Does genital warts cause erectile dysfunction? This is a common concern among men diagnosed with this sexually transmitted infection. Genital warts, caused by low-risk strains of human papillomavirus (HPV), are one of the most frequently diagnosed STIs in the UK. Whilst both genital warts and erectile dysfunction can affect sexual health, they arise through entirely different mechanisms. Understanding whether a direct link exists between these conditions is essential for appropriate management and to address understandable anxieties. This article examines the evidence, explores the psychological impact of STI diagnosis on sexual function, and provides guidance on treatment options and when to seek medical advice.

Understanding Genital Warts and Erectile Dysfunction

Genital warts are one of the most common sexually transmitted infections (STIs) in the UK, caused by certain strains of the human papillomavirus (HPV), particularly types 6 and 11. These appear as small, flesh-coloured or pink growths on the genital area, including the penis, scrotum, vulva, or around the anus. The UK Health Security Agency (UKHSA) reports that genital warts remain a frequently diagnosed STI at sexual health clinics. The NHS HPV vaccination programme, which protects against HPV types 6 and 11 (as well as high-risk cancer-causing types), has contributed to a reduction in genital warts incidence among vaccinated cohorts.

Erectile dysfunction (ED) is the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual activity, typically lasting three months or longer. It affects men of all ages but becomes more prevalent with advancing age. Common causes include cardiovascular disease, diabetes, hormonal imbalances, neurological conditions, certain medications, and psychological factors such as anxiety or depression.

Whilst both conditions can affect sexual health and wellbeing, they arise through entirely different mechanisms. Genital warts are caused by a viral infection transmitted through skin-to-skin contact during sexual activity, whereas erectile dysfunction typically results from vascular, neurological, hormonal, or psychological factors. Understanding the distinction between these two conditions is essential for appropriate management and to address patient concerns about potential links between HPV infection and erectile function.

Many men diagnosed with genital warts understandably worry about broader implications for their sexual health. This article examines the evidence regarding any potential connection between genital warts and erectile dysfunction, explores the psychological impact of STI diagnosis on sexual function, and provides guidance on treatment options and when to seek medical advice.

Can Genital Warts Directly Cause Erectile Dysfunction?

There is no established direct physiological link between genital warts and erectile dysfunction. According to the British Association for Sexual Health and HIV (BASHH) and NHS guidance, the HPV strains that cause genital warts (primarily types 6 and 11) are considered low-risk variants that do not penetrate deep tissue structures or affect the vascular, neurological, or hormonal systems responsible for erectile function.

Erectile function depends on a complex interplay of adequate blood flow to the penis, intact nerve pathways, appropriate hormonal levels (particularly testosterone), and psychological readiness for sexual activity. The presence of genital warts on the skin surface does not interfere with these physiological mechanisms. The warts themselves are superficial epithelial growths that do not damage the erectile tissue (corpora cavernosa), penile blood vessels, or the nerves responsible for initiating and maintaining erections.

Current medical literature and guidance from organisations such as NICE (National Institute for Health and Care Excellence) and BASHH do not identify genital warts as a causative factor for erectile dysfunction. Studies examining HPV infection have not demonstrated that the virus itself impairs erectile function through biological mechanisms.

However, it is important to note that some men with genital warts may experience erectile difficulties. In rare cases, extensive or painful lesions, or temporary discomfort following treatment procedures, may transiently affect sexual function, but this does not constitute true erectile dysfunction. More commonly, erectile difficulties are attributable to psychological factors rather than direct physical causation. The emotional distress, anxiety, and self-consciousness associated with having visible genital lesions can certainly impact sexual performance.

Any persistent erectile difficulties (lasting three months or longer) warrant separate medical evaluation to identify underlying causes, including common factors such as cardiovascular disease, diabetes, hormonal imbalances, neurological conditions, or medication side effects.

Psychological Impact of Genital Warts on Sexual Function

The psychological burden of a genital warts diagnosis can significantly affect sexual function and overall wellbeing. Receiving an STI diagnosis often triggers feelings of shame, embarrassment, anxiety, and reduced self-esteem. Many individuals worry about transmitting the infection to partners, face concerns about relationship implications, and experience anxiety about their sexual attractiveness.

These psychological factors can manifest as sexual dysfunction, including erectile difficulties. Performance anxiety is a well-recognised cause of situational erectile dysfunction, particularly in younger men. When a man feels self-conscious about visible genital lesions or worries about his partner's reaction, the resulting anxiety can interfere with the physiological processes necessary for achieving an erection. The sympathetic nervous system activation associated with anxiety counteracts the parasympathetic relaxation required for erectile function.

Research has demonstrated that psychological factors account for a substantial proportion of erectile dysfunction cases. The stress associated with managing a chronic or recurrent condition like genital warts can contribute to this. Some men may avoid sexual intimacy altogether due to embarrassment, leading to relationship strain and further psychological distress. Evidence suggests that individuals diagnosed with STIs may experience higher rates of depression and anxiety, both of which are independently associated with sexual dysfunction. The bidirectional relationship between psychological wellbeing and sexual function means that addressing mental health concerns is often essential for resolving sexual difficulties.

