How to Recognize HPV in Men (Human Papillomavirus)

Genital human papillomavirus (HPV) is probably the most common sexually transmitted infection (STI), infecting almost all sexually active people at some point in their lives.^{[1]XResearch source} Fortunately, there are more than 40 strains of HPV, and only a few of them lead to serious health risks. The virus is undetectable in men who do not have symptoms, and may lie dormant for years before causing any issues. For this reason, it is important to examine yourself regularly if you have ever been sexually active. Most infections clear up on their own, but tell a doctor about your symptoms anyway to rule out cancer caused by HPV.

Part 1

Part 1 of 2:

Recognizing Signs and Symptoms of HPV

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1
Understand how HPV is transmitted. HPV can spread through any skin-to-skin contact involving the genitals. This can happen during vaginal sex, anal sex, hand-to-genital contact, genital-to-genital contact without penetration, and (rarely) oral sex.^{[2]XResearch source} HPV can remain in your system for years without causing symptoms. This means you could still have HPV even if you have not recently had sex, or if you have only been having sex with one partner.
- You cannot get HPV from shaking hands or from inanimate objects such as toilet seats (except possibly shared sex toys). The virus does not spread through the air.
- Condoms do not protect you completely from HPV, but they may reduce the chance of transmission.^{[3]XTrustworthy SourceCenters for Disease Control and PreventionMain public health institute for the US, run by the Dept. of Health and Human ServicesGo to source}
2
Identify genital warts. Some strains of HPV can cause genital warts: lumps or growths in the genital or anal region. These are considered low risk strains, since they rarely lead to cancer.^{[4]XTrustworthy SourceAmerican Cancer SocietyNonprofit devoted to promoting cancer research, education, and supportGo to source} If you're not sure whether you have genital warts, compare your symptoms to the following:
- The most common location for genital warts in men is under the foreskin of an uncircumcised penis, or on the shaft of a circumcised penis. Warts can also appear on the testicles, groin, thighs, or around the anus.
- Less commonly, warts can appear inside the anus or urethra, causing bleeding or discomfort at the toilet. You do not need to have anal sex to get anal warts.^{[5]XResearch source}
- The warts can vary in number, shape (flat, raised, or cauliflower-like), color (skin-colored, red, pink, grey, or white), firmness; and symptoms (none, itchiness, or pain).
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3
Look for signs of anal cancer. HPV rarely causes cancer in men. Even though almost every sexually active person has been exposed to HPV, it only causes anal cancer in about 1,600 U.S. men a year.^{[6]XTrustworthy SourceCenters for Disease Control and PreventionMain public health institute for the US, run by the Dept. of Health and Human ServicesGo to source} Anal cancer can begin without any obvious symptoms, or with one or more of the following:
- Bleeding, pain, or itching of the anus.
- Unusual discharge from the anus.
- Swollen lymph nodes (lumps you can feel) in the anal or groin area.
- Unusual bowel movements or a change in the shape of your stools.
4
Identify penile cancer. About 700 U.S. men each year are diagnosed with HPV-caused penile cancer.^{[7]XTrustworthy SourceCenters for Disease Control and PreventionMain public health institute for the US, run by the Dept. of Health and Human ServicesGo to source} Possible signs of early penile cancer include:^{[8]XTrustworthy SourceAmerican Cancer SocietyNonprofit devoted to promoting cancer research, education, and supportGo to source}
- An area of penis skin becoming thicker or changing color, usually on the tip or foreskin (if uncircumcised)
- A lump or sore on the penis, usually not painful
- A reddish, velvety rash
- Small, crusty bumps
- Flat, bluish-brown growths
- Smelly discharge under the foreskin
- Swelling at the end of the penis
5
Watch for signs of throat and mouth cancer. HPV increases the risk of cancer in the throat or back of the mouth (cancer of the oropharynx), even if it's not the direct cause.^{[9]XTrustworthy SourceCenters for Disease Control and PreventionMain public health institute for the US, run by the Dept. of Health and Human ServicesGo to source} Possible signs include:
- A persistent sore throat or ear pain
- Difficulty swallowing, opening the mouth fully, or moving the tongue
- Unexplained weight loss
- Lump in the neck, mouth, or throat
- Hoarseness or voice changes that last more than two weeks
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Be aware of risk factors for HPV in men. Certain characteristics make an HPV infection more likely. Even if you are not showing symptoms, it's a good idea to educate yourself about possible medical checkups and treatments if you fall into any of these categories:^{[10]XTrustworthy SourceAmerican Cancer SocietyNonprofit devoted to promoting cancer research, education, and supportGo to source}
- Men who have sex with men, especially those who receive anal sex
- Men with compromised immune systems, such as those with HIV/AIDS, a recent organ transplant, or immunosuppressant medication
- Men with many sexual partners (of any sex), especially if condoms are not used
- Heavy use of tobacco, alcohol, hot yerba mate, or betel increase your risk of some HPV-linked cancers (especially in the mouth and throat).
- Uncircumcised men might be at higher risk, but the data is unclear.^{[11]XTrustworthy SourcePubMed CentralJournal archive from the U.S. National Institutes of HealthGo to source}

