Human papillomavirus (HPV) / Genital warts

What is it?

HPV, which stands for human papillomavirus is the most common sexually transmitted infection. 70% of the adult population will have had at least one genital HPV infection during their lifetime. Human papillomavirus is the name of a group of viruses that includes more than 100 different strains or types. More than 30 of these viruses are sexually transmitted, and they can infect the genital area. Some of these viruses are called “high-risk” types, and may cause abnormal Pap tests. They may also lead to cancer of the cervix, vulva, vagina, anus, throat or penis. Others are called “low-risk” types, and they may cause mild Pap test abnormalities or genital warts. The strains that cause warts are not the same strains that may lead to cancer, though people can be infected with more than one strain.

How is it spread?

HPV is spread by direct skin-to-skin contact with warts or an infected area during vaginal or anal sex including some forms of foreplay where genital areas can rub together. Genital warts may appear within a few weeks of exposure. It is also believed that in rare cases, warts may appear years after exposure. Most HPV infections have no signs or symptoms; therefore, most infected persons are unaware they are infected, yet they can transmit the virus to a sexual partner.

What are the symptoms?

Most people who have a genital HPV infection do not know they are infected. The virus lives in the skin or mucous membranes and usually causes no symptoms. Some people get visible genital warts. Genital warts usually appear as flesh-colored growths or bumps. They can be raised or flat, single or multiple, small or large, and sometimes cauliflower shaped. They can appear on the vulva, in or around the vagina or anus, on the cervix, and on the penis, scrotum, groin, or thigh. The warts may cause itching, painful intercourse, and vaginal or rectal bleeding. Some warts can grow quickly. If they are not treated, they can grow large enough to obstruct the vaginal, urethral or rectal openings, though this is rare. Warts can grow especially fast during pregnancy.  

How is it diagnosed?

Genital warts are diagnosed by visual inspection. A Pap test can screen for changes to the cells of your cervix that could indicate but does not HPV infection. If you are having sex, it is important to have a Pap test done every 3 years, unless your Paps have not been normal. If you have an abnormal Pap, your health care provider will instruct you on appropriate follow up.

How is it treated?

There is no cure for HPV infection, although there are several treatment options for genital warts.  It can sometimes be a frustrating process as repeat treatments are often necessary.  As some warts are treated, new ones may appear.  Some warts may disappear without treatment.

Treatment options may include:

  • Liquid nitrogen

  • Podophyllin (should not be used by pregnant people)

  • TCA (trichloroacetic acid)

  • Prescription creams for home treatment

What about my sexual partner(s)?

It may be difficult to talk about HPV with your partner, but it is important that both you and your partner(s) know the transmission risks before having sex. Once the warts have been treated and are gone, it less likely you will transmit the virus to others, and this likelihood diminishes over time. It is agreed by experts that most people will clear the virus in approximately 2 years.

Prevention

Because so many people have HPV and do not show symptoms, there is no way to completely prevent yourself from getting HPV unless you refrain from genital contact. Using latex condoms and avoiding sexual contact when warts are present offers significant but not total protection. Getting vaccinated against HPV is the best form of prevention now available.

HPV vaccine (Gardasil 9)

The newest vaccine offers protection against nine different strains of HPV: the two most commonly implicated in causing genital warts and the seven that are most likely to cause abnormal paps and other HPV-related cancers. The vaccine is provided free of charge to all children in Grade 7 in Ontario. The vaccine comes in 3 doses and costs about $190 per dose. Talk to your health care provider about getting the HPV vaccine.

Please see our HPV vaccination page for more information.