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Friday, Jan. 1, 2010

A Warty Situation

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I have a wart on my penis that has been there for about 15 years. It is getting larger, about 10 millimeters, currently. I have been monogamous with my partner for 20 years. Three questions: Can this wart be removed? Can I infect my partner? Will a condom prevent infection?

Genital warts are caused by the human papillomavirus (HPV), which has received lots of attention recently for its link to cervical and other types of cancer. Before the recent research on HPV, cancer and vaccines, most people were more familiar with genital warts as an annoying, but treatable, sexually transmitted infection than they were with HPV.

There are more than 100 different strains of HPV, and the ones that cause genital warts are different than the ones that are linked to cancer. It's possible to be infected with more than one strain at once, so it's a good idea for you and your partner to ask your health care provider about getting Pap smears (if your partner is male and you have anal sex, an anal Pap smear can be done). Pap smears look for precancerous cell changes caused by HPV.

Genital warts can be removed by a health care provider in several ways. Removing the warts does not mean that HPV has been eliminated from your system, though; there's a possibility that warts could return or that the virus could still be passed to a sexual partner. However, removing warts is still the best way to go, since at the very least it will reduce the risk of transmitting HPV to a partner and will also get rid of any irritating symptoms.

Warts can be removed by cryotherapy (freezing), electrocautery (burning them off with an electric current), the application of chemical compounds, surgical removal and several other methods. These are all done by a health care provider in her or his office. At-home prescription creams can also be given to a patient to apply themselves. While many of these methods sound cringe-inducing, for one wart or a small amount of them, they should be pretty quick. Your health care provider can give you more information about what she or he is able to perform.

If you've been with your partner for 20 years and you've had the wart on your penis for most of that time, it's likely that your partner is already infected with HPV. She or he could currently have genital warts, perhaps in areas of the body that are difficult to see, such as inside the vagina or anus. Sometimes it's difficult to distinguish genital warts from normal lumps and bumps in the genital area. It could also be that your partner is infected with HPV, but never had an outbreak of genital warts.

Condoms can lower the risk of transmitting HPV to a partner, but can't eliminate it completely. This is because HPV is passed through skin-to-skin contact, and condoms don't cover all the areas of skin that touch during sex. If the wart on your penis is covered by a condom during sex, that helps lower the risk, but you may have smaller warts on other areas of your genitals that you aren't aware of, or you may have HPV present on the surface of your skin even where warts aren't present. Even researchers don't know how likely it is for HPV to be transmitted through skin-to-skin contact where there are no warts.

It's common for people who have been in monogamous relationships for a long time, and then have had HPV show up suddenly, to wonder where it came from. In your relationship, it sounds like you and your partner were monogamous for five years and then you developed a wart. It's possible for symptoms of HPV infection, such as genital warts, to take several years to develop after a person is initially exposed. In addition, some people who are infected with HPV show no symptoms at all, so they have no idea that they have it. You could have acquired the virus from a previous partner and not developed a wart for a long time, or your current partner could have had HPV before he or she met you, but had no symptoms. It's almost impossible to determine when and how an individual was infected with HPV. The important thing to remember is that it is not necessarily a sign of infidelity.

Want Laura to answer your questions in SEXpress? Send them to laura@shepex.com. Not all questions received will be answered in the column, and Laura cannot provide personal answers to questions that do not appear here. Questions sent to this address may be reproduced in this column, both in print and online, and may be edited for clarity and content.

Laura Anne Stuart has a master’s degree in public health and has worked as a sexuality educator for more than a decade. She owns the Tool Shed, an erotic boutique on Milwaukee’s East Side.

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