Human Papillomavirus (HPV)

HPV in men

Studies show that up to half of men or people assigned male at birth (AMAB) between the ages of 18-59 may have an HPV infection in a given year. Around 1 in 4 of those men may have high-risk HPV.

Around 90% of men will get HPV at some point in their life. 

HPV often goes undiagnosed in men or people who don’t have a cervix. That’s because people with male sex organs are less likely to have symptoms of an infection, and there’s no FDA-approved way to test men for HPV.

However, high-risk HPV can cause the following types of cancer in males:

• Penile cancer
• Anal cancer
• Mouth and throat cancer

Mouth and throat cancers are the most common kinds of HPV-related cancers diagnosed in men or people AMAB. You’re more likely to get anal cancer if you have HIV or if you’re a man who has sex with other men.

If you’re a man or AMAB, you can give HPV to other people even if you don’t have symptoms. Ask your doctor if the HPV vaccine is right for you.

Types of HPV

Human papillomavirus isn’t just one virus. There are 200 different types of HPV (that we know about). Each type, or strain, has its own number.

HPV lives in thin, flat cells called squamous epithelial cells. You have these cells on your skin and in wet places. These moist "mucous membranes" are found on the surface of your vagina, anus, vulva, cervix, and head of the penis, along with the inside of your mouth and throat.

Besides the number, you can break down HPV types into different groups based on which type of cells they affect. These include:

• Cutaneous HPV. This type lives on your skin and causes warts on areas such as your arms, hands, legs, or feet. These warts are different from genital warts.

• Mucosal HPV. This type lives in the wet parts of your body you can touch from the outside. This includes areas such as your vagina, penis, anus, mouth, and throat.

Around 40 strains of HPV are known to affect your genitals or other mucosal areas. Most are low-risk and don’t cause serious health problems, but there are a handful of high-risk HPV types that doctors worry about.

HPV Symptoms

Your immune system usually clears HPV from your body within 1-2 years. During that time, you may never know that you have an infection. But around 1% of people with low-risk HPV get obvious symptoms of genital warts.

You could get a cough, breathing problems, trouble swallowing, or hoarseness if you get warts on your vocal cords or airways (respiratory papillomatosis).

Sometimes high-risk strains of HPV can stay in the body for many years. When this happens, you may find out you have an infection because you get symptoms from cancer caused by HPV and not from the virus itself.

Are all warts caused by HPV?

The term "papilloma" refers to a kind of noncancerous wart caused by some HPV types. All warts are caused by some kind of human papillomavirus. But different strains of HPV cause different types of warts.

The types of warts caused by HPV may include: 

• Genital warts. You may get flat spots or raised bumps. They usually form on the outside of your vagina (vulva) or penis. But genital warts can also show up on the anus, cervix, scrotum, or anus.
• Common warts. These rough bumps typically show up on your hands and fingers.
• Plantar warts. These are hard, grainy, and sometimes painful bumps that affect the bottom of your feet.
• Flat warts. Slightly raised spots with a flat top. You can get them anywhere, but they’re common on the face and legs.

HPV and cancer

The vast majority of HPV infections go away without causing health problems. But high-risk strains of HPV can cause changes in your cells that can turn into cervical cancer, especially if the virus stays in your body for 10 to 20 years and you’re a woman or person with a cervix who is older than 30.

Other things to know about HPV and cancer include:

• You can prevent cervical cancer if you catch cell changes early with a Pap test.
• High-risk HPV can cause head and neck cancer, though this isn’t common.
• About 30% of mouth cancers are HPV-related, often seen in people aged 20-39.
• Rates of anal cancers related to HPV are going up, particularly in people with HIV.

HPV Causes

You usually get an HPV infection through direct skin-to-skin contact. The virus enters your body through some kind of opening in your skin, such as a cut, scrape, or other tear in your skin or mucosal layers (such as the kind that line your vagina, penis, anus, or mouth and throat).

You can pass HPV to your baby if you have an active infection that causes genital warts when you’re pregnant. In rare cases, this can cause a noncancerous growth in your baby’s voice box (larynx).

Is HPV contagious? 

Yes. HPV spreads easily from person to person. That’s why there’s an 80% chance you’ll get it by the time you’re 45, particularly if you’re not vaccinated. 

You can get an infection from someone if they don’t have noticeable symptoms. But you can also get HPV by touching someone else’s wart, or, less commonly, by touching a surface that comes into contact with skin that has HPV on it.

Risk factors for HPV include:

• Damaged skin. Places on your skin that have been cut a lot or have holes are more likely to get common warts.
• Direct contact. If you touch someone’s warts or come into contact with surfaces their warts have touched, you can get HPV.
• Number of sexual partners. The more sexual partners you have, the higher your risk of getting HPV. If you have sex with someone who has many partners, that increases your risk, too.
• Age. Children are more likely to get common warts. Genital warts are more common in adolescents and young adults.
• Weak immune system. If you have a condition such as HIV or AIDS or are on treatment that weakens your immune system, you’re more likely to get HPV.

HPV Tests

There’s no blood test for HPV. But if you have genital warts, your doctor may be able to diagnose you just by looking at them.

