What is HPV? Symptoms, Transmission, and the HPV Vaccine

Human Papillomavirus (HPV) is a common DNA virus that infects the skin and mucous membranes, and it is the most widespread sexually transmitted infection. It is so common in society that the average adult has an 80 percent chance of encountering this virus by the age of 50. Although it often remains in the body without causing any symptoms, in some cases, it can lead to serious health problems such as genital warts and cervical cancer.

In Brief:

• 80 percent of adults will encounter HPV at some point in their lives.
• There are more than 170 types of the virus; over 40 of these are transmitted through sexual contact.
• A large majority of infections clear up on their own thanks to a strong immune system.
• HPV types 6 and 11 can cause genital warts, while types such as 16 and 18 can cause cancer.
• Having regular smear tests is vital to catch cervical cancer in its early stages.
• The 9-valent HPV vaccine provides a high rate of protection against the most dangerous types of the virus.

What is HPV and How Common is It?

The simplest answer to what HPV is, is that it is a family of DNA viruses that target the cells in the epithelial layer of the skin. To date, approximately 170 different types of HPV have been identified. While some of these types cause warts on the hands or feet, more than 40 types directly affect the genital area and are sexually transmitted. A person can be infected with more than one type of HPV at the same time.

The peak of HPV infection is generally seen between the ages of 20 and 25. The vast majority of people acquire this virus at some point in their lives. However, not everyone who is infected becomes ill. The person's immune system usually steps in, suppressing the virus and clearing it from the body on its own. For this reason, many people who carry HPV continue their lives without even realizing they have the virus.

How is HPV Transmitted and What Are the Risk Factors?

The most common route of HPV transmission is sexual contact. The virus is transmitted through direct contact with the skin or mucous membranes of an infected person. It can easily be passed through skin-to-skin contact during vaginal, anal, or oral sex. Even without full sexual intercourse, contact between genital areas is sufficient for the virus to pass.

Although condom use provides protection against many sexually transmitted diseases, it does not completely eliminate the risk of HPV. This is because the virus can also be present on skin areas not covered by the condom. Having multiple sexual partners, starting sexual activity at an early age, and having a weak immune system are among the main factors that increase the risk of HPV infection. Smoking also suppresses immunity, paving the way for the virus to become permanent in the body.

What Are the Symptoms of HPV?

HPV infection is mostly asymptomatic (without symptoms). After entering the body, the virus can remain silent for months or even years. When it does show symptoms, the most common presentation is genital warts. Some high-risk HPV types, on the other hand, cause cellular changes leading to precancerous lesions. These lesions cannot be seen from the outside and do not cause pain; they can only be detected through screening tests.

What Are Genital Warts?

Genital warts, medically known as condyloma, are flesh-colored bumps usually caused by HPV types 6 and 11. In women, they can appear on the vulva, inside the vagina, on the cervix, or around the anus; in men, they can appear on the penis, scrotum, or around the anus. Their size can vary from a pinhead to a cauliflower-like appearance. They are generally painless but can sometimes cause itching, slight bleeding, or a feeling of discomfort.

How is HPV Diagnosed at the Hospital?

HPV is diagnosed primarily through routine gynecological examinations and screening tests, especially in women. The Pap smear test is the most fundamental method used to detect cellular changes in the cervix. During this test, a cell sample is painlessly taken from the cervix using a small brush. The collected sample is examined in the laboratory to check for the presence of precancerous cells. For more detailed information on this topic, you can read our article What is Cervical Cancer? Symptoms, HPV Vaccine, and Smear Test.

In addition to the smear test, the HPV DNA test is also widely used. This test detects the genetic material of the virus, definitively identifying which HPV type you are infected with. If a high-risk situation is detected in the smear or HPV DNA test, your doctor will examine the cervix in detail using an illuminated and magnifying device called a colposcope. If deemed necessary, a biopsy is taken from suspicious areas to make a definitive diagnosis.

How is HPV Treated?

In current medical approaches, there is no specific drug treatment that will completely eliminate the virus from the body. HPV treatment is aimed at resolving the health problems (warts and cellular abnormalities) caused by the virus. Cryotherapy (freezing), electrocauterization (burning), laser therapy, or special creams are used in the treatment of genital warts. Even if the warts are treated, the virus can remain in the body, so there is always a risk of the warts recurring.

When precancerous lesions are detected in the cervix, the goal is to remove these cells from the body before they turn into cancer. Minor surgical procedures such as LEEP (cutting and removing the diseased tissue with an electric current) or conization (removing a cone-shaped wedge of tissue from the cervix) are performed for this purpose. Keeping the immune system strong, eating a healthy diet, and staying away from smoking during the treatment process directly affect recovery.

HPV Infection in Men and the Vaccination Process

HPV infection in men usually shows no symptoms and progresses silently. However, men can unknowingly transmit the virus to their partners, increasing the risk of cervical cancer in women. The most common symptom in men is genital warts. Furthermore, high-risk HPV types can lead to penile, anal, and oropharyngeal (head and neck) cancers in men. For more information about wart problems in men, you can take a look at our article The Invisible Problem of Men: HPV and the Recurrence Riddle in Wart Treatment.

