Ask the Gynecologist: How freaked out should I be about a positive HPV test?

In this recurring guest column, Kate White, M.D., of Boston Medical Center, answers your questions on all things gynecology. As the author of the Mayo Clinic Press book Your Sexual Health, she’s ready to dole out wisdom on sex, periods, menopause and more. Submit a question here.

Q: I just got a message from my doctor that my HPV test came back positive. How freaked out should I be right now? What does this mean for my cancer risk? Do I need to tell my sexual partners about this?

A: Take a deep breath: Almost everyone gets human papillomavirus (HPV) at some point.

HPV is so common that nearly all sexually active women, men and nonbinary folks get the virus at some point in their lives. At any given time, about 42 million people are infected with HPV and may not even know it.

HPV is the cause of most cancers of the cervix (and vagina). But most HPV infections clear on their own or become undetectable, and most infections never lead to disease (such as genital warts or changing cervical cells found by a Pap test). If you’re under 30, you’re even more likely to clear your HPV infection on your own.

If you get diagnosed with HPV, should you tell your partner(s)? The answer to that question is an unequivocal yes for every other sexually transmitted infection. But it’s a bit tricky with HPV. Partners with penises can’t be tested for the virus, and no one can be directly treated for the infection. Genital warts or cervical cells can be removed if needed, but this doesn’t eliminate the virus from your system. And you’ll never know who gave the infection to whom.

So, while I recommend honesty in all things sexual, you can be forgiven for not talking to your partner about your HPV infection. If you do decide to talk about it, come with information from your gyno or the Centers for Disease Control and Prevention (CDC) about how common the infection is, and how you both likely have it. You can also have your partner follow up with a doctor or health clinic — or send them the link to this post.

Though you already have HPV, you should consider vaccination if you are not yet vaccinated. The vaccine prevents getting infected with other strains you don’t yet have that would put you at risk of cancer. Everyone from age 11 to 26, no matter their gender identity, should get the vaccine series. Some people older than that — age 27 to 45 — may benefit, and they should talk with their doctor. Beyond that, using external or internal condoms every time you have intercourse can reduce your risk of HPV infection. Notice I said “reduce.” Since HPV lives in the skin of your genitals, direct contact or rubbing up against your partner — during intercourse or at any other time — can transmit HPV.

And be sure to follow your gyno’s suggestions for any follow-up care. Any time you have an abnormal Pap test (including a positive HPV result), your gyno will recommend one of three things: stay on your normal testing schedule (because there’s no cause for concern), repeat the Pap in one year, or come in for a detailed exam of your cervix called a colposcopy. You may have more testing or treatment based on the results.

Ultimately, it’s good that your HPV was detected. Now your health care team can monitor you appropriately and intervene if needed. If you follow your gyno’s recommendations, the chances of you developing cancer are slim.

A version of this text appears in Dr. Kate’s book Your Sexual Health.

The content on this site is to educate consumers on health care and medical issues. Nothing about the content on this site should be considered, or used as a substitute for, medical advice, diagnosis or treatment. This site and its services do not constitute the practice of any medical or other professional health care advice, diagnosis or treatment.

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Kate White, M.D., OB-GYN

Dr. White, author of Your Guide to Miscarriage & Pregnancy Loss and Your Sexual Health, is an associate professor of obstetrics and gynecology at the Boston University School of Medicine and the vice chair of academics in the OB-GYN department at Boston Medical Center. She is a fellow of the American College of Obstetricians and Gynecologists, a fellow of the Society of Family Planning, and a member of the American Public Health Association. As a board-certified OB-GYN, mother and pregnancy loss survivor, Dr. Kate has been caring for women for more than 20 years, helping them navigate every stage leading up to menopause, including periods, childbirth and pregnancy loss. She also conducts research in contraception, has been continuously grant funded for 15 years, and frequently lectures regionally and nationally on topics related to women’s reproductive health. Dr. Kate lives outside of Boston with her husband and their three children.

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