A Complete Review of genital warts Complications in Men: Consequences of Ignoring Treatment

Complications of genital warts in men are an issue many men face, but often do not understand well enough. For some, these skin lesions seem to be only a temporary cosmetic problem, while the reality is different.

HPV, the main cause of genital warts, is not limited to women and in men can also cause important complications such as infertility, chronic inflammation, sexual disorders, and even cancer of the penis, anus, or throat. Neglecting timely treatment paves the way for progression of wart disease and causes repeated recurrence and long-term involvement of the reproductive system.

In this article, we review the early and progressive symptoms of genital warts in men in a precise and scientific way, discuss the risks of ignoring treatment, explain the relationship between this disease, infertility, and cancer, and finally describe prevention and management strategies.

If you or someone close to you is facing this concern, reading this article can be an important step toward awareness, health, and making the right decision. Stay with us to the end.

What Are the Symptoms of genital warts in Men?

Male genital warts are one of the most common complications of infection with human papillomavirus (Human papillomavirus), which is usually transmitted through sexual contact.

These lesions do not always appear immediately after contact and may take weeks or even months to become visible. Recognizing the early symptoms of this disease helps with faster diagnosis and timely treatment.

Below, we have listed the symptoms of genital warts in men:

• Small, rough bumps appear on or around the skin of the penis.

• The warts may be white, pink, or the same color as the skin.

• These lesions are usually painless.

• Warts can grow singly or in clusters resembling cauliflower.

• They most often appear on the penis, scrotum, perineum (between the anus and penis), or around the anus.

• In some men, the warts cause itching or burning.

• Sometimes mild bleeding is seen at the site of the wart.

• Some people feel discomfort or pain during sexual intercourse or urination.

• If the warts are constantly irritated or rubbed, they may develop more intense itching, burning, or even a superficial ulcer.

How Are Male genital warts Diagnosed?

The physician usually diagnoses genital warts with a simple examination. During this examination, the genital area, scrotum, perineum, and, if needed, the area around the anus are checked. This is because the shape and location of the lesion are usually sufficient for diagnosis.

If the appearance of the warts is unusual or the physician suspects a specific type of virus, an HPV typing test is ordered to determine the exact virus type. In cases where there may be warts inside the anus, the physician uses an instrument called an anoscope to examine the anal canal.

In this way, diagnosis of genital warts is usually simple and requires testing or more detailed evaluation only in special situations.

Symptoms of Chronic genital warts

If HPV remains in the body for a long time and appropriate treatment or control is not carried out, the warts can become chronic. In this situation, the lesions gradually change shape and usually have a more bothersome appearance and symptoms than in the early stages, as follows:

• Warts become larger and thicker

• Clustered spread and a rougher surface

• Inflammation or ulceration of the skin around the involved area

• Increased likelihood of itching, localized pain, or discharge from the lesions

Do Untreated genital warts Have Complications?

Yes. If genital warts are not treated, they can cause multiple complications. Although in most cases HPV infection is cleared spontaneously by the immune system within two years, this does not mean the disease is harmless. Below are the most important complications of untreated warts:

• In some cases, untreated warts may cause localized secondary infections after irritation or scratching.

• Psychological effects such as sexual performance anxiety or reduced sexual desire are among the complications of this condition.

• Urethral obstruction by large warts can lead to burning or difficulty urinating.

• In chronic cases or in people with immune deficiency, the likelihood of penile cancer caused by high-risk HPV types, especially type 16, increases.

• The harms of male genital warts are not limited to the body. Worry about transmission to a sexual partner, shame, loss of self-confidence, and relationship problems are significant psychological effects of this condition.

Now, to help you better understand the consequences of not treating genital warts, we have summarized the complications of non-treatment in the table below:

Risks and Complications of genital warts in Men

Although genital warts may seem asymptomatic and harmless, as mentioned earlier, ignoring or not treating them can have serious consequences.

