Symptoms of HPV

Because some strains of human papillomavirus (HPV) cause cervical cancer, it's important for women to know how to recognize the symptoms of HPV. It's also important for them to be able to recognize when a partner, male or female, might have genital warts, because some strains of HPV also cause genital warts. Likewise, men should be educated about HPV so that they can recognize it in themselves or their partners.

The first thing to know about HPV, though, is that the virus is virtually undetectable and causes no symptoms in a large proportion of those who are infected. The National Institute of Allergy and Infectious Diseases (NIAID) reports that half of women infected with HPV—and even fewer men—have no specific symptoms.

Warts & Bumps

In some people, the HPV virus types that cause cervical cancer (primarily strains 16 and 18, as well as 33 and 35) spur the formation of tiny, nipple-like bumps (papillae) in the area around the genitals. In fact, the word papilloma comes from the Latin word for nipple. These projections can be as small as 1 millimeter (mm)—about the thickness of a U.S. dime. Adjacent growths, however, can form cauliflower-like clusters that reach several centimeters (cm) in diameter (about the width of a piece of M&Ms candy). The strains of HPV that are largely responsible for genital warts—strains 6 and 11, can also form cauliflower like clusters that form around the genitals and anus

Because symptoms and signs of disease are largely absent, it's impossible to tell for sure whether you or your partner has HPV. By the time symptoms do develop, transmission will already have occurred. Nevertheless, recognizing symptoms if they do exist will allow you to seek treatment and, if you are a woman, receive more frequent screenings for cervical cancer, at your doctor's discretion. Learn more about screening for cervical cancer.

The lumpy growths or masses that can form after HPV exposure show up in different places in men and women. In women, they tend to appear in moist areas such as the labia minora (inner vaginal lips) and near or inside the entrance to the vagina. The can also grow on the cervix, vulva, or in and around the anus. In men, genital warts can appear on the scrotum (testicular sac), in and around the anus, on the glans (head) or shaft of the penis, or under the foreskin in uncircumcised men. Occasionally, genital warts arise in the groin area or on the upper thighs.

HPV growths are painless, but may be itchy. Large masses may have a discharge and can even bleed during sexual intercourse or other sexual contact. The warts appear moist and range in color from pearly white to fleshy pink, gray, or brown. Most people, but not all, who have sexual contact with an HPV-infected person will develop genital warts within a few weeks or up to three months after infection.

Symptoms of cervical cancer

Unfortunately, women with cervical cancer tend not to have symptoms until the cancer becomes invasive—that is, the cancerous cells grow through the top layer of cervical tissue and invade the deeper tissues below.

When women do have symptoms of cervical cancer, they may include the following:

  • Irregular vaginal bleeding (discussed below)
  • Vaginal discharge with an unpleasant odor
  • Vaginal discharge tinged with blood
  • Pelvic or back pain
  • Bladder obstruction caused by encroachment of the tumor on the structures of the urinary tract
  • Difficulty with defecation due to obstruction
  • Swelling of the leg if cancer invades the pelvic wall, obstructing vessels through which lymph fluid drains

Irregular bleeding is the most common symptom of cervical cancer. This bleeding may occur after sexual intercourse or between menstrual periods. It can even occur in a postmenopausal woman whose menstrual periods have stopped. Vaginal bleeding in postmenopausal women should be considered a genital tract cancer until proven otherwise and thus requires a visit to a physician.

Sometimes the bleeding shows up as little more than a blood-streaked vaginal discharge. Women tend to discount such spotting because they're used to menstrual bleeding. Abnormal or irregular bleeding can have any number of causes, some of them serious and others benign. In every case, however, the cause should be urgently investigated. Ignoring the problem can have dire consequences because it may give the cancer time to invade the deep tissues of the cervix, spread to regional lymph nodes, and metastasize to other organs and tissues.