Hi Fredo,

I am a 33 y.o. male who was recently diagnosed with GW. To make a long story short, I noticed a couple of tiny bumps under my public hair a couple of months ago, but didn't really think anything of it. They seemed normal enough..

Well, I recently went to the doc to get my regular STD check, and when I showed him the bumps, he told me they could be GW. Of course, I freaked out. So, they took a skin sample and sent it to the lab. A couple of weeks later, I returned, and I was told, "well, it looks consistent with GW, but we can't really tell you for sure." So much for clarity...

As a preventative measure, (and to make myself feel better) I had the doc cryo the few bumps that I had, and I'm now in the process of healing. Hopefully, I won't need any more applications, and I can get on with my life.

Anyway, my concern centers around the girl who I was with prior to my diagnosis. We had sex literally the night before my first visit to the doc, and had sex perhaps one other time a couple of weeks prior to that. Both times, I knew that I had a few bumps, but I didn't think much of it. Now that I've been diagnosed, I'm extremely worried that she's going to develop GW, and confront me about it. (She was only with one other guy for an entire year before me.)

We had something special, and I still care about her deeply. However, we've both moved on, and I am filled with guilt about this. I feel like I should've gotten myself checked out before having sex with her, but I didn't really think I had GW. I don't know if I was just being naive, selfish or what. I just wish I would've gotten them checked out sooner.

Of course the doc's attitude about the whole thing was very nonchalant. He told me that I could've had this for years, and that it's only showing up now, or that she could've as well. He thinks that I'm overreacting, and that even if she contracts GW and confronts me, there's no way of telling if it was me that gave it to her. Still, I've read some figures that say her chance of getting GW after being exposed to me is high, something like 66% or more. I'm convinced that if she's diagnosed, it came from me...

I'm still dealing with my own diagnosis too. Emotionally, I've had some tough days. Further, the cryo left my skin black, and it's starting to blister. I just hope that this heals well, and I'm never going to see GW again on my body. It's very difficult when you think this is never going to happen to you.

Incidentally, I'm eating better -- lots of fresh fruit and veggies -- I'm taking vitamin C and B 50 every night, and I'm getting plenty of rest and exercise. I'm not sure how much of a difference this is going to make though -- I've always been really healthy and health conscious.

Anyway, thanks for listening. It helps just to get some of this out. I have read the thread about telling future partners, but I don't remember if I saw anything about telling past partners. I do know that she gets regular pap smears. Hopefully, she'll never develop GW, and I can try to put this all behind me. I still wish I could turn back time -- I would take sex and sexuality so much more seriously, and not treat it as a conquest without consequences.

So, any help/suggestions/encouragement/support from you or anyone else would be much appreciated. Thank you so much.

Hi Max,

Thanks for posting. Only a small number of individuals with the types of HPV that cause warts will actually develop lesions they see or feel, or that are diagnosed clinically. A good number will have unrecognized/undetected lesions.

Most sexually active people have one or more HPV infections in their lifetimes, and the majority are never aware. On top of that, HPV infections tend to be cleared over time by the immune response. I can't say if you should tell her or not; there is no general consensus at this point on informing partners about genital warts, especially those in the past. One thing to consider is that telling a past partner might generate a great deal of anxiety with no real resulting medical benefit. Sometimes the best reason to have these conversations is if there's a great deal of guilt involved, so it's really up to what you're comfortable with.

I hope this helps. Post again anytime.

Best,
Fredo

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ASHA Moderator

Fredo - I appreciate the quick reply.

I take it from your first paragraph that it's possible that I could've infected her, but she may never develop detectable lesions. Is there any period of time after which I can feel confident that this may be the case? I've heard that if someone's been exposed to GW, that any signs should appear within ninety days or so.

Your response about generating anxiety without a great deal of medical benefit was pretty much in line with what my doc told me. Nevertheless, I am still having a hard time dealing with the guilty feelings that I'm having -- i.e., if I knew or recognized that something wasn't right with my body, I should've abstained until I knew what was going on. Do you have any strategies for minimizing or dealing with those types of feelings?

I guess that I'm just concerned (as many people are who are diagnosed with GW) about her reaction. Will she blame me and get angry at me? I feel like she would be furious, and the repercussions could be very bad. All I really want is understanding and her acceptance that I didn't know what going on with my body, and I didn't think that I was putting her at risk of anything.

As an aside, do you know how long it takes to heal from cryo? As stated, I had three small areas treated in the pubic region. I'm wondering how long the hearing process is going to take, and what the chances are of my skin looking normal afterwards. I've read some studies where hyper or hypo pigmentation occurs after cryo...