These warts are caused by HPV, and some types of this virus are directly related to cancer and fertility problems. If the virus remains in the body, it can turn from a simple lesion into larger problems. Therefore, the most important harms of genital warts in men are as follows:

• Increased risk of penile cancer

• Impaired sperm quality and infertility

• Chronic inflammation in the genital area or urinary tract

• Ongoing transmission of infection to the sexual partner

• Ulcer formation, bad odor, and secondary infections

• Severe psychological impact on sexual desire and performance

Do genital warts Cause Infertility in Men?

genital warts do not directly cause infertility, but some HPV types can affect sperm quality. Research has shown that HPV in semen may reduce sperm motility and lower the chance of fertility.

This effect usually occurs through reduced sperm count and motility, damage to sperm DNA, inflammation in genital tissues such as the testis or epididymis, and in some cases partial obstruction in the path of semen outflow.

For this reason, although definite infertility is not seen in all affected men, the presence of the virus can reduce fertility chances in some men.

The Relationship Between HPV and Male Penile Cancer

HPV types 16 and 18 are considered high-risk genital warts virus types and, if they remain in the body for a long time, can become malignant. For this reason, about 40 to 50% of all cases of penile cancer (Penile Cancer) are associated with HPV, and HPV-16 accounts for about 60 to 63% of HPV-positive cases.

However, according to the CDC in 2023, the HPV vaccine is effective in preventing more than 90% of cancers related to high-risk HPV types, especially HPV-16 and HPV-18. This includes cervical cancer, anal cancer, and some cases of penile, throat, and oral cancer.

Involvement of the Male Urinary Tract With HPV

Sometimes genital warts develop exactly at the urethral opening. In this situation, the person may face problems that make daily life and even passing urine more difficult.

The most common signs in this situation include burning or pain during urination, unusual discharge from the urethra, or a feeling of pressure and blockage in the urinary pathway. In some men, this condition can also cause frequent urination or even chronic urethral inflammation.

Relationship Between genital warts and Male Sexual Disorders

genital warts are not only a physical problem; even if they are painless, they can still create major psychological pressure. Many men develop lower sexual desire because of fear of transmitting the disease. Anxiety and worry also cause stress during intercourse or affect sexual performance.

On the other hand, changes in the appearance of the genital area can cause shame or reduced self-confidence. This issue leads some people to avoid sexual intercourse, and as a result their emotional or married life is also harmed.

Secondary Infections Caused by HPV in Men

If the warts become scratched, inflamed, or ulcerated, they create a suitable site for bacterial entry. Below, we draw your attention to some signs of secondary infection caused by HPV:

• Purulent discharge or bad odor

• Redness or swelling around the wart

• Pain or bleeding

• Increase in the number of lesions over a short time

When Do genital warts Become Chronic in Men?

In some people, especially those with a weaker immune system, genital warts may be recurrent or resistant to treatment. Signs that can indicate long-term persistence of HPV infection include:

• Recurrence of warts after several treatments

• Persistence of warts for more than 6 months in healthy people, or longer in immunodeficient patients

• Reduced response to common treatments such as cryotherapy or imiquimod (Imiquimod)

• Spread of warts to new areas, especially in HIV-positive patients

Prevalence of HPV Complications in Men

Based on data from official CDC sources, the prevalence of HPV complications in men is as follows:

Why Do Men Ignore Treatment for genital warts?

Ignoring treatment for genital warts is a common but concerning behavior among men. Although this disease appears benign, HPV complications in men can range from physical and psychological problems to the risk of transmission to a sexual partner or the development of some cancers.

Nevertheless, many men avoid pursuing treatment for different reasons. Below, we review the most important reasons men neglect treatment for genital warts:

Misconceptions About genital warts

Some men have misconceptions about this disease, which leads to delayed medical visits and even transmission of the virus to a sexual partner. genital warts can recur, spread, or in some cases be associated with high-risk HPV types if not treated. Some of these misconceptions are as follows:

• genital warts get better on their own and do not need treatment.

• This is only a cosmetic issue, not a serious disease.

• genital warts do not cause cancer in men, and only women should worry about HPV.

Fear of Visiting a Doctor and Social Embarrassment

One of the most important barriers to treatment is cultural taboo and embarrassment about seeing a doctor. Many men are ashamed to raise their problem or worry about being judged by the physician or people around them. This feeling causes concealment and continuation of the disease cycle. In reality, treatment in the early stages is much simpler and less costly.

