We often think of HPV as a women’s health problem. We know certain strains of it cause cervical cancer and it’s one of the reasons women get regular pap smears and HPV tests. Plus, when the vaccine first came out over a decade ago, it was only recommended for girls.
The truth, however, is that men need to know about HPV as well because it can cause genital warts and cancers of the penis, anus, mouth and throat. In fact, nearly four out of every 10 cancers caused by HPV occur in men.
Before you panic, you should know that most HPV infections in men and women are no big deal. You get HPV, you have no symptoms and eventually your body clears itself of the virus without you or your healthcare provider ever being the wiser.
Of course, not everyone has this experience. Some types of the virus cause genital warts and others lead to cancer. There are no tests for HPV in men and few symptoms. The best thing men can do is to get informed, be vigilant about prevention and keep an eye out for any changes to our bodies.
HPV, or human papillomavirus, is the most common sexually transmitted infection (STI) in the U.S. It’s so common that experts believe nearly every sexually active person will have it at some point in their lives.
This is because the virus is so easily spread from infected skin to uninfected skin. Unlike other STIs, with HPV, the skin doesn’t have to be delicate or broken, nor do you have to exchange body fluids to get it. It’s passed through vaginal, oral and anal sex and can be passed through other “close sexual touching” as well (think naked humping).
There are more than 100 different types of HPV that have been identified. We know that some of them (types six and 11 specifically) cause genital warts, and others (16 and 18) cause most cervical cancer in women and anal cancer in both women and men. There are other high risk types known to cause cancer as well.
Genital Warts in Men
In men, genital warts can show up on the tip or shaft of the penis. They can also show up on the scrotum or anus and in the mouth or throat.
Warts don’t usually cause discomfort, so the only way to detect them is by seeing or touching. It’s a good idea to inspect your genitals every now and again for new lumps or bumps. If you’re comfortable, enlist your partner to check on the spots that you can’t see very well (few people are flexible enough to examine their own anus, but mirrors can help you get pretty creative, if that’s your thing).
It’s hard to explain exactly what genital warts look like because they can be very different. Start by thinking about any warts you may have had on your fingers or feet when you were younger. These are actually caused by a different type of HPV. That type doesn’t infect the genitals, but it may give you some visual clues as to what you’re looking for.
Genital warts can be flat or raised, smooth or rough. They may be the same color as your skin or they may be a little pink, brownish, yellowish or gray. Warts often come out in clusters, but can also appear as a single wart — or not appear at all. When there’s a number of them clustered together they may start to resemble a cauliflower.
Remember, you want to find warts early, so you’re looking for something small — the scary STI slide show that some of us saw in sex ed class showed giant condylomas that really did look like whole heads of cauliflower, but it took time for them to look like that and you want to catch them much sooner.
Anal warts may cause some itching, bleeding or discharge, or you may feel like there is a lump in the anus. But this usually only happens after they’ve grown larger.
If you see or feel anything unusual, go get it checked out by a doctor immediately. They know what they’re looking for and can usually diagnose warts with just a visual exam.
Treating HPV in Men
There are creams that they can prescribe for you to use at home that can get rid of the warts. Or, they may suggest an in-office procedure during which they cut off the warts, burn off the warts with an electric current, freeze off the warts with liquid nitrogen or apply strong chemicals to get rid of the warts.
We shouldn’t have to say this but, in case you were planning a DIY treatment (spoiler: you shouldn’t), never use over-the-counter wart medication from the pharmacy on your genitals.
Also, it’s important to know that the body usually creates enough antibodies to clear most strains of HPV in one or two years. However, warts can still reoccur even after treatment, and some strains can lie dormant in the body for years before the body clears them.
It’s also worth noting that the types of HPV that cause genital warts are not the same types that cause cancer.
Cancers Caused by HPV in Males
HPV is most associated with cervical cancer, which is predicted to cause over 4,000 deaths in women in the U.S. this year. There are far fewer deaths from cervical cancer than there used to be because we have tests that screen for precancerous changes to cervical cells, and these can be treated before they develop into cancer. Unfortunately, we do not have the same type of tests to discover other HPV-linked cancers at the very early stages — like the types of HPV-linked cancers that occur in men.
Luckily, men can — and should — be on the lookout for symptoms of these cancers.
HPV-linked penile cancer is rare, with only around 1,300 cases anticipated to be diagnosed in the U.S. this year, according to the American Cancer Society.
There are about 2,300 cases of HPV-linked anal cancer diagnosed in men in the U.S. each year. This type of cancer often has no symptoms, but some men may experience anal bleeding, pain, itching or discharge. Changes in your stool can also be an indicator of anal cancer.
Cancers of the mouth and throat — called oropharynx cancers — are more common. About 38,000 men will be diagnosed with them this year, according to the American Cancer Society.
Symptoms of these cancers include sores in the mouth or on the lip that don’t heal, a sore throat or ear pain that doesn’t go away, trouble chewing or swallowing, unexplained hoarseness or voice changes, mouth or tongue numbness, a lump or mass in the neck or unexplained weight loss.
If you have the symptoms mentioned above or are otherwise concerned about your risk of HPV-linked cancer, you should see a healthcare provider who can evaluate you and perform tests, if needed.
Screening for HPV in Men
In general, experts do not recommend any kind of regular screening for these cancers in part because research has not yet shown whether such screenings can ultimately prevent these cancers the way testing and treating early can prevent cervical cancer.
Studies show that men who have sex with men are at a much greater risk of developing anal cancer, as are men with weakened immune systems, such as those who have HIV. For this reason, some experts suggest yearly cancer screening for these men. Talk to your health care provider about your risks and their recommendations.
In the meantime, look for any changes to your penis, scrotum, anus or mouth, and see your healthcare provider if you find anything new or abnormal, even if it doesn’t hurt.
Prevention is Everything
Preventing HPV is important because it is so easily spread and we have no screening tests to detect it in men. The usual STI-prevention rules apply to preventing HPV as well. Less sex and fewer partners can reduce your risk.
Using latex condoms can reduce the risk of transmitting HPV as long as the area of infected skin is covered by the condom.
Condoms have a bad reputation for taking the fun out of sex, but today’s condoms are thinner than ever, come in pleasure-enhancing shapes and include high quality lube on the outside and inside. For condoms to work, you have to use them from start to finish every time you have sex.
The most recent FDA-approved HPV vaccine — called Gardasil-9 — prevents nine types of HPV, including the ones known to cause 91 percent of anal cancers, 63 percent of penile cancers and 89 percent of oropharynx cancers (the original version of the vaccine only protects against four types).
The CDC recommends that all young people get the vaccine at age 11 or 12, and FDA has now approved its use in anyone as young as nine through age 45, if necessary. If you haven’t had it yet, talk to your healthcare provider to discuss whether you should get it. Getting vaccinated is one of the most important things any of us can do to protect ourselves and reduce the overall rates of HPV and HPV-related cancers.
No Need to Freak Out
Even though there are no tests for HPV in men or screening tests for HPV-related cancers of the penis, anus or mouth/throat, the situation is not dire.
Remember, your body will take care of most HPV infections and you may never even know you had them. And we now have a vaccine that protects against the types most likely to cause cancer. Get vaccinated and keep an eye out for any changes to the skin around your penis, testicles or anus, and talk to your healthcare provider if you have any concerns.