Also, is it best to abstain from sexual contact until completely healed? My current partner knows about my diagnosis and has been very supportive. So, is there an increased risk of transmission while I'm healing? Is it possible that since the symptomatic tissues are essentially dead, the risk isn't any higher than, say, the risk of me transmitting when I'm completely healed and asymptomatic? My doc told me that as long as my partner was comfortable with it, the risk of transmission isn't any greater, I just need to be careful since the healing process can be painful.

Thanks!

Healing depends, in part, on how many warts were removed, how large a surface area was involved, and so on. Typically, this runs about 2-3 weeks, maybe less with very few or small warts. Scarring is usually minimal, if any occurs at all.




Lesions often do occur in a few weeks up to several months, but really could take an indefinite number of months (or even years). However, most cases never involve visible or easily detected warts; only a tiny number are diagnosed.



A current partner is likely to have the virus. Researchers can't say for sure if removing warts reduces the risk, but many of them speculate that it does. If warts don't recur for several months, the risk of transmitting the virus at that point also can't be defined, but again, many believe the risks will have diminished greatly. It's hard to put a more specific point on it than that, however.

Hope this helps.

Best,
Fredo

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ASHA Moderator

Fredo - thank you so much for your input.

I realize that you're probably already answered questions similar to mine on the forum, but your personal response to me really means a lot!

Glad to do it, and thanks for posting!

Fredo

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ASHA Moderator

Hi Fredo,

I finally got my lab results. They were as follows:

"The skin biopsy from the pubic area shows a squamous epithelial hyperplasia with mild hyperkeratosis and focal increased granulosis. Definitive HPV effect is not identified in the biopsy. A condyloma cannot be entirely excluded; however, definitive features are not identified. Correlate clinically."

What can I take from this? Do I or don't I have GW? Is there some other condition that appears to be similar to GW that I may have?

Coincidentally, I've discussed the results with two docs in the same practice group. The one who diagnosed me seemed to think I did indeed have GW. The other, who was more experienced, seemed to think that I did not have GW.

I am so confused.

I'm still having a really hard time with all of this. I'm not sleeping, and I'm so afraid of the effects of disclosure to future partners. I feel like I've been changed forever, and that I'm not going to be able to develop the kind of relationship that I want in my life.

Very depressed,

Max

Wow, I don't know what to say, that's all confusing. Difficult to sort out, considering the health care providers are of differing opinions. The report does seem to indicate the lack of anything definitive re: HPV, and one Doc says you don't have it...but I can see where there's some doubt.


Partners are probably more of an issue if you strike up a connection with someone while the lesions/bumps are present. Once they're treated and you're able to go awhile with no recurrences, man, it's hard to strongly urge you to bring up HPV with someone new, given the fact you haven't really been diagnosed. I wish I had something better to offer you, pal!

What did the docs say regarding new partners and discussing this, anything?

Fredo

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ASHA Moderator

Thanks for the reply, Fredo.

The docs both were of the opinion that I didn't need to disclose this to future partners once I'm treated and I'm lesion free.

The first doc (the one who diagnosed me) told me that "everyone has this anyway, so there's really no point in disclosing". He was very nonchalant and dismissive about the whole thing.

The second doc told me that there's no need to disclose, and that the lab results leaned more towards the direction of not having GW. During the course of that discussion, I showed him a spot that was missed by the cryo doc, and he told me that the lesion didn't look like GW.

Still, I'm left with the lingering feeling that I do indeed have HPV. I've had one additional tiny spot appear since my cryo, and the one spot that was missed has grown a bit, and is now more pronounced. Further, nobody has told me what, if anything, these bumps are, if not HPV. You know the saying, "if it looks like a duck, walks like a duck and sounds like a duck, well...."

I'm going back soon for cryo to the two tiny spots that I have. I'm hopeful that after treatment, nothing will recur, and I'll be symptom free forever.

I agree that I need to discuss this with any potential partners while the bumps are present. However, once symptom free, I want so badly to put this behind me, and to never have to discuss it with any future partners. I don't know what I would do though if I start a relationship, and at some point my partner develops lesions. The guilt would be overwhelming...

I'm so frustrated about the lack of clarity from my providers. If I hadn't asked for a biopsy, my diagnosis would've been GW, end of story. I paid for the biopsy, and now, there's nothing but more confusion. I suppose the simplest course is to just listen to both docs -- get treated, and don't worry about disclosing to future partners. However, that's easier said than done.

Anyway, thanks for your response and for being so supportive.

~Max~

Absolutely. This is so difficult for you to have to sort out, and your frustration is very understandable. The more you do, it seems the more confusing things become.

I think your providers have given you reasonable guidance re: new partners but you're right, that's not always easy to do. You are very much concerned about others, to your everlasting credit. Just keep in mind it's entirely possible (perhaps probable...) you don't have genital warts and if you do, your body is likely to clear the underlying virus at some point. Few of those with HPV of any sort will develop detectable lesions.

