Hello,

I have been with my girlfriend for nearly a year and our relationship is going quite well. However, due to a sexual encounter she had prior to our relationship, she eventually noticed lesions which were diagnosed as genital warts (this was in December 2008.) Although she was very frustrated, ashamed and sad, I was accepting of the situation - after a little research I realized that there was no reason to panic. We stopped having sex for several months; she was treated (Condyline, then laser surgery), then we had protected sex for a few months. She noticed a few new small lesions in the same areas and we stopped having sex again after treatment (more Condyline, followed by cryotherapy). Since then we've started having sex again, though she still has some minor lesions present.

All through this I assumed I was carrying HPV but was asymptomatic, as I had read most men are. In the last few days, however, I've noticed a few minor bumps that I believe are genital warts (will be seeing my doctor soon to confirm). Needless to say that I am not pleased with this development, but I'm not really alarmed or worried. As I said, I will be seeing my doctor soon and will probably be starting some form of treatment.

My questions relate to what our sex life will be like for the next few months now that we both know we have HPV. Previously we had protected sex, knowing that I was probably but not certainly carrying the virus. Now that I'm quite sure I have it with visible lesions, should we do anything differently?

The information I've read on this board has led me to believe that we're not at a very high risk of reinfecting each other once one of us clears up, nor that having sex would "worsen" the lesions on one or both of us. I've also seen that most information points to a low risk of transmission orally, but I haven't been performing oral sex on her. To sum up my questions:

A) Is it worth having protected sex if neither of us can make the other's lesions worse? How reliable is this information?

B) Should we avoid oral sex altogether or, again, is it not worth it?

C) Considering we are in a long-term relationship, when is it safe to have unprotected intercourse and oral sex again? When we've both been cleared up for awhile?

D) Is it a plausible option for couples in our situation (both partners with HPV and visible symptoms) to have unprotected (penetrative and oral) sex on a consistent basis, both of us treating our warts throughout? Is it better to avoid sex, get cleared up, then start again? Does this make a difference considering the risk of reinfection?

I'm sure similar questions have been posted but like most people, I suppose, a personal answer is always more reassuring. Thanks in advance.

Hi and thanks for posting. As you've probably noticed from the posts you've read here, there are seldom clear, black and white answers with many HPV questions. This is largely because research just hasn't uncovered the answers yet, so there's a lot of "most experts think" and "no data indicate..." and so on. Frustrating, to say the least. First, ask your/her doctor what they recommend for your specific situation. We'll try and give general answers to these questions.

A) Is it worth having protected sex if neither of us can make the other's lesions worse? How reliable is this information?

No evidence that couples who share the same HPV infection will make things worse by continuing to have sex. There are some small Dutch studies that suggest (but can't be said to prove) that couples who have HPV and use condoms clear both the virus and related lesions a bit more quickly. The mechanism of action here isn't clear, a number of theories but who knows.

B) Should we avoid oral sex altogether or, again, is it not worth it?

Also unknown, but most folks savvy in this area would recommend you not perform oral sex on a partner while any lesions (warts or cell changes) are present.

C) Considering we are in a long-term relationship, when is it safe to have unprotected intercourse and oral sex again? When we've both been cleared up for awhile?

God, I wish we had an answer to this. It depends a lot on how freaked out you guys are, and you don't seem to be very much so. Waiting until the lesions have cleared is reasonable, but there's no consistent guidance I've seen that says wait "X" number of weeks/months. A couple in your situation, where you already have a history of unprotected sex, would probably need to worry too much about this.

D) Is it a plausible option for couples in our situation (both partners with HPV and visible symptoms) to have unprotected (penetrative and oral) sex on a consistent basis, both of us treating our warts throughout? Is it better to avoid sex, get cleared up, then start again? Does this make a difference considering the risk of reinfection?

Refer to my previous responses here. No studies I know of have shown that continuing to have sex makes it worse, but there is some evidence that condom use might clear things up a little more quickly.

I'll post that article below, ok?

Best,
Fredo

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ASHA Moderator

Condom Use and HPV Clearance

The efficacy of condom use in preventing HPV transmission is unknown and stirs much debate in the increasingly politicized arena of public health. The discussion may become even more robust following two recent studies from the Netherlands indicating that consistent use of condoms may aid in clearing both HPV and lesions associated with the virus.

Researchers from Albert Schweitzer Hospital in Dordrecht divided women with HPV and cervical cell changes (Cervical Intraepithelial Neoplasia or CIN) into two groups, one that was instructed to use condoms consistently with their male sexual partner and one that was not. Over two years, the condom group (64 women evaluated) showed 53% regression of lesions compared to 35% among the noncondom group (61 women evaluated).

The condom group also was more likely to test negative for HPV after two years, with 23% clearing the virus versus only 4% of the noncondom group.

In related research, a group of investigators from Amsterdam’s VU University Medical Center followed 100 male partners of women with CIN. The men, who had penile lesions, were also divided into condom and noncondom groups. The women whose male partners used condoms (57 evaluated) had some lesions regress more quickly, in roughly seven and one-half months, compared to just under fourteen months for the group not using condoms (43 evaluated).

The effectiveness of condom use in preventing HPV transmission is unknown, however. These studies, although designed in a manner to evaluate the effect of condom use prospectively, did not evaluate consistent or correct use or condoms with the study participants.

While the Dutch researchers conclude that condom use aids in the clearance of HPV and genital lesions (probably by reducing additional exposure to the virus and decreasing viral load), questions remain as to the impact of condom use on HPV transmission, and clearance of HPV-associated lesions.

References


Hogewoning CJ et al. Condom Use Promotes Regression of Cervical Intraepithelial Neoplasia and Clearance of Human Papillomavirus: a Randomized Clinical Trial. International Journal of Cancer Dec 2003; 107(5):811-816


MCG Bleeker et al. Condom Use Promotes Regression of Human Papillomavirus-Associated Lesions in Male Sexual Partners of Women with Cervical Intraepithelial Neoplasia. International Journal of Cancer Dec 2003; 107(5):804-810

Originally published in HPV News. (c) 2004-2009 The American Social Health Association. All right reserved.

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Posted by Fredo

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ASHA Moderator