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HPV, Warts and Moluscum Contagiosum
Hi!
I had a pap smear 1.5 years ago, which showed up with HPV; they told me it was NOT the strain associated with warts and to come back for pap smears regularly, which I have been doing.The last time (approx 8 months ago) I showed cell changes on my cervix and so had to be booked in to get these treated (cauterised; 2 months ago). About 1 year ago, I developed a group of three small bumps on the inside of my thigh- I went to a GUM clinic, concerned that they could be warts because of my HPV detection. The doctor there said no, that they were moluscum contagiosum, froze them and they have since gone, with the odd one croping up on my bottom or thigh but clearing on their own 4-6 months later. The trouble is however, that my boyfriend from 1.5 years ago (with whom I had unprotected sex then and who, 10 months ago, I gave hand pleasure) now called to tell me he has been diagnosed with genital warts, and has not had anoth partner since me. Similarly, I had (protected) sex with a man 1 year ago, who said soon after that he developed small raised bumps on his pubic region; I think it was him I got the moluscum contagiosum from so this could be that, or, this could be warts that I am carrying- I am just very confused.
So, my questions:
i) I must have had the high-risk HPV strain, associated with cervical cell changes to require cauteriation, so would it be possible that I (if the moluscum diagnosis was wrong?), and the two men, have developed genital warts from this strain?
ii) Would it be possible to pass moluscum contagiosum on, from me to my ex-bf, by hand pleasure (my hands on his genitals) and for this to be mis-diagnosed as genital warts?
iii) My last smear (when I got the cells cauterised) showed up clear, without HPV, but am I still at risk to pass this on- with vaginal or oral sex- or cause warts in a man I sleep with? (I am not sexually active, and have not been in 1 year until I figure this out!)
Many thanks for your help.
I had a pap smear 1.5 years ago, which showed up with HPV; they told me it was NOT the strain associated with warts and to come back for pap smears regularly, which I have been doing.The last time (approx 8 months ago) I showed cell changes on my cervix and so had to be booked in to get these treated (cauterised; 2 months ago). About 1 year ago, I developed a group of three small bumps on the inside of my thigh- I went to a GUM clinic, concerned that they could be warts because of my HPV detection. The doctor there said no, that they were moluscum contagiosum, froze them and they have since gone, with the odd one croping up on my bottom or thigh but clearing on their own 4-6 months later. The trouble is however, that my boyfriend from 1.5 years ago (with whom I had unprotected sex then and who, 10 months ago, I gave hand pleasure) now called to tell me he has been diagnosed with genital warts, and has not had anoth partner since me. Similarly, I had (protected) sex with a man 1 year ago, who said soon after that he developed small raised bumps on his pubic region; I think it was him I got the moluscum contagiosum from so this could be that, or, this could be warts that I am carrying- I am just very confused.
So, my questions:
i) I must have had the high-risk HPV strain, associated with cervical cell changes to require cauteriation, so would it be possible that I (if the moluscum diagnosis was wrong?), and the two men, have developed genital warts from this strain?
ii) Would it be possible to pass moluscum contagiosum on, from me to my ex-bf, by hand pleasure (my hands on his genitals) and for this to be mis-diagnosed as genital warts?
iii) My last smear (when I got the cells cauterised) showed up clear, without HPV, but am I still at risk to pass this on- with vaginal or oral sex- or cause warts in a man I sleep with? (I am not sexually active, and have not been in 1 year until I figure this out!)
Many thanks for your help.
MEDICAL PROFESSIONAL
Dr. Handsfield is traveling so I am covering some of his threads in his absence. To reassure you, he and I have worked together for over 30 years and while our styles vary, we have never disagreeed on managemnt recommendations
As Dr. Handsfield indicated HPV infections are very widespread and their importance is overblown. While they are an important cause of disease in a very small proportion of women, for women who get regular medical care and follow-up withtheir health care providers there is little to worry about.
As a generalization, even if you had oral HPV infection (and this is rather unlikely- oral HPV is less common than genital infections), after more than a year, most HPV infections would have resolved themselves. Then, if infection was present, oral HPV appears to be less efficiently transmitted than genital infection, reflecting differences in the sites of infection and the biology of the viruses. Thus, in answer could it happen? - yes. Is it likely of probable? - no , just the opposite.