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Seeking Medical Evaluation and Treatment When Needed

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1
Consider a vaccine. One series of the HPV vaccine provides safe, long-lasting protection against many of the HPV strains that cause cancer (but not all).^{[12]XTrustworthy SourceAmerican Cancer SocietyNonprofit devoted to promoting cancer research, education, and supportGo to source} Because the vaccine is much more effective on young people, the Center for Disease Control recommends it for the following men:^{[13]XTrustworthy SourceCenters for Disease Control and PreventionMain public health institute for the US, run by the Dept. of Health and Human ServicesGo to source}
- All men 21 or younger (ideally at age 11 or 12 before sexual activity)
- All men who have sex with men at the age of 26 or younger
- All men with a compromised immune system age 26 or younger (including HIV positive men)
- Tell the provider about any severe allergies you have before getting the vaccine, especially to latex or yeast.
2
Treat genital warts. Genital warts may go away on their own after a few months, and will never lead to cancer. The main reason to treat them is your own comfort. Treatments include creams or ointments (such as Podofilox, Imiquimod, or Sinecatechins) which you can apply at home, or removal at the doctor's office by freezing (cryotherapy), acid, or surgery. A doctor can also apply vinegar to illuminate warts that aren't yet raised or visible.^{[14]XResearch source}
- You can transmit HPV even if you don't have symptoms, but the chances are higher while you have genital warts. Talk to your sexual partners about this risk, and cover the warts with condoms or other barriers if possible.
- Although the strains of HPV that cause genital warts do not cause cancer, you may have been exposed to more than one strain. You should still talk to your doctor if you have noticed any possible cancer signs or unexplained symptoms.
3
Ask about anal cancer screening if you have sex with men. HPV-related anal cancer rates are much higher among men who have sex with men. If you fall into this category, tell your doctor about your sexual orientation, and ask about the anal pap smear test. Your doctor may recommend a test every three years (one year if you are HIV positive) to screen for anal cancer.
- Not all doctors agree that a regular screening is necessary or helpful, but they should still educate you about the test and allow you to make your own decision. If your doctor does not offer this service or cannot tell you about it, seek a second opinion.
- If homosexuality is illegal in your country, you may be able to get treatment and health education resources from an international LGBT or HIV prevention organization.
4
Examine yourself regularly. Self-examination can help you detect any HPV signs as early as possible. If it turns out to be cancer, it will be much easier to remove if you catch it early. When in doubt, visit the doctor promptly when you see any unexplained symptom.
- Regularly examine your penis and genital area for any signs of warts and/or areas that look unusual on the penis.^{[15]XResearch source}
5
Discuss possible cancer symptoms with the doctor. Your doctor should examine the area and ask you questions to help diagnose the problem. If they think HPV-related cancer could be a possibility, they can take a biopsy and let you know the result within a few days.^{[16]XTrustworthy SourceAmerican Cancer SocietyNonprofit devoted to promoting cancer research, education, and supportGo to source}
- Your dentist can check for signs of mouth and throat cancer during a routine checkup.
- If you are diagnosed with cancer, the treatment will depend on the severity and how early it was discovered. You may be able to remove early cancer with minor surgical procedures or local treatments such as laser removal or freezing. If the cancer has already spread, you may need radiation or chemotherapy.^{[17]XTrustworthy SourceAmerican Cancer SocietyNonprofit devoted to promoting cancer research, education, and supportGo to source}

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Note that anal cancer is not the same as colorectal (colon) cancer. Most colon cancer is not linked to HPV, although there is some evidence that it is in some cases.^{[18]XTrustworthy SourcePubMed CentralJournal archive from the U.S. National Institutes of HealthGo to source} Your doctor can perform routine screening tests for colon cancer and tell you more about risk factors and symptoms.
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You or your partner may have had HPV for many years with no signs or symptoms. HPV should never be considered a sign of infidelity in a relationship. There is no way of determining who was/is responsible for spreading the infection. 1% of sexually active men have genital warts at any given time.
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