What is HPV? An OB/GYN Explains
I† just found out I have HPV. What is it?
HPV (Human Papillomavirus) is the most common sexually transmitted disease, and it will infect 75 percent of young women before the age of 50, if they donít get vaccinated. Itís the virus that causes genital and anal warts, abnormal pap smears, and cervical cancer. Even if youíre a virgin when you hook up with someone, you can end up with HPV — even if your partner has only slept with one other person.
This is not a disease of freaks and hoochies. (If it is, then Iím one of those hoochies, since I got it from my husband. Poor guy. He feels bad.) Even if youíre really careful, you can still get it, and next thing you know, youíve got genital warts and cervical cancer. While they do reduce the risk of transmission, condoms donít completely protect you, since your labia can touch the skin around your partnerís genitals, even with a condom on. All it takes is intimate genital touching between you and your partner.
Why is HPV so common and why is everyone talking about it?
The strains of HPV that tend to cause abnormal pap smears and cervical cancer donít cause any problems in men. So they donít even know they have it. Which means theyíre passing it around from woman to woman, like a beach ball. You gotta wonder when the guy says, ďOh, thatís so weird. ALL my girlfriends have had abnormal pap smears.Ē Duh, dude. Itís you!
What can happen to you if you catch HPV?
HPV can cause warts, abnormal pap smears, and cervical cancer. Usually, warts are caused by HPV types 6 and 11, the two most common strains. These strains cause problems for both men and women, since men can get genital warts and anal warts as well. Asking your partner if heís ever had warts can give you an idea of whether your partner might carry HPV.† But even if your partner says no, it doesnít mean youíre out of the woods. Some people carry the virus but their immune systems keep it from wreaking havoc on their genitals. Even so, they can shed the virus from their genitals and pass it along. Then if your immune system is weak one day, BOOM. There it is. Cauliflower crotch