Healthcare professionals should recognise the psychological impact of genital warts and provide appropriate support, reassurance, and, where necessary, referral to counselling services or psychosexual therapy. NHS Talking Therapies (formerly IAPT) offer accessible support for anxiety and depression. Accredited psychosexual therapists can be found through registers such as the College of Sexual and Relationship Therapists (COSRT). Open communication with sexual partners and accurate information about transmission risks can help alleviate anxiety and improve sexual confidence during and after treatment.

Treatment Options for Genital Warts in the UK

Treatment for genital warts in the UK follows BASHH guidelines and aims to remove visible warts, alleviate symptoms, and reduce anxiety, though it does not eliminate HPV infection entirely. Treatment choice depends on wart number, size, location, patient preference, and whether the patient is pregnant or immunocompromised.

Topical treatments that patients can self-apply at home include:

• Podophyllotoxin cream or solution (0.15% or 0.5%): Applied twice daily for three consecutive days per week, for up to four weeks. It works by preventing wart cell division. This treatment is contraindicated in pregnancy. Avoid application to mucosal surfaces or large areas of skin.

• Imiquimod cream (5%): Applied three times weekly at night for up to 16 weeks. This immunomodulator stimulates local immune responses against HPV-infected cells. The cream should be washed off after 6–10 hours. Imiquimod is generally avoided in pregnancy unless the benefits outweigh the risks; discuss with your healthcare provider. The cream may weaken latex condoms and diaphragms whilst on the skin; avoid sexual contact during application periods.

Both treatments require careful application to affected areas only, avoiding normal skin and mucosal surfaces. Common side effects include local redness, soreness, erosion, itching, and burning. If you experience severe local reactions, stop treatment and seek clinical review. Do not use over-the-counter wart treatments intended for hands or feet on genital skin.

Clinic-based treatments administered by healthcare professionals include:

• Cryotherapy: Freezing warts with liquid nitrogen, typically requiring multiple sessions at weekly or fortnightly intervals. This is a preferred option during pregnancy.

• Trichloroacetic acid (TCA): A chemical treatment applied directly to warts, suitable for small numbers of warts and safe in pregnancy.

• Surgical excision or electrocautery: Reserved for extensive or treatment-resistant cases.

• Laser therapy: Available in specialist centres for difficult cases.

Treatment response varies considerably between individuals. Some warts resolve spontaneously without treatment, whilst others prove resistant to multiple therapies. Recurrence is common, though rates vary by treatment modality and individual factors; warts may reappear as HPV can persist in surrounding normal-appearing skin. Immunocompromised patients may experience more refractory disease and should be managed by specialists.

Patients should be advised to avoid sexual contact during treatment and until warts have completely resolved. Condom use reduces but does not eliminate transmission risk, as HPV spreads through skin-to-skin contact in areas not covered by condoms.

Partner notification and screening are not routinely recommended for genital warts, as there is no HPV screening test for partners and most will have already been exposed. However, your healthcare provider may offer testing for other STIs as appropriate.

If you experience side effects from any treatment, you can report them via the MHRA Yellow Card scheme at yellowcard.mhra.gov.uk or through the Yellow Card app.

When to Seek Medical Advice for Sexual Health Concerns

Prompt medical consultation is advisable if you notice any unusual genital lesions, lumps, or skin changes. Whilst genital warts are generally harmless, accurate diagnosis is essential to exclude other conditions and initiate appropriate treatment. Self-diagnosis is unreliable, as various conditions can mimic genital warts, including normal anatomical variants (pearly penile papules), skin tags, molluscum contagiosum, or more serious conditions such as syphilis or penile cancer.

You should contact your GP or local sexual health clinic if you:

• Notice any new lumps, bumps, or growths on your genital area

• Experience persistent erectile difficulties lasting more than three months

• Have concerns about possible STI exposure

• Notice bleeding, pain, or discharge associated with genital lesions

• Experience significant anxiety or distress affecting your sexual relationships or mental wellbeing

• Are pregnant, immunocompromised, or have lesions affecting urination

Seek urgent assessment if you notice:

• Unexplained penile ulceration or a firm, indurated mass (possible cancer)

• Rapidly enlarging, bleeding, or changing lesions

• Features suggestive of syphilis or other systemic infection

NICE guidance recommends urgent referral for suspected penile cancer in certain circumstances; your GP will assess whether this is necessary.

For erectile dysfunction specifically, medical evaluation is recommended if difficulties persist beyond three months or cause significant distress. Your GP can assess for underlying causes such as cardiovascular disease, diabetes, hormonal imbalances, or medication side effects. Early investigation is particularly important as erectile dysfunction can be an early warning sign of cardiovascular disease, and your GP may conduct a cardiovascular risk assessment.

Sexual health clinics (also called genitourinary medicine or GUM clinics) offer confidential, specialist services for STI diagnosis and treatment. These services are free on the NHS and do not require GP referral. You can find your nearest clinic at nhs.uk/service-search/sexual-health. Many clinics offer walk-in appointments or online booking systems.

If psychological factors are contributing to sexual difficulties, your GP can refer you to NHS Talking Therapies or psychosexual therapy services. Relationship counselling through organisations like Relate may benefit couples navigating the challenges of STI diagnosis.

Remember that healthcare professionals are accustomed to discussing sexual health concerns and provide non-judgemental care. Early intervention typically leads to better outcomes for both genital warts and erectile dysfunction, so do not delay seeking help due to embarrassment. Your sexual health is an important component of overall wellbeing and deserves appropriate medical attention.

Frequently Asked Questions