Vaccinating boys and adult men is of great importance both to protect their own health and to stop the spread of the virus in society. The CDC (Centers for Disease Control and Prevention) recommends that boys aged 11-12 be included in the routine HPV vaccination program, just like girls. Vaccinating men is one of the most effective ways to break the chain of transmission of the virus to women.

Who Should Get the HPV Vaccine and When?

Today, the most preferred vaccine is the 9-valent HPV vaccine, which provides protection against 9 different HPV types (6, 11, 16, 18, 31, 33, 45, 52, and 58). These types are responsible for approximately 90 percent of HPV-related cancers. The vaccine is administered as an intramuscular injection in the upper arm or thigh. The total dose is usually completed as 3 doses within a 6-month schedule.

The most ideal period for vaccination is between the ages of 11 and 12, before any encounter with the virus. However, vaccination can start as early as age 9. The FDA (U.S. Food and Drug Administration) has approved the HPV vaccine for individuals between the ages of 9 and 45. Even if a person has previously been infected with HPV or has had genital warts, it is recommended that they get vaccinated. The goal here is not to treat the existing infection, but to ensure the person gains immunity against other dangerous HPV types they have not yet encountered. It should be kept in mind that the vaccine response is much stronger at younger ages.

Complications: Cervical Cancer and Other Risks

In only 1 to 3 out of 100 women who encounter an HPV infection do cellular abnormalities progress and turn into cancer. However, carcinogenic HPV types are found in 99.7 percent of women diagnosed with cervical cancer. The persistent presence of the virus in the body causes deteriorations in the cervical cells over time, known as dysplasia.

If these precursor lesions are not treated, they can turn into invasive cervical cancer over the years. HPV can pave the way not only for cervical cancer but also for vaginal, vulvar, anal, penile, and tonsil/base of tongue cancers. Therefore, it is a vital necessity not to neglect regular screening tests and to stay away from factors that weaken the immune system.

When Should You See a Doctor?

Although HPV usually progresses silently, some symptoms require urgent medical evaluation. If you experience the following situations, you should consult a gynecologist and obstetrician or a urologist without delay:

• Newly formed flesh-colored bumps in the genital area, around the anus, or inside the mouth,
• Unexplained vaginal bleeding during or after sexual intercourse,
• Abnormal bleeding occurring outside of menstrual periods or after menopause,
• Persistent, foul-smelling, or bloody vaginal discharge,
• Continuous severe pain in the pelvic region (lower part of the abdomen).

If you experience sudden, uncontrollable severe bleeding from the vaginal area, or if intense dizziness or a feeling of fainting develops due to this bleeding, you should immediately call 112 emergency services or go to the emergency department of the nearest hospital.

The Diagnosis and Treatment Process at BHT CLINIC

At BHT CLINIC İstanbul Tema Hastanesi, we offer a multidisciplinary approach to the diagnosis and treatment of HPV infections. HPV DNA typing and smear tests are performed with great precision in our microbiology laboratories equipped with advanced technology. When necessary, colposcopy and minor surgical interventions are safely carried out by our expert physician staff.

Our hospital's Infectious Diseases, Gynecology and Obstetrics, and Urology departments plan treatment processes with the utmost respect for our patients' privacy. We are always by your side for your health with our 24/7 emergency service and expert staff. To have your regular screenings done and to get detailed information about the vaccination process, you can book an appointment through our website.

Frequently Asked Questions

How much does the HPV vaccine cost?

The price of the HPV vaccine varies depending on exchange rates, the pharmacy where the vaccine is obtained, and the healthcare facility where it is administered. Since the vaccine is not currently included in the routine state vaccination schedule in Türkiye, it is provided for a fee. You can contact our hospital for current pricing information and administration details.

Do HPV warts go away on their own?

Yes, in some cases, a strong immune system can clear HPV warts on its own over months or years. However, because the risk of the warts growing, spreading, and being transmitted is high, it is generally recommended that they be treated under a physician's supervision using methods such as freezing or burning.

What happens if an HPV test is positive?

A positive HPV test does not mean you have cancer. This result simply indicates that you carry the virus. Depending on the type of virus and your smear test result, your doctor may refer you for advanced examinations like a colposcopy or monitor you at more frequent intervals.

Can virgins get HPV?

Yes, HPV can also be seen in virgins. Full sexual intercourse (penetration) is not required for the virus to be transmitted. Superficial skin contact with the genital area of an infected person is sufficient for transmission.

Can men get tested for HPV?

There is no routine and approved screening test for men like the smear or cervical HPV DNA test used for women. In men, diagnosis is usually made through a clinical examination of visible warts or a biopsy taken from suspicious lesions.

This article is for informational purposes only; please be sure to consult your physician for diagnosis and treatment.