If you don’t have symptoms that your doctor can see, other HPV tests may include:

• Vinegar solution test. This test uses a vinegar (acetic acid) solution. Your doctor applies it to your genital area. If you have lesions in the area, they’ll turn white.
• Pap test. Your doctor uses a swab to collect samples from your cervix or vagina. They send the samples to a lab to see if you have abnormal cells. Abnormal cells can lead to cancer.
• Colposcopy. This is a test your doctor may use to check for HPV on your cervix. They’ll find and remove cells that may turn into cancer. They’ll use an instrument called a colposcope to magnify your cervix and take tissue samples (called a biopsy).
• Anoscopy. Your doctor may look inside your anus with a camera to check for warts, abnormal cells, or other signs of cancer. 
• DNA test. If you’re a woman or someone with a cervix who is older than age 30, your doctor may recommend this test along with a Pap test. They look at the DNA of the cells of your cervix to see if you have the type of HPV that can lead to cancer.

HPV Treatments

There’s no treatment for the HPV infection itself. But you can get treatment for the warts or cell changes and cancer caused by HPV.

Warts may go away without treatment, especially in kids. These growths may come back since there’s no cure for HPV. Some medications can treat them, including:

• Imiquimod. This is a prescription cream that helps your immune system get rid of HPV. It can cause some redness and swelling around the area you apply it.
• Podofilox. You apply this gel directly to genital warts to destroy their tissue. You may get some burning and itching from it.
• Salicylic acid. You put treatments with this ingredient directly on the wart. They destroy the wart one layer at a time. You shouldn’t use it on your face.
• Trichloroacetic acid. This burns off warts on your palms, soles of your feet, and genitals. It may irritate your skin.

HPV Complications

When HPV doesn’t go away, it can lead to other problems. Some HPV infections cause lesions, or abnormal areas on your tongue, tonsils, soft palate, or in your nose or larynx.

HPV can also cause cancer. Certain strains of HPV can lead to cancer of the:

• Genitals
• Anus
• Mouth and upper respiratory tract

HPV Prevention

You may not be able to avoid exposure to all types of HPV. That’s because it can spread so easily through skin-to-skin contact, including vaginal, anal, or oral sex.

It’s important to note that you can’t get HPV from: 

• Sitting on a toilet seat
• Swimming in a pool or hot tub
• Sharing utensils
• Coming into contact with HPV-infected blood

The only way to prevent an HPV-related genital or throat infection is to avoid all sexual contact. But that’s not realistic for most people, and you can get HPV even if you have vaginal, anal, or oral sex with just one person.

There are ways to lessen your chances of getting HPV or passing it to others, including: 

• Get the HPV vaccine.
• Get your child vaccinated (by age 11 or 12, if possible).
• Always wear a condom (though, the skin not covered by the condom can get HPV).
• Choose fewer sex partners.
• Get routine Pap tests.

HPV vaccine 

The HPV vaccine is most effective if you get it before you’re sexually active, which is why it’s recommended that people of all genders get it by age 11 or 12 (or at least by age 26).

But anyone between the ages of 9 and 45 can get the HPV vaccine. If you’re older than 26, ask your doctor if they think you might benefit from the series of shots.

There are three HPV vaccines, including:

• Cervarix
• Gardasil
• Gardasil-9 (the only vaccine currently used in the U.S.)

The vaccines target high-risk types of HPV. All three guard against HPV 16 and 18. Gardasil and Gardasil-9 are also effective against HPV 6 and 11, which cause most genital warts. Gardasil-9 also targets high-risk strains 31, 33, 45, 52, and 58.

The HPV vaccine is not recommended for pregnant people.

HPV vaccine side effects

While the HPV vaccine is generally considered safe, you might have some short-term side effects. They’re generally mild and similar to things you might experience from other vaccines.

Takeaways

HPV, or human papillomavirus, is a very common group of viruses. Almost everyone gets an HPV infection at some point in their life, often through sexual contact. Your body usually clears the virus in a few years without causing symptoms. But some types of HPV can lead to cancer.

There’s an HPV vaccine. It’s approved for males and females aged 9-45. 

If you have a cervix, your doctor can check for HPV or precancerous or cancerous cell changes with routine screenings. Ask how often you should get these tests.

HPV FAQs

Can HPV affect pregnancy?

You can still get pregnant if you have HPV. But you could get genital warts that bleed, get bigger, or multiply. Genital warts can sometimes block your vaginal canal, which means you might need a C-section. Rarely, you can pass HPV to your baby. They could get warts on their vocal cords, lungs, or airways.

Do I need to be tested for HPV?

If you have a cervix, you should get routine screenings for cervical cancer and HPV between the ages of 25-65. There’s no FDA-approved test to check for HPV in men or people assigned male at birth. But sometimes, doctors use a Pap test to check for HPV in the anus. Ask your doctor if this test might be right for you.

Does high-risk HPV always lead to cervical cancer?

No. About 90% of HPV infections go away without causing serious health problems. If you do have high-risk HPV and you have a cervix, routine Pap tests can detect HPV-related cell changes before they turn into cervical cancer.

Can adults over 26 get the HPV vaccine?

Yes. The vaccine is most effective if you get it when you’re a preteen. However, the FDA has approved the HPV vaccine for people up to age 45. If you’re older than 26, ask your doctor if you should get it.