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Preventing HPV Infection

Monday, December 23rd, 2013

Human papillomavirus (HPV) is the most common sexually transmitted infection (STI). HPV can lead to a number of serious health problems, such as genital warts and some types of cancer. Many people who have HPV do not know it, because it often causes no symptoms. HPV should not be confused with either herpes or HIV. While these can all be transmitted through sex, they cause different problems and produce different symptoms.

Anyone who has ever had sex has potentially been exposed to HPV. Remember – not everyone who has it is even aware they have it. At least half of all people who are sexually active will get HPV at some point. This statistic remains constant even in the case of people who have only one sexual partner in their entire lifetime.

Most commonly, HPV is transmitted through vaginal and anal sex. It does not discriminate between straight and homosexual couples. Furthermore, even if years have passed since contact with an infected person, HPV infection can still be present. In rare instances, HPV can be passed from a pregnant woman to her baby during delivery. In addition, one person can contract more than one type of HPV.

In most cases, HPV will go away on its own without causing any serious problems. Sometimes, however, the infection will stick around and cause serious issues such as genital warts, cervical cancer, or other types of cancer.

According to the CDC (Centers for Disease Control), HPV is the main cause of cervical cancer in women. There are about 12,000 new cervical cancer cases each year in the United States. Cervical cancer causes about 4,000 deaths in women each year in the United States. There are about 15,000 HPV-associated cancers in the United States that may be prevented by vaccines each year in women, including cervical, anal, vaginal, vulvar and oropharyngeal cancers.  In addition, about 7,000 HPV-associated cancers in the United States may be prevented by vaccine each year in men.  Approximately 1 in 100 sexually active adults in the United States have genital warts at any given time.

 

Should You or Your Daughter Get an HPV Vaccine?

Individuals can reduce their risk of getting HPV by getting vaccinated. As with any newer vaccine, there have been rumors regarding dangerous side effects. However, the fact is that the HPV vaccine has been shown to be safe and effective, and since at least 70% of all cervical cancers are caused by HPV, it is absolutely recommended that people who are able to get the vaccine do so. Gardasil is one vaccine that should be given to girls and young women between 11 and 26 years of age. Another available vaccine is Cervarix. The vaccines are given in the form of three doses (injections) administered over a period of six months; for the best protection, it is important to receive all of the doses (injections).

Sexually active individuals can also choose to lower their risk by using condoms. It is possible for HPV to affect areas that the condom does not cover, so realize that condoms are not 100% effective against the transmission of HPV. A vaccination is recommended even for people who always use condoms and plan to continue to do so.

Gardasil is also licensed, safe, and effective for males ages 9 through 26 years. CDC recommends Gardasil for all boys aged 11 or 12 years, and for males aged 13 through 21 years, who did not get any or all of the three recommended doses when they were younger. All men may receive the vaccine through age 26, and should speak with their doctor to find out if getting vaccinated is right for them.

 

The vaccine is also recommended for gay and bisexual men (or any man who has sex with men) and men with compromised immune systems (including HIV) through age 26, if they did not get fully vaccinated when they were younger.

 

Finally, limiting the number of sexual partners a person has can reduce their risk of being exposed to HPV; so can choosing a partner with few or no previous partners. But again, even if only have one sexual partner ever, you still have at least a 50% chance of contracting HPV – so, in you are in the appropriate age range, you should still receive the vaccine if possible.

– Yvonne S. Thornton, M. D., M. P. H.

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You’ve Been Diagnosed with HPV. Now What?

Monday, December 10th, 2012

Have you gotten your HPV vaccination yet? If not, go get one now. HPV, or the human papillomavirus, is the single most common cause of cervical cancer in women. In many cases, women don’t even realize that they have HPV. For that reason, it’s important that every sexually active person is vaccinated because it is technically an STD (sexually transmitted disease) transmitted through intercourse. The HPV vaccination is simple, especially compared with the possible consequences of cancer treatment without it.  As stated in a prior blog in 2009, the benefits of being vaccinated against HPV far outweigh the small potential dangers.  If you are between 9 and 26, you should seriously consider getting the vaccination.

If you’ve been diagnosed with HPV, you’re probably wondering what happens next. It is too late to get vaccinated at this point, but it’s important that you understand how high your risk for getting cancer is. Though HPV (depending on its type) causes cancer in many instances, it is not to say that you’ll get it for certain. Many high-risk HPV infections simply go away on their own without leaving anything more than a few cell abnormalities. This spontaneous clearance of the virus usually occurs in women who are younger than 30 years of age.  It’s also important that you understand ways to decrease your risk once you’re diagnosed with HPV. Smoking and poor oral hygiene have both been linked to increase cancer risk following an HPV diagnosis, so it’s important that you take proper preventative measures.

