My HPV Hurts!
Dr. Jay Goldberg, MD – Women’s Care of Beverly Hills
What is HPV?
HPV is a virus of which there are more than 100 types. Most strains of the virus have no affect or may simply be a type that causes common warts on hands and feet. For most men and women, HPV infections have no symptoms and go away on their own. Roughly speaking, 30 types of HPV affect the genital area, and some women do not clear their infection, thus resulting in changes to the genital area. HPV 16 and HPV 18 cause approximately 70% of the cervical cancer cases and roughly 90% of the strains involved in genital warts are HPV 6 and HPV 11.
How is HPV transmitted?
HPV is transmitted through contact, usually intimate skin-to-skin contact. Because there are so many types of HPV, it is possible to contract one or more HPV infections in your lifetime. The more sexual partners you have, the greater the likelihood of contracting HPV. The best way to avoid HPV transmission is to avoid direct contact with the genital area.
Is HPV common?
Recent studies report that 25% of women aged 15 – 59 currently have HPV, and that over 80% of women will have had at least one HPV infection in their lifetime.
How does HPV cause cancer?
The cervix is at the top of the vagina and leads to the uterus. A PAP smear is performed on the cervix by a physician, and is currently the best way to determine abnormal cells on the cervix. Certain types of HPV can cause changes in the cells of the cervix that can first become precancerous and then cancerous if not detected and treated properly.
How do I prevent HPV?
Avoiding sexual contact with an infected person is the only 100% effective prevention method. A physician should perform a PAP smear starting at the onset of sexual activity and no later than 21 years old. Nowadays, most physician test for HPV when the PAP smear is abnormal. If sexually active, the best way to avoid cervical cancer is to obtain annual gynecologic examinations and follow through with your physician’s recommendations.
What is the HPV vaccine?
Merck’s vaccine, Gardasil is the first vaccine developed to prevent cervical cancer, precancerous genital lesions, and genital warts due to HPV.
Who should get the HPV vaccine?
The Centers for Disease Control and Prevention (CDC) recommends the HPV vaccine for all 11 and 12 year old girls. The recommendation allows for vaccination to begin at age nine. Vaccination also is recommended for females aged 13 through 26 years who have not been previously vaccinated or who have not completed the full series of shots.
Are there other HPV vaccines in development?
GlaxoSmithKline’s Cervarix is another HPV vaccine and it’s in the final stages of clinical testing, but it is not yet licensed. The hope is that this vaccine will protect against the two types of HPV that cause most cervical cancers.
What if my PAP smear is abnormal and I test positive for HPV?
If the HPV infection has caused abnormal cell changes, there are four main treatments:
- Watch and wait. Sometimes the cell changes — called cervical dysplasia, precancerous cell changes, or cervical intraepithelial neoplasia — will heal on their own.
- Cryotherapy. This involves freezing the abnormal cells with liquid nitrogen.
- Conization. This procedure, also known as a cone biopsy, removes the abnormal areas.
- LEEP or Loop Electrosurgical Excision Procedure. The abnormal cells are removed with a painless electrical current.
The goal is to remove all the abnormal cells and thus remove most or all of the cells with HPV.
Tell me more about genital warts.
The types of HPV that cause genital warts are different from the types that cause cervical cancer. They appear anywhere in the genital area from inside the vagina to the lips of the vagina to the perineum and anal area, and can also occur in the groin and under pubic hair. Genital warts classically have a cauliflower-shaped appearance, but can be raised, flat, single, clustered, small and large.
When do genital warts first appear and how long do they last?
Genital warts may appear within a few weeks of contact, a few months, and rarely, years. This makes it difficult to nail down exactly when the transmission occurred. How long warts are present is dependent on how well your immune system responds to HPV and how well the warts respond to various medical treatments.
What treatments are available for genital warts?
Speak with your physician. Every physician has had different experiences and has different comfort levels, but options are:
- At home treatment with prescription creams
- In office treatments
- Acid application by your physician
- Cryotherapy
- Electrocautery and/or laser therapy (sometimes performed in an operating room setting)
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Thanks to Dr. Jay Goldberg for his expert insight and advice!
You can read more about HPV here at My Blank Hurts!
The vaccines for HPV are controversial. Here is an article from the New York Times. It’s a long but thought-provoking article that begs many questions about a number of things including the marketing practices of Big Pharma, the necessity of the vaccines, the benefits, risks, costs, and more. Good reading.
Be informed, and be well.
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