. (And if you’re having unprotected sex, you both should make sure your non-HPV STI testing is up to date.)
If you’re having sex with multiple people, learning you have HPV could be a reminder to have the safest sex possible. But because of HPV’s wily nature, there’s still not a ton you can do in that realm. You could use condoms and dental dams for safer sex but, again, they’re not 100 percent effective in preventing the spread of HPV because the virus passes from skin-to-skin.
Telling sexual partners you have HPV
This probably won’t surprise you at this point, but it really depends on your situation. “Unfortunately, there are no standard medical guidelines to direct physicians or patients in HPV disclosure,” Dr. Lau says.
But there are times when it definitely makes more sense to share. For instance, if you’re in a monogamous relationship, Dr. Matseoane-Peterssen recommends talking to your partner about your diagnosis purely for any emotional support you may need, because being diagnosed with an STI can be scary.
But keep in mind that when telling a sexual partner that you have HPV, it’s effectively telling them they may have HPV, too. It can be helpful to come prepared with information to assuage any fears they may have, like the fact that having HPV is super common, might clear from their system pretty quickly, and doesn’t necessarily mean anything bad will happen to their health.
Still, this information might be less useful to partners with penises since it’s not like they can run out and go get tested for HPV. But having that in the back of their mind could at least help them be more vigilant of any symptoms of genital warts or, in the very worst (and least likely) case, things like anal bleeding or penile skin changes that could indicate HPV-related cancer.
If your partner has a vulva, Dr. Matseoane-Peterssen absolutely recommends talking to them about your diagnosis because they can go get tested for HPV and, whether positive or negative, be more diligent about scheduling regular cervical cancer screenings.
If anything, hearing about your diagnosis may encourage your partners to get the HPV vaccine if they haven’t already. While the vaccine used to only be available for people under 26, the FDA recently approved a version of it, Gardasil-9, for all people between 27 and 45, regardless of sex. This newest version of the vaccine protects against nine HPV types that can cause cancer and health issues like warts.
“It’s a really exciting and beautiful thing that we have a vaccine that could save people from getting cancer,” Dr. Butler says. She suggests that everyone get the vaccine, even people who have already been diagnosed with HPV. Because there are so many different types of the virus, getting the vaccine could still protect people against types they haven’t yet encountered.
Limiting your exposure to HPV
If you’ve never gotten an abnormal Pap, positive HPV test, or genital warts, you may be wondering how to best protect yourself since HPV is so prevalent. Even if you have experienced one (or more) of those, it’s possible to get another HPV strain, which your body may or may not clear.
That’s why it’s essential to protect yourself with these tips:
- Get vaccinated if you haven’t already.
- Stay on top of your Pap and HPV tests so that if you do contract HPV, you can catch it as early as possible and be aware of next steps (if any).
- Always use condoms and dental dams, but remember that they’re better at protecting against some infections than others, which is why regular screening and STI testing are so important.
Once you’ve got all of that covered, you’ve pretty much done all you can do. “You have to live your life,” Dr. Lau says.