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How to have safe sex with genital warts?

Unfortunately, there’s no safe sex with genital warts as they are very contagious

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What are genital warts?

Genital warts are irregular tissue growths that at first will show up as single warts, but with time, clusters of warts can appear. The shape, size, and color of genital warts differ from case to case, but typically they are colored like the surrounding skin and have a rough, hard texture, similar to raw cauliflower. Since other STIs — for example, syphilis — can also cause abnormal tissue growth, it’s recommended that you see a doctor when you notice unusual bumps or warts in the genital areas. A simple test can help determine whether you indeed have genital warts.

Genital warts are a very common sexually transmitted infection (STI) caused by the human papillomavirus (HPV). Within the HPV group, there are about 40 sub-types that can be sexually transmitted, but two strains (type 6 and type 11) are responsible for over 90% of the 1 million genital wart cases diagnosed by U.S. doctors each year.

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In fact, the number of annual HPV infections is much higher — it’s estimated that at any given moment at least 10% of the sexually active population in the U.S. have genital warts associated with HPV. It’s even more prevalent among college-age women and men. However, in most people, the immune system can suppress the virus so that no visible warts or other symptoms develop. Even without any warts, people with HPV infection, remain just as contagious to others. That’s the tricky thing about HPV and genital warts. You may have an infection without even knowing it and unwittingly pass it on to your partner during sex.

How are HPV and genital warts transmitted?

The fact that HPV infections and associated genital warts are the most widespread STI in the world, demonstrates just how extremely contagious this viral disease is. It can be transmitted through oral, vaginal, or anal sex, but often, just contact with infected skin is enough. For women, the risk of catching HPV from an infected partner during sex (with or without actual vaginal intercourse) is about 75%. In the world of STIs, these are very high odds. To compare, HIV transmission probability for a single sexual encounter is approximately 1%.

As mentioned, if you contract HPV type 6 or 11, most likely you won’t even develop any genital warts if your immune system is properly functioning. But you will be just as contagious as someone who has developed visible warts. This is why if you suspect you may have contracted HPV, it’s always recommended to seek medical help to find out for sure.

Can I prevent passing on genital warts?

Unfortunately, the only 100% protection against HPV transmission is abstinence. If you know that you or your partner have HPV or genital warts, it’s recommended that you stop having sex until the infection has been successfully treated, or until your body has developed sufficient antibodies to keep the virus in check, and prevent it from being contagious. Even after treatment is completed, you should avoid unprotected sex for another six months to minimize transmission risk. 

With an ongoing HPV infection (with or without warts) even condoms don’t fully protect you, since there will be still plenty of skin-to-skin contact on the areas not covered by the condom.

It may offer you some consolation though that within 1-2 years, HPV infections either disappear or weaken on their own in 80% of people. The immune system then has developed enough antibodies to either fully eradicate the virus or suppress it enough to no longer be contagious. So, while the temporary impact on your sex life may be frustrating, most likely it will not end up becoming a long-term problem.  

How can genital warts be treated?

Not much can be done against the underlying HPV infection. That’s your immune system’s job and it may take up to two years to succeed. However, there are antiviral creams (including Imiquimod) that are available by prescription, and can help you get rid of genital warts with about 3 to 4 weeks of treatment.
Should these creams not deliver the expected results, or if your warts are already at an advanced stage (forming large clusters), surgical removal may be the only option. Such removals are simple procedures that can use lasers, chemicals, and freezing. They normally don’t hurt and don’t cause complications.


Your gynecologist can tell you more about available medications and surgical removal options.

References

  1. Trottier, Helen, and Eduardo L. Franco. “The Epidemiology of Genital Human Papillomavirus Infection.” Vaccine, vol. 24, Mar. 2006, pp. S4–S15, 10.1016/j.vaccine.2005.09.054. Accessed 24 May. 2020.
  2. Gall, Stanley A. “Female Genital Warts: Global Trends and Treatments.” Infectious Diseases in Obstetrics and Gynecology, vol. 9, no. 3, 2001, pp. 149–154, www.ncbi.nlm.nih.gov/pmc/articles/PMC1784648/, 10.1155/S1064744901000278. Accessed 24 May 2020.
  3. Patel, Harshila, et al. “Systematic Review of the Incidence and Prevalence of Genital Warts.” BMC Infectious Diseases, vol. 13, no. 1, 25 Jan. 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC3618302/, 10.1186/1471-2334-13-39. Accessed 24 May 2020.
     

Information

Reviewed by Dr Roy Kedem, MD

Information last reviewed 12/06/21

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