It is a jungle out there. It should surprise no one that if they were to bring a sexually transmitted infection into a relationship, their partner would be none-too-happy. However, many infections will bring symptoms to the cheating male and, if they seek treatment before passing it to their partner, they can escape without being exposed. There are, however, 2 sexually transmitted infections that usually will not afford this escape opportunity for the cheating male. Which two can provide this service? They are the human papilloma virus ( HPV ) and trichomonas.
Many sexually transmitted infections like gonorrhea or chlamydia, for instance, often are accompanied by symptoms in a cheating partner that motivates them to seek treatment. Males will often experience urethral discharge and or painful urination with these infections and seek treatment. If they are able to accomplish this before passing it to their partner, they may escape unscathed. The key here is the symptoms they experience. These symptoms are their friend, warning them to seek treatment. That is the difference. HPV and trichomonas do not usually provide this service to the cheating male. Let us look at the two infections individually to understand why.
First, the human papilloma virus or ( HPV ) is the most common sexually transmitted infection today. It is estimated that a staggering 70-90% of sexually active people will be exposed to some form of this virus. There are many different types of this virus, each identified by their individual number and the list of numbers is long. Additionally, these virae are generally separated into two groups, low risk and high risk. Generally speaking, the low risk forms are responsible for causing genital warts or “condyloma” and the high risk are associated with precancerous and cancerous lesions of the cervix and other parts of the body. For the purpose of this discussion, we will focus on the high risk types.
High risk HPV is considered “high risk” because, following exposure, and if left untreated, it will cause precancer or cancer in some people. It is because of these high risk forms of the virus that we perform pap smears in women. The pap smear is a screening test used to identify women with precancerous changes of the cervix. If the pap smear identifies a woman with cervical cancer then it has failed. The purpose is to screen women, identify those at risk and then treat them BEFORE they develop a malignancy.
There are two basic parts to the pap smear. First is the evaluation of the cervical cells themselves under microscopic magnification, a cytologic evaluation. Cytology is the study of cells. The second part is a screen for the presence of one of the forms of high risk HPV. A woman can have a “normal” pap smear but have a positive screen for high risk HPV. In this case, she has been exposed to the virus, but the virus has not yet caused any precancerous changes in the cervix.
The pap smear has been one of the most important scientific advances in health care for women saving many, many women from a truly devastating diagnosis with miserable consequences. That is just it, though. Pap smears are for women. There is no pap smear for the penis. And an infection with HPV is completely asymptomatic. This is true for men and women, actually. That is, until the virus is allowed to cause the damage that it does and results in a cancerous lesion that will cause vaginal bleeding. The fact that the infection with HPV is asymptomatic is exactly what makes the pap smear so incredibly important. When my patients present for their annual exams and undergo a pap smear, I can inform them of the infection and monitor and or treat them as required. Men do not have this service. They acquire the infection and remain completely asymptomatic. The virus can cause precancerous lesions of the penis known as, Bowenoid papulosis, as well as penile cancer, but this is much less common than cancer of the cervix.
So how are these men caught cheating? The typical scenario plays out something like this. I have a patient who has been coming in for 10 years for her annual exam. Every year her pap smear is normal and her high risk HPV screen is negative. Then suddenly, in her 11th year with me, her pap returns with a positive high risk HPV. I meet with her and inquire as to whether or not she has had a new partner, if she has not, then her partner has. I mentioned before that HPV is the most common STI with 70-90% of sexually active people being exposed. However, if you have 2 uninfected monogamous people in a relationship, HPV will not suddenly appear. If it does, someone has taken a new partner. And please, ladies, do not buy the “toilet seat” defense. Inform your man that is not a means of transmission.
The second stealthy infection is known as trichomoniasis, or”trick” in some circles. Trichomonas is a protozoal infection (as opposed to a bacterial infection). These tricky little fellas cause a horrendous frothy, foul smelling discharge in women but are normally completely asymptomatic in men. So the unsuspecting cheating male believes he has gotten away with something until his partner returns from her doctor visit with a prescription for Flagyl and a lot of questions.
Unlike the HPV infection, whose test must be sent off to the lab for analysis, most of the time the trichomonas infection can be diagnosed in the gynecologist’s office by inspecting a slide of vaginal fluid under the microscope. The protozoae have a distinctive flagylated tail that spins in constant motion. Fortunately, infections with trichomonas are easier to treat and much less dangerous than an infection with one of the high risk HPV strains. The bug’s ability to identify cheaters is no less effective, however.
So cheaters beware and ladies, if you are unlucky enough to find yourself combating one of these infections, you should have a sit-down with your partner. Although unpleasant, to say the least, these infections may provide you with valuable information about a troubled relationship.