I hope this is helpful. EWH
As Dr. Handsfield indicated HPV infections are very widespread and their importance is overblown. While they are an important cause of disease in a very small proportion of women, for women who get regular medical care and follow-up withtheir health care providers there is little to worry about.
As a generalization, even if you had oral HPV infection (and this is rather unlikely- oral HPV is less common than genital infections), after more than a year, most HPV infections would have resolved themselves. Then, if infection was present, oral HPV appears to be less efficiently transmitted than genital infection, reflecting differences in the sites of infection and the biology of the viruses. Thus, in answer could it happen? - yes. Is it likely of probable? - no , just the opposite.
I hope this is helpful. EWH
OK, many thanks for your detailed answer, I guess it confirms some things I had thought and I will be returning to my doctor soon for another Smear test.
Can I just ask, since I have the opportunity, is it known if HPV can be passed by oral sex- giving or receiving? I.e. would I be liable to pass it on from my mouth to a man?
Many thanks again.
Best wishes.
Can I just ask, since I have the opportunity, is it known if HPV can be passed by oral sex- giving or receiving? I.e. would I be liable to pass it on from my mouth to a man?
Many thanks again.
Best wishes.
MEDICAL PROFESSIONAL
You ask good questions. However, you should also address them to your GUM clinic provider, and also consider visiting the clinic again, with your partner. The best way by far to sort out uncertainties about STDs in couples is for both to be evaluated by the same knowledgeable provider. The UK GUM clinics are among the best STD service centers in the world; you should take full advantage of what they can offer.
The other thing to remember is that HPV often behaves atypically. There are lots of situations in which it simply isn't possible to sort out who was infected, when, or by whom. In general, I and most STD specialists just advise patients not to try to work it out. Just deal with the infection, knowing that HPV is rarely serious or dangerous. Even the high risk types rarely cause bad disease, if properly managed.
To your questions:
1) Many people with HPV are infected simultaneously with more than one strain. You could have had a low risk (wart-causing) HPV infection in addition to a high risk one. Whether this explains your two partners' warts, or whether either might have acquired them elsewhere, I just can't say. I also can't speculate about possible misdiagnosis of your molluscum or your partners' warts.
2) Molluscum transmission mechanisms have never been researched. Genital area infections are generally assumed to be transmitted through intercourse, but oral or hand-to-genital transmission might be possible. It just isn't known.
3) Most cervical HPV infections clear up on their own. That your pap has become normal suggests, but does not prove, that your infection has cleared up. But this is a question for the doctor managing the problem and/or your GUM provider.
I am sorry to hear you have been celibate for a year because of your cervical HPV disease. That usually is unnecessary and sounds like an overreaction. Certainly there is no reason to stop having sex with a regular partner, since most such men already have been infected and no harm comes from reexposure. But this also is something to discuss with your own providers.
Sorry I can't be more helpful. Best wishes-- HHH, MD
The other thing to remember is that HPV often behaves atypically. There are lots of situations in which it simply isn't possible to sort out who was infected, when, or by whom. In general, I and most STD specialists just advise patients not to try to work it out. Just deal with the infection, knowing that HPV is rarely serious or dangerous. Even the high risk types rarely cause bad disease, if properly managed.
To your questions:
1) Many people with HPV are infected simultaneously with more than one strain. You could have had a low risk (wart-causing) HPV infection in addition to a high risk one. Whether this explains your two partners' warts, or whether either might have acquired them elsewhere, I just can't say. I also can't speculate about possible misdiagnosis of your molluscum or your partners' warts.
2) Molluscum transmission mechanisms have never been researched. Genital area infections are generally assumed to be transmitted through intercourse, but oral or hand-to-genital transmission might be possible. It just isn't known.
3) Most cervical HPV infections clear up on their own. That your pap has become normal suggests, but does not prove, that your infection has cleared up. But this is a question for the doctor managing the problem and/or your GUM provider.
I am sorry to hear you have been celibate for a year because of your cervical HPV disease. That usually is unnecessary and sounds like an overreaction. Certainly there is no reason to stop having sex with a regular partner, since most such men already have been infected and no harm comes from reexposure. But this also is something to discuss with your own providers.
Sorry I can't be more helpful. Best wishes-- HHH, MD
You are reading content posted in the STDs Forum
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