In some ways, your HPV diagnosis is a perfect way for your doctors to more closely monitor your risk of developing cervical cancer. Many women who have cervical cancer can go years without even knowing that the cells are developing. It is a silent progression from a precancerous lesion to full-blown cervical cancer.  After your HPV diagnosis, doctors will know to check for cervical and anal cancer regularly. If they notice a tumor, they can take action quickly, which is the best way for you to beat it. It can take up to twenty years for cancer cells to develop after an initial HPV infection, so regular screening is necessary. Even if a tumor forms, you still have very good chance that it is not even cancerous.

You might be devastated when you first learn that you’ve contracted HPV. However, depending your age, it may resolve or it may persist.  If it does persist, then it certainly increases your risk for cervical cancer.  However, it does not necessarily mean that you will get it for sure. Stay on top of your regular screenings and stay positive.

Read more about HPV and cervical cancer in my newly updated health book, INSIDE INFORMATION FOR WOMEN.

– Yvonne S. Thornton, M. D., M. P. H.

 

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Sex, Lies, and HPV

Monday, December 3rd, 2012


All women have the right to keep their sex lives a secret and only share details with an intimate crowd of friends and partners. However, you might be surprised when your gynecologist asks for details about your first sexual experience. He or she might ask what age you had your first sexual partner and even what type of intercourse occurred. While you might be hesitant to share the details at first, it’s actually extremely important that you’re as honest as possible. Your gynecologist needs to know the details because recent studies have linked the age of your first intercourse with the likelihood that you’ll contract the human papillomavirus (HPV).  HPV has been found to be a precursor and is linked to cervical cancer.

In many cases, women who had sexual intercourse for the first time at a young age contracted HPV later in life. Even if you don’t have HPV now, your sexual history will help your gynecologist decide which types of infections and viruses to look out for.  Also, he or she may recommend being vaccinated against HPV with the Quadrivalent vaccine (Gardisil). The reasoning behind the connection between sexual history and HPV is partly because of sexual choices. There is a good chance that someone who had sex early on will have had more sexual partners than other adults, which will directly increase her likelihood of contracting HPV. Your gynecologist will also ask if you ever had any non-consensual sex, because the types of partners you’ve had and their health will also contribute to whether or not you’ll get HPV.

When your physician asks about your early sexual history, don’t worry about being judged. The best thing you can do for your own health is to be honest and share any detail you can remember. It might seem strange sharing such information with a stranger, but rest assured that she will keep the information confidential and within the walls of the office. If you’re concerned about your gynecologist’s honesty and you don’t trust that the information will remain private, it’s time to start looking for a new one. Your health is paramount, and you should feel comfortable sharing any information that will make for a more accurate diagnosis.

-Yvonne S. Thornton, M.D.,M.P.H.

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Why getting the HPV vaccine (Gardasil®) makes sense

Friday, October 30th, 2009

Too often, the Internet is filled with rumors about the dangers of vaccines. And those rumors are typically based on misinformation, disinformation and fear.

That’s been the case with Gardasil® (Quadrivalent Human Papillomavirus  (Types 6, 11, 16, 18) Recombinant Vaccine), the vaccine that protects girls and young women from the human papilloma virus (HPV).  Many people who have HPV may not show any signs or symptoms.  This means that they can pass on the virus to others and not know it. A male or female of any age who takes part in any kind of sexual activity that involves genital contact is at risk.

While all medicines carry some risk, the benefits of being vaccinated against HPV far outweigh the small potential dangers.

A large part of the backlash against this vaccine may be due to an effort by the drug’s manufacturer to make vaccination mandatory.

Do I believe that young girls and women should be forced to get the vaccine? Absolutely not. Coercion would be a mistake. And that attempt by the drug maker appeared, in this physician’s opinion, to place profits above the right to make a personal choice.

But, getting past the bad decisions of pharmaceutical companies, let’s look at the benefits for our daughters and ourselves. We know for a fact that HPV is connected to cervical cancer. And we know for a fact that cervical cancer is a horrible disease.

So, if you can get a vaccine that will largely protect you against HPV, then getting vaccinated is an absolute no-brainer. Gardasil® protects against four types of HPV: two types (Types 16, 18) that cause about 70 percent of cervical cancer cases, and two more types (Types 6, 11) that cause about 90 percent of genital warts.

The HPV vaccine is typically offered to girls and women between the ages of 9 and 26.  Given in a series of three injections (initial vaccine, another in two months and the last in six months).   For adolescents and younger, I would recommend discussing the vaccine with your gynecologist when your daughter comes in for her first gynecologic visit, which should be between 11 and 12 years of age. That first visit is only for an introduction to a gynecologist and a pelvic examination is not performed. It is a “get acquainted” visit and it is then that the benefits of the vaccine should be discussed.  Gardasil® is most effective if you can vaccinate before a woman risks being exposed to HPV … in other words, before she becomes sexually active.

As a woman gets older, her body isn’t as susceptible to the damage of HPV, so vaccinating isn’t recommended.

– Yvonne S. Thornton, MD, MPH

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