Dear Dr G,

I am a 35-year-old man who has not had any sex in eight years.

In my late twenties, I noticed a small flower-like growth on my penis.

The doctor told me that this was a genital wart and I was shocked to find out that it was caused by the human papillomavirus (HPV), a sexually transmitted infection (STI).

I was even more horrified when I learnt that it could be easily transmitted to my partner, which can lead to cervical cancer.

We broke off when she found out about the warts, and I never dated since.

I would like to put Dr. G on the spot about the issue.

What exactly is HPV? I thought the virus only affects women?

How do I know I was really infected with it? Are the viruses contagious and how can I reduce the risk of transmission?

I am now in my mid-30s and feel I am wasting the “golden years” of my sex life. I understand HPV is not curable, but do I have to go without sex for the rest of my life?

Regards,
Sexless Steven

The existence of genital warts has been documented since the time of the ancient Greeks, and its causation by a virus was only determined in 1907.

Today, almost 80 million Americans are infected with HPV and about 14 million new cases are added each year. This indicates that 1% of sexually-active adults live with recurrent genital warts.

Genital warts are an infection caused by transmission of the human papillomavirus (HPV) during sexual contact. Out of the 170 subtypes of HPV, more than 40 are spread through genital and anal contact, and HPV 6 and HPV 11 are commonly linked to genital warts.

Risk factors for HPV infection include early age of sexual intercourse, multiple sexual partners, poor hygiene and smoking.

Nearly all sexually active persons are infected by HPV at some point in their lives, making it the most common sexually transmitted infection globally. 90% of affected individuals demonstrate no symptoms and the virus is thought to resolve spontaneously within two years. In others, however, HPV persists in the genitalia rendering either warts or precancerous lesions.

The diagnosis of the virus in men is not as accurate as a PAP smear for women. A visible “flower-like” lesion suggests HPV infection, and these can be further determined using a vinegar solution to identify the lesion.

In some cases, normal skin tags can be mistakenly diagnosed as genital warts. The scrapping of the lesion for a DNA analysis of the subtype of the virus is the most accurate diagnosis method.

The most effective way to get protection against HPV is to get vaccinated. Although the vaccine is supposed to be for both sexually naive boys and girls at the age of 13, protection is also demonstrable up to the age of 45.

Other ways to diminish transmission of HPV include reducing the number of sexual partners and avoid having sexual contact with a partner when warts are present.

The US Centre for Disease Control and Prevention revealed that male condoms may reduce the risk of HPV transmission, but to a lesser degree in comparison to other forms of STI. This is because HPV can also be transmissible by exposed genital skin that cannot be completely covered during sexual contact.

The French philosopher, Albert Camus, who was the second youngest recipient of Nobel Prize in Literature once said: “autumn is a second spring when every leaf is a flower.”

The curious nature of the transmission of HPV is that it is highly contagious with each sexual contact, but the manifestations may vary from being dormant or precariously insidious.

When nearly all sexually active adults are infected with HPV virus at some point of their sexual lives, it is indeed fair to assume “every visible leaf is a potential flower in the pants!”

When Dr G is put on the spot by insisting on abstinence as the only sure way to prevent HPV transmission, his view is to get vaccinated and stay monogamous, as “Your Autumn may be the second Spring, it will soon turn into Winter if the guilt of the flowers in the pants keeps you forever sexless!”

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