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HPV After 50? It's No Joke

By Barb Depree, MD

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You've come a long way, baby. You survived the sexual revolution of the 1960s and 1970s. You raised your family. You have a rewarding career. And you're conquering menopause.

Now it's time to face facts about human papillomavirus (HPV), the most common sexually transmitted infection.

It's also the most common cause of abnormal pap smears, although a new abnormal pap result doesn't mean you've been re-infected.

HPV 101

There are roughly 100 different types of HPV, and the most dangerous ones don't have any symptoms.

And, just like other viruses, it can't be treated with antibiotics.

Think you're not at risk? Think again, because 8 of 10 sexually active people are infected at some point in their lives. And, according to a 2013 study, you can develop HPV after age 50 when a virus that was dormant for years "reactivates" decades later.

Kinda like getting chicken pox as a kid and then fighting shingles years later. Except worse, because some high-risk types of HPV (e.g., types 16, 18 and 13) could lead to cervical cancer as well as head and neck, cervical, vulvar, vaginal, penile and anal cancer.

HPV infections occur when the virus enters your body, primarily by skin-to-skin contact. In some cases you may develop genital warts, which look like flat lesions, small cauliflower-like bumps or tiny stem-like protrusion. They can show up on your vulva, cervix, vagina or near your anus. (Warts can be treated with creams or, in some cases, removed.)

You can also get HPV infections in your throat, tongue, tonsils, larynx and nose.

Safety first

Women are twice as likely as men to develop STIs, especially after menopause when our genitals have aged and we're more likely to develop small tears and cuts. (By the way, moisturizers and lubricants can help with that.)

Keep these tips in mind:

  • Don't put off pap smears—especially if you've had multiple partners. At ages 30-65, you should have a Pap test every three years (or every five years if your health care provider does dual testing). Talk to your health care provider about the right plan for you, given their specific options. And, if you get an abnormal result, be sure to follow doctors' orders.
  • If you're in a newer or non-monogamous relationship, use protection to avoid getting and spreading HPV.
  • If you've been with the same partner for 20 years, you can't be re-infected by the same HPV type. So no worries. You can relax and enjoy sex without a condom.

The bottom line: Although most HPV types are harmless, you're always smart to be on guard.

Barb DePree, MD, has been a gynecologist for 30 years, specializing in menopause care for the past 10. Dr. DePree was named the Certified Menopause Practitioner of the Year in 2013 by the North American Menopause Society. The award particularly recognized the outreach, communication and education she does through MiddlesexMD, a website she founded and where this blog first appeared. She also is director of the Women's Midlife Services at Holland Hospital, Holland, Michigan.