Low Awareness of the HPV Vaccine

Many people still do not know that the HPV vaccine exists or understand its benefits. This vaccine can prevent infection with high-risk virus types and therefore prevent genital warts risks for men, such as penile, throat, or anal cancer. Unfortunately, low awareness of HPV has caused many men not to seek vaccination even at the appropriate age.

Are genital warts Dangerous in Men?

genital warts in men are not always benign. If they are caused by high-risk HPV types or are not treated, they can be associated with serious physical and psychological complications. Some of these risks affect the person himself, and others affect the sexual partner. The most important risks of warts for sexual health are as follows:

• Increased risk of penile cancer if infected with HPV type 16 or 18

• Increased likelihood of anal cancer up to 17-fold in men who have anal intercourse or are HIV-positive

• Possibility of HPV-related cancers in the mouth, throat, and base of tongue

• Transmission of the virus to a sexual partner even without symptoms

• Visible and sometimes painful warts in the genital area or around the anus

• Increased risk of cervical cancer in a female sexual partner if the virus is transmitted

• Reduced sexual self-confidence, anxiety, and ongoing psychological worry

• Chronic HPV infection in men with weak immunity or delayed treatment

• Repeated wart recurrence after incomplete treatment or nonstandard self-treatment

• Absence of symptoms in the early stages and the person's lack of awareness of infection

Symptoms of genital warts Progression

genital warts may remain unchanged in some people, but in others they grow or change shape over time. Recognizing the signs of progression can help with early diagnosis and prevention of complications. Some of the most important HPV symptoms in men are as follows:

• Increase in the number and size of lesions in different areas

• Cluster formation or lesions resembling cauliflower

• Greater roughness and change of texture to an irregular pattern

• Itching, burning, or pain due to contact or friction

• Bleeding, especially during sexual intercourse or irritation

• Discomfort or urinary disturbance if the urethral area is involved

Routes of genital warts Transmission in Men

HPV in men is transmitted through direct skin-to-skin contact, especially during sexual activity. An infected person can transmit the virus even without visible symptoms. The most common transmission routes are as follows:

1. Vaginal sexual contact with an infected person

2. Anal sexual contact with an infected person

3. Oral sexual contact with a person carrying HPV

4. Contact between genital skin and an infected area even without penetration

5. Transmission of the virus from a person who has no symptoms but is a carrier

Do genital warts Increase Cancer Risk in Men?

genital warts are benign in most cases, but if they are caused by high-risk HPV types such as HPV-16 or HPV-18, cancer can occur in men. These virus types can gradually create changes in cells, and if the infection remains for a long time, they can create the background for cancer.

Although the likelihood of cancer in men is much lower than in women and does not have the same broad significance as cervical cancer, risks still exist. The cancers most associated with HPV in men include:

• Anal cancer, which in more than 90% of cases is related to complications of anal genital warts.

• Penile cancer, in which 60 to 70% of patients are infected with HPV.

• Cancer of the throat, tonsil, and base of tongue, which is closely related to HPV-16, especially in men.

The problem is that many men are unaware they have HPV, because the virus usually remains asymptomatic and may stay active in the body for years. This lack of awareness gives cells enough time to enter precancerous stages.

Some groups are at higher risk than others, including men with weak immune systems, such as patients with HIV, men who have sex with men, and people who have multiple sexual partners or whose sexual partner is infected with HPV.

Ways to Prevent genital warts in Men

The HPV vaccine (HPV Vaccine) is one of the most effective strategies for preventing this disease, and according to the recommendation of the CDC, it can prevent up to 90% of HPV-related cancers. Other strategies for preventing genital warts in men include using condoms, limiting the number of sexual partners, and seeing a specialist early if initial symptoms appear.

Conclusion

genital warts are not just a superficial problem; if left untreated, they can lead to serious problems such as infertility, cancer, or sexual dysfunction. HPV, the main cause of this disease, remains asymptomatic in many cases, which makes diagnosis and prevention more difficult.

Men should be aware of warning symptoms and avoid delaying medical evaluation. Early referral to a specialist, completing treatment, and avoiding self-treatment are vital steps for controlling this disease.

Using appropriate diagnostic methods, maintaining sexual hygiene, and receiving HPV vaccination can prevent many complications of HPV. For more information, we suggest reading the comprehensive article on the risks and complications of genital warts.

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