Keep posting, as often as you like. Let us know how you're doing!

Fredo

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Hi Fredo,

I was definitively diagnosed with GW today. I went to a very well qualified, experienced dermatologist and brought my lab report from the biopsy with me.

He diagnosed me pretty quickly after performing a physical exam, and had some interesting things to say. First, the pathology work didn't include a DNA test for HPV. He said that he sees loads of warts cases where no "hpv effect" is seen in the lab results. Second, when I asked him about my GW being the low risk type of HPV, he wasn't so sure. He told me that it was hard to tell what type I have. Maybe he was referring to any other possible concurrent HPV infection, I don't know. Thoughts? I'd love to be able to tell my current partner when I disclose this that I have a low risk type..

Anyway, I cried for a bit in the exam room, and then got it together. He told me that GW's are way more common than the statistics suggest -- just today, he was treating 10 or more patients with the same problem!

He performed some pinpoint cryo, and prescribed aldara for me, once every other day. He's going to follow up with me monthly, and cryo any new warts. He told me that my horizon to being clear, and able to have intercourse, was likely around six months, assuming the treatment goes well. Does this seem about right? (I realize there are no definite statements, but I'm just looking for a good probability.)

As an aside, I was shocked at the cost of aldara -- $375 for fifteen single use packets, with the insurance deduction! Is there anywhere or any way that I can get this cheaper?

So, it looks like I've got some months of treatment ahead of me. I'm going to tell my girlfriend in the very near future, and I'd like to be able to give her some solid information. For example, I'd like to tell her that I only have the low risk type of HPV. I'd also like to tell her that after I'm clear for about six months, that the risks of transmission to her are greatly diminished. This is my understanding from all of the information that's been provided on this site. So, I hope I'm stating the facts accurately.

Can I also tell her that the longer a person goes past six months without symptoms, the less likely they are to transmit this? Also, what if she's already had the gardasil vaccine? My doc seemed to think that we could have intercourse without waiting if she's already been vaccinated.

Thanks for being so great, and I apologize if I've asked redundant (or already answered) questions.

~Max~

Fredo,

I just wanted to let you know that I disclosed my diagnosis to my girlfriend last night, and she was nothing but supportive! She told me that she wasn't going to let this stand in the way of being with me...so happy right now!

She's going to look into getting the gardasil vaccine, and we're going to wait the standard six months. (This is a convenient time frame, considering my doctor's treatment schedule for me.)

Just a few follow up questions assuming she's been vaccinated:

1) Once I'm lesion free for say, six months, can we have unprotected sex?

2) Does is matter if I have lesions or not? (In other words, would the vaccine protect against an active outbreak?)

3) If she doesn't get the vaccine, and I'm lesion free for six months, is it fair to say that she's still at risk for contracting HPV, but if she does, it will likely not cause lesions? (I guess I'm a little confused -- it seems that if you have visible lesions, chances are your partner will develop them too, but it you don't, and the infection appears to be latent or suppressed, your partner may get HPV, but not develop lesions.)

4) Does the location of the lesions matter? (I didn't have any on my penis.)

I just want to have a normal, happy sex life, and be able to engage in unprotected monogamous sex after my treatment and after her vaccination. This is possible, right?

Hope these questions weren't too much.

Thanks!

~Max~

Hi Max,

Glad to hear things went so well with your girlfriend! I think partners are generally more accepting than we might think, and I appreciate you for sharing this.

If she gets the vaccine, she'll develop protection against any HPV types covered by the vaccine that she doesn't have. There is no set point at which you know for certain the virus can no longer be transmitted, but many experts believe the risks decline markedly in one who has gone a number of months with no recurrences. It's hard to be more specific than that, though.

Most individuals with the types of HPV associated with warts will never develop detectable signs, but if they do it can happen regardless of whether or not their partner had any visible signs.

Read more about this at http://www.ashastd.org/phpbb/viewtopic.php?t=394.

Take care and post again anytime.

Best,
Fredo

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ASHA Moderator

Hi Fredo,

Glad to share my success story regarding disclosure. I want others to read this and realize that, if you are with the right person, they will stay with you, and offer you the love and support you need to get through this.

I read the thread about long term infectivity. However, I'm still a bit confused. You said: "Most individuals with the types of HPV associated with warts will never develop detectable signs, but if they do it can happen regardless of whether or not their partner had any visible signs."

How do I square this with the information on, for example, the Gardasil website which says that 2 out of 3 people who have contact with a partner with visible warts will develop lesions themselves?

Thanks again,

Max

Good question, and I think the answer is that warts are often very tiny and difficult to detect (even with a medical exam). As a result, most never see or feel anything.

Best,
Fredo

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