HPV Symptoms: What Are the Signs in Women and Men?
Does HPV cause symptoms? HPV symptoms in women and men, what genital warts look like, why cell changes in the cervix cause no symptoms, how HPV is detected with the smear and HPV test, and conditions that are mistaken for warts.
Short answer: About 80–90% of HPV infections cause no symptoms at all, and most are cleared on their own by the immune system within 1–2 years. The sign that can be seen with the eye is usually genital warts, caused by low-risk types. The high-risk types that can lead to cervical cancer, on the other hand, cause no symptoms at the cell-change stage; this is why in women HPV is detected not through symptoms but through the smear and HPV test.
HPV (human papillomavirus) is the most common sexually transmitted infection. The most accurate answer to the question "what are the symptoms of HPV?" may come as a surprise: most of the time there are no symptoms at all. In this article we explain when HPV does cause symptoms, what women and men should look out for, and how HPV is detected when there are no symptoms. For the general picture of HPV testing, vaccination and follow-up of a positive result, see our HPV page; for wart treatment, see our genital wart (condyloma) treatment page.
Does HPV Cause Symptoms?
About 80–90% of HPV infections in the genital area cause no symptoms at all; they produce no visible change and no complaint. In people with a healthy immune system, most infections are cleared from the body or suppressed on their own within 1–2 years (on average in 9–15 months).
Only about 10% of infections become persistent (long-lasting). This is the group that carries a risk of cell changes over many years, and these changes do not cause symptoms either. In short, having no symptoms does not mean you do not have HPV.
HPV has two main groups, and the symptoms differ depending on the group:
- Low-risk types (most often 6 and 11): Cause genital warts. These are not cancer-causing types.
- High-risk types (such as 16, 18, 31, 33, 45, 52 and 58): Can cause cell changes, above all in the cervix (the neck of the womb), and in the long term cancer. These types do not cause warts and progress silently.
The Visible Sign of HPV: Genital Warts
The sign of HPV that can be seen with the eye is genital warts (medically called condyloma acuminata).
- Appearance: They may be skin-coloured, pink, grey-white or brownish. They appear as bumps that are flat, dome-shaped, firm and crusty, or clustered like a cauliflower.
- Complaints: Most of the time they do not hurt. Depending on their size and location, there may be itching, mild pain, burning, tenderness or bleeding caused by friction.
- Single or many: They can appear as a single bump or as several warts close together.
Not every newly noticed bump in the genital area is a wart; below we list separately the conditions that are confused with warts.
HPV Symptoms in Women
Where do warts appear?
In women, genital warts can appear on the outer genital area (vulva), the vaginal wall, the cervix, the opening of the urethra (the urinary opening), the area between the anus and the vagina (perineum), around the anus and, rarely, inside the mouth. Warts inside the vagina or on the cervix may not be noticed by the woman herself; they are seen during an examination.
Do cell changes in the cervix cause symptoms?
No. The cell changes that high-risk HPV causes in the cervix (medically called CIN — a pre-cancerous change seen within the epithelium (surface cell layer) that covers the cervix) do not cause pain, discharge or bleeding. These changes are detected only through screening tests, that is, the smear and HPV test.
What symptoms are seen in cervical cancer?
If cell changes are not treated and progress to cancer over the years, symptoms appear. The most typical first symptom is bleeding after sex. Apart from this, the following may be seen:
- Spotting or bleeding between periods
- Bleeding after menopause
- Foul-smelling, watery or bloody vaginal discharge
- Groin and lower back pain
- Pain during sex
These complaints also have much more common causes that have nothing to do with cancer. However, bleeding after sex and bleeding after menopause in particular are situations that require an examination.
Why do symptoms appear late?
The progression of HPV infection to cervical cancer is a very slow process; usually 10–20 years pass between infection and the development of cancer. Because changes at the cell level do not affect the tissue, blood vessels or nerves, the body gives no warning until a mass forms. This is where the importance of screening tests comes from: during this long silent period, they give the opportunity to catch changes and treat them before cancer develops.
HPV Symptoms in Men
- Warts: In men, low-risk types cause warts on the shaft of the penis, the head of the penis, the inner surface of the foreskin, the scrotum, the opening of the urethra and around the anus.
- High-risk types: In men, too, they mostly cause no symptoms. Rarely, they can cause cancers of the penis, the anus and the mouth and throat (pharynx).
- No routine test: If there is no wart or suspicious lesion (tissue change), there is no approved routine test for HPV screening in men. In high-risk groups, such as people who are HIV positive, a swab taken from the anus may be examined.
A man with no symptoms can also carry and transmit the virus. For details on this topic, see our article HPV in men: testing, vaccination and what partners should do.
How Is HPV Detected If There Are No Symptoms?
In women, HPV is detected through cervical cancer screening, without waiting for symptoms:
- The smear test examines the cells of the cervix.
- The HPV test looks for the presence of high-risk HPV types.
In Türkiye, the Ministry of Health's national programme recommends an HPV test every 5 years for women aged 30–65. For which test is done at which age and how often, see our page on the smear test and HPV test; for the difference between the two tests, see our article what is the difference between a smear test and an HPV test. If your HPV test came back positive, the next steps are explained in our article what to do if HPV is positive.
Conditions Mistaken for Warts
Some structures in the genital area can look like warts. They are told apart during an examination:
- Pearly penile papules (small bumps): Small bumps lined up in a row around the rim of the head of the penis in men. They are harmless and not contagious; they are a normal anatomical structure.
- Vestibular papillomatosis: Thin, pink projections seen at the entrance of the vagina in women. It is not an infection; it is a normal structure.
- Molluscum contagiosum: Shiny, dome-shaped bumps with a slightly sunken centre, caused by a different virus.
- Lesions caused by syphilis: In the second stage of the disease, broad-based, moist, grey-white and highly contagious patches can appear; they need a separate diagnosis and treatment.
- Others: Oil gland cysts, inflammation of the hair roots, skin tags and, rarely, the early stages of skin cancer.
For this reason, a newly noticed bump in the genital area should first be diagnosed, rather than tried to be treated at home.
When Is an Examination Needed?
- A newly noticed bump in the genital area or around the anus
- Bleeding after sex
- Bleeding between periods or after menopause
- Foul-smelling or bloody discharge
- Your partner having been diagnosed with genital warts
- The screening test suited to your age being due or overdue
Frequently Asked Questions
If I have no HPV symptoms, does that mean the virus has gone?
No. Most HPV infections cause no symptoms in the first place. Whether the virus has cleared on its own is shown not by symptoms but by screening tests.
Does HPV cause itching?
Genital warts can sometimes cause itching. However, itching alone does not point to HPV; there may be other causes, such as vaginal infections. For details, see our vaginal infection treatment page.
Does HPV cause discharge?
HPV infection itself usually does not cause discharge. Foul-smelling, watery or bloody discharge is counted among the advanced symptoms of cervical cancer; however, discharge has many more common causes. For the types of discharge, see our vaginal discharge page.
Do HPV warts turn into cancer?
Most genital warts are caused by low-risk types (6 and 11) that do not cause cancer. However, because a high-risk type may also be present in the same person, it is important for women diagnosed with warts to keep to their screening schedule.
Can a man with no symptoms transmit HPV?
Yes. In men, too, HPV mostly causes no symptoms, and a man with no symptoms can carry and transmit the virus.