How to Recognize HPV in Men (Human Papillomavirus)

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Genital human papillomavirus (HPV) is probably the most common sexually transmitted infection (STI), infecting about 85% of all sexually active people at some point in their lives. [1] 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. HPV can spread through any skin-to-skin contact involving the genitals. This can happen during vaginal sex, anal sex, or hand-to-genital contact. 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. [2]
    • You cannot get HPV from shaking hands or 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]
  2. 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] If you're not sure whether you have genital warts, compare your symptoms to the following:
    • Warts typically appear on the tip or shaft of the penis. [5] They 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. [6] You do not need to have anal sex to get anal warts. [7]
    • 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). [8]
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  3. 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 2,200 U.S. men a year. [9] Anal cancer can begin without any obvious symptoms, or with one or more of the following: [10]
    • 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.
    • Blood in stool.
    • Having to go to the bathroom more often.
  4. About 900 U.S. men each year are diagnosed with HPV-caused penile cancer. [11] Possible signs of early penile cancer include: [12]
    • 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.
    • Lumps under the skin in the groin area.
  5. HPV increases the risk of cancer in the throat or back of the mouth (oropharyngeal cancer), even if it's not the direct cause. [13] About 72% of all oropharyngeal cancer in men is caused by HPV. [14] Possible signs include: [15] ​
    • A persistent sore throat (pharyngitis) or ear pain.
    • Difficulty swallowing (dysphagia), opening the mouth fully (trismus), or moving the tongue.
    • Unexplained weight loss.
    • Lump in the neck, mouth, or throat.
    • Hoarseness or voice changes that last more than two weeks.
    • Coughing up blood.
    • A white patch on your tongue or lining of your mouth that doesn’t go away.
  6. 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:
    • Men who have sex with men, especially those who receive anal sex. [16]
    • Men with compromised immune systems, such as those with HIV/AIDS, a recent organ transplant, or immunosuppressant medication. [17]
    • Men with many sexual partners (of any sex), especially if condoms are not used. [18]
    • Heavy use of tobacco, alcohol, hot yerba mate, or betel that increases your risk of some HPV-linked cancers (especially in the mouth and throat). [19]
    • Uncircumcised men might be at higher risk, but the data is unclear. [20]
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Part 2
Part 2 of 2:

Seeking Medical Evaluation and Treatment When Needed

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  1. One series of the HPV vaccine provides safe, long-lasting protection against many of the HPV strains that cause cancer (but not all). [21] Because the vaccine is much more effective on young people, the Center for Disease Control recommends it for all men under 26, and especially for the following men: [22]
    • All men 21 or younger (ideally at age 11 or 12 before sexual activity). [23]
    • 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). [24]
    • Tell your provider about any severe allergies you have before getting the vaccine, especially to latex or yeast. [25]
  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. [26] A doctor can also apply vinegar to illuminate warts that aren't yet raised or visible.
    • 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. 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. [27] Your doctor may recommend a test every three years (or every year if you are HIV positive) to screen for anal cancer. [28]
    • 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 LGBTQ+ or HIV prevention organization.
  4. There is no clinically approved test for HPV in men, but a visual self-examination for genital warts (or cancer symptoms) can help you detect any HPV signs as early as possible. [29] 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. [30]
  5. 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. [31]
    • 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. [32]
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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. About 1% of sexually active men have genital warts at any given time. [33]
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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. [34] Your doctor can perform routine screening tests for colon cancer and tell you more about risk factors and symptoms.
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      References

      1. ↑ https://www.cdc.gov/hpv/hcp/clinical-overview/index.html
      2. ↑ https://www.cdc.gov/sti/about/about-genital-hpv-infection.html
      3. ↑ https://www.cancer.org/cancer/risk-prevention/hpv/hpv-prevention.html
      4. ↑ https://healthcenter.vt.edu/content/dam/healthcenter_vt_edu/assets/docs/HPV-and-Men-CDC-factsheet-feb-2015.pdf
      5. ↑ https://www.mayoclinic.org/diseases-conditions/genital-warts/symptoms-causes/syc-20355234
      6. ↑ https://www.sciencedirect.com/science/article/pii/S0094014305702202
      7. ↑ https://patient.info/sexual-health/sexually-transmitted-infections-leaflet/anogenital-warts
      8. ↑ https://healthcenter.vt.edu/content/dam/healthcenter_vt_edu/assets/docs/HPV-and-Men-CDC-factsheet-feb-2015.pdf
      9. ↑ https://www.cdc.gov/cancer/hpv/cases.html
      1. ↑ https://www.mayoclinic.org/diseases-conditions/anal-cancer/symptoms-causes/syc-20354140
      2. ↑ https://www.cdc.gov/cancer/hpv/cases.html
      3. ↑ https://www.cancer.org/cancer/types/penile-cancer/detection-diagnosis-staging/signs-symptoms.html
      4. ↑ https://my.clevelandclinic.org/health/diseases/12180-oropharyngeal-cancer
      5. ↑ https://www.cdc.gov/cancer/hpv/cases.html
      6. ↑ https://my.clevelandclinic.org/health/diseases/12180-oropharyngeal-cancer
      7. ↑ https://www.nhsinform.scot/healthy-living/immunisation/hpv-vaccine-for-men-who-have-sex-with-men-msm/
      8. ↑ https://www.nhsinform.scot/healthy-living/immunisation/hpv-vaccine-for-men-who-have-sex-with-men-msm/
      9. ↑ https://pmc.ncbi.nlm.nih.gov/articles/PMC6210641/
      10. ↑ https://cancer.ca/en/cancer-information/cancer-types/esophageal/risks
      11. ↑ https://pmc.ncbi.nlm.nih.gov/articles/PMC3210112/
      12. ↑ https://www.cancer.org/cancer/risk-prevention/hpv/hpv-vaccines.html
      13. ↑ https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.html
      14. ↑ https://my.clevelandclinic.org/health/treatments/21613-hpv-vaccine
      15. ↑ https://www.gov.uk/government/publications/hpv-vaccination-for-msm-posters-and-leaflets/information-on-hpv-vaccination-for-msm
      16. ↑ https://www.mayoclinic.org/drugs-supplements/human-papillomavirus-vaccine-intramuscular-route/description/drg-20127679
      17. ↑ https://www.mayoclinic.org/diseases-conditions/genital-warts/diagnosis-treatment/drc-20355240
      18. ↑ https://www.cancer.gov/news-events/cancer-currents-blog/2024/anal-cancer-screening-self-collected
      19. ↑ https://www.cancer.org/cancer/types/anal-cancer/detection-diagnosis-staging/detection.html
      20. ↑ https://www.ashasexualhealth.org/what-men-should-know/
      21. ↑ https://www.ashasexualhealth.org/what-men-should-know/
      22. ↑ https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-and-cancer
      23. ↑ https://www.cancer.org/cancer/types/penile-cancer/treating.html
      24. ↑ https://pmc.ncbi.nlm.nih.gov/articles/PMC3209812/
      25. ↑ https://pubmed.ncbi.nlm.nih.gov/23895733/

      About This Article

      Article Summary X

      Recognizing HPV in men can be challenging since most men don't show any symptoms, at least not right away. Additionally, most HPV infections clear up on their own, so it can be easy to dismiss. However, you'll want to see your doctor if you notice certain symptoms, like genital warts, swollen lymph nodes in the anal or groin region, a persistent sore throat and unexplained weight loss, or swelling at the end of your penis. Depending on your symptoms, your doctor may recommend a cancer screening. For more tips from our Medical co-author, including how to look for signs of anal cancer, keep reading!

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