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I have HPV. What now?

We all hope the awkwardness will pass after we get our Pap and HPV tests. So it can be a blow when you hear that you have tested positive for HPV. What happens now?

First of all, you are not alone.

“More than 80% of people will become infected at some point in their lives,” says gynecological oncologist Lois Ramondetta, MD

The good news is that in most cases, your immune system clears the virus before health problems arise. The risk of cancer increases if your body cannot fight the virus for some reason and it remains in your system.

Ahead, Ramondetta shares more information about HPV and what you need to know if you have it.

What is HPV?

HPV stands for Human Papillomavirus. There are more than 100 variants of the virus.

The virus lives on your skin and spreads during intimate contact, Ramondetta says. This includes:

  • Sexual intercourse
  • Oral sex
  • Genital contact

Most HPV strains do not cause cancer – or any symptoms at all. In cases where HPV does have symptoms, these may include:

Genital Warts

Some strains of HPV cause genital papillomas or warts in both men and women. These warts usually appear several months after you are exposed to HPV. They can be treated with prescription medications or removed. The Centers for Disease Control and Prevention (CDC) writes that genital warts can go away on their own, stay the same, or increase in size or number.

Certain cancers

Other strains of HPV are known to carry a high risk and can cause cancer. HPV 16 and HPV 18 are two strains often linked to cancer, but there are also a handful of other high-risk subtypes, Ramondetta says.

In women, these strains can cause:

In men, high-risk strains of HPV can cause:

Other health problems

Ramondetta says HPV can cause other health problems, including:

  • Pre-cancers of the vulva and cervix
  • Respiratory papillomatosis, or papillomas on the voice box
  • Papillomas in young children. In rare cases, HPV can be transmitted from mother to her child when it leaves the birth canal.

How is HPV diagnosed?

HPV usually has no symptoms, so it can be difficult to tell you have it, says Ramondetta. For this reason, she says everyone should assume they will be exposed to HPV at some point in their lives, with most people being exposed around the age of 20.

HPV is diagnosed via an HPV test. Currently, only women can be screened for HPV. This screening is usually performed at the same time as a smear test by a doctor. Your doctor will use a soft brush to take a sample of cells from your cervix. This sample is sent to a laboratory for testing.

Here you can see how often M. D. Anderson recommends that women at average risk for cervical cancer undergo HPV testing.

Women aged 21 to 29

Women aged 21 to 29 should have a Pap smear every three years. Women who choose not to get a Pap smear should start getting HPV tests every five years starting at age 25.

Women aged 30 to 64

M. D. Anderson recommends that women aged 30 and older have a Pap and HPV test every five years.

Women over 65 years old

Some women may be able to stop screening at age 65, depending on their medical history. Women should speak with their gynecologist to decide how to proceed.

What is my risk of cancer if I have HPV?

If you get a positive HPV test, your doctor has detected one or more high-risk strains of the virus.

Our experts say the most important thing to know if you have HPV is that the risk of cancer is very small, but should be taken seriously.

“Don’t panic or ignore it,” says Ramondetta. “Make sure you check with your doctor about next steps and try to keep things in perspective. If you have HPV, chances are it won’t be a problem for you in the long term.

Your immune system will attack the virus and it will probably be gone within two years. Of the millions of cases of HPV diagnosed annually, only a small number become cancerous. Most of these cases are cervical cancer; almost all cases of cervical cancer are caused by the HPV virus.

The HPV vaccine can help the body recognize and eliminate the virus more effectively, Ramondetta says.

“The vaccine is so effective because it essentially gives your immune system the ‘cheat sheet’ for recognizing the virus,” she says.

Other HPV-related cancers are rare. Routine screening is not recommended or available at this time.

While dentists are starting to check for oropharyngeal cancer (throat cancer), they cannot test for HPV. In addition, because oropharyngeal cancer forms deep in the throat, it is more challenging to detect early. It is often found after a lump has developed.

Making healthy lifestyle choices gives your body the best chance of clearing the virus.

“Choosing healthy foods full of antioxidants, staying active, lowering your stress levels and avoiding tobacco are all ways to keep your immune system strong,” says Ramondetta.

Do I need additional HPV testing?

The results of your Pap smear and HPV test are used to determine if you need additional testing.

Positive HPV test, normal pap

If you test positive for HPV and your Pap smear is normal, your doctor will most likely recommend repeating the Pap and HPV screening exams within a year.

If your second HPV test is negative, continue with regular Pap and HPV tests.

If your second HPV test is positive, your doctor may recommend a colposcopy.

During a colposcopy, your doctor will look more closely at the cervix, vagina or vulva with a special microscope called a colposcope. The doctor looks for abnormal cells or blood vessels, which may require further treatment.

Positive HPV test, abnormal pap

If you test positive for HPV and your Pap smear was abnormal, your doctor will likely perform a colposcopy. Try to consult a doctor who specializes in this procedure.

Talking to your partner about HPV

With any medical problem, it is normal to wonder, “How did this happen?” With HPV, it can be very difficult to determine when you have been exposed. It is possible that the virus was present in your system for quite some time before it was detected. People often don’t know that they have contracted it or passed it on.

“HPV could be around for years before it emerges, if it ever does,” Ramondetta says.

When talking to your partner about your diagnosis, remember that 80% of people will have HPV at some point in their lives.

Your partner can pick it up from you. However, they have probably already been discovered by you or someone else.

If your partner is a woman, she should be sure to follow the screening guidelines outlined above to keep up with her own Pap and HPV tests so that if a problem arises, it is caught early.

Protect yourself against HPV

Because HPV lives on your skin, condoms don’t completely protect you from it.

The best way to protect yourself from HPV-related cancers is to get the HPV vaccine.

Ramondetta says getting the HPV vaccine after being infected doesn’t clear the infection. However, getting the vaccine before you are exposed to HPV can prevent seven high-risk subtypes and two low-risk subtypes.

All men and women should get the HPV vaccine. To be optimally protected, children should ideally be vaccinated between the ages of 9 and 14; the sooner the better. Unvaccinated adults between the ages of 27 and 45 should talk to their doctor about the benefits of the vaccine.

If you get your first dose of the HPV vaccine between the ages of 9 and 14, only two doses are needed. Those who receive their first dose of the vaccine after age 15 will need three doses for full immunity.

You can’t get HPV from the HPV vaccine, which is safe and has no serious side effects, Ramondetta says.

“The vaccine has been proven time and time again to be safe, effective and long-lasting,” she said. “It’s something I haven’t hesitated to give my children. I try to encourage every parent to get their first shot at age 9 or 10, so they only need two in total for decades of protection.”

Request an appointment via M. D. Anderson online or call 1-877-632-6789.