I have HPV. Now what?

We all hope the awkwardness is over after we get our Pap and HPV tests. So hearing that you have tested positive for HPV can be a blow. What happens next?

Well, for one, you’re not alone.

“More than 80% of people will be infected at some point in their lifetime,” says gynecologic oncologist Lois Ramondetta, M.D.

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

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

What is HPV?

HPV stands for human papillomavirus. There are more than 100 strains of the virus.

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

• Intercourse
• Oral sex
• Genital contact

Most strains of HPV do not cause cancer – or any symptoms at all. However, in cases where HPV does have symptoms, they might include:

Genital warts

Some HPV strains cause genital papillomas, or warts, in both men and women. These warts will usually show up a few months after you are exposed to HPV. They can be treated with prescription medication or removed. The Centers for Disease Control and Prevention (CDC) writes that genital warts may disappear on their own, stay the same or grow in size or number.

Certain cancers

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

In women, these strains can cause:

• Cervical cancer
• Vaginal cancer
• Vulvar cancer
• Anal cancer
• Oropharyngeal (throat) cancer

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

• Penile cancer
• Anal cancer
• Oropharyngeal (throat) cancer

Other health issues

Ramondetta says HPV can cause other health issues, 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 passed from a mother to her child as they exit the birth canal.

How is HPV diagnosed?

HPV usually doesn’t have any symptoms, so it can be hard to tell you have it, Ramondetta says. For this reason, she says everyone should assume they will be exposed to HPV at some point in their lives, with most being exposed in their 20s.

HPV is diagnosed through an HPV test. Currently, only women can be screened for HPV. This screening is usually done at a doctor’s office at the same time as a Pap test. Your practitioner will use a soft brush to take a sample of cells from your cervix. This sample will be sent to a lab for testing.

Here’s how often MD Anderson recommends women at average risk for cervical cancer should get HPV tests.

Women ages 21 to 29

Women ages 21 to 29 should get a Pap test every three years. Women who choose not to get Pap tests should begin HPV tests every five years beginning at age 25.

Women ages 30 to 64

MD Anderson recommends women 30 and over get a Pap and HPV test every five years.

Women over age 65

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

What’s my cancer risk if I have HPV?

If you get a positive HPV test, your physician 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, and don’t ignore it,” Ramondetta says. “Make sure you follow up with your doctor on the next steps and try to keep things in perspective. If you have HPV, there’s a very good chance it won’t be a long-term problem for you.”

Your immune system will attack the virus, and it will likely be gone within two years. Of the millions of cases of HPV diagnosed every year, only a small number become cancer. Most of those cases are cervical cancer; almost all cervical cancer cases 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 (throat) cancer, they are not able to test for HPV. Additionally, because oropharyngeal cancer forms deep in the throat, it is more challenging to detect early. It is often found after a lump develops.

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

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

Do I need additional HPV testing?

The results of your Pap 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 test is normal, your doctor will most likely recommend repeating the Pap and HPV screening exams in one year.

If your second HPV test comes back negative, continue regular Pap and HPV tests.

If your second HPV test comes back 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 is looking 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 test was abnormal, your doctor will probably follow up with a colposcopy. Try to see a physician who specializes in this procedure.

Talking to your partner about HPV

With any medical problem, it's natural to wonder: “How did this happen?” With HPV, it can be very difficult to pinpoint when you were exposed. It's possible that the virus was in your system for a long time before it was detected. People often never know they have caught it or passed it on.

“HPV could’ve been there for years before it shows up, if it ever does,” Ramondetta says.

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

Your partner can catch it from you. However, they have probably already been exposed by you or someone else.

If your partner is a woman, she should be sure to follow screening guidelines described above in order to keep up with her own Pap and HPV testing so if a problem does develop, it is found early.

Protect yourself from HPV

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

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

Ramondetta says that getting the HPV vaccine after being infected doesn’t make the infection go away. However, getting the vaccine before you're exposed to HPV can prevent against 7 high risk subtypes and 2 low risk subtypes.

All males and females should get the HPV vaccine. Ideally, to be best protected, children should be vaccinated between 9-14 years of age; the earlier, the better. Unvaccinated adults ages 27–45 should talk to their doctor about the benefits of the vaccine.

If you get your first dose of the HPV vaccine between ages 9 and 14, only two doses are required. Those who get 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 again and again to be safe and effective and long lasting," she says. “It is something I didn’t hesitate to give my children. I try to encourage every parent to get their 9- or 10-year-olds the first shot so they only need two total for decades of protection.”

Request an appointment at MD Anderson online or call 1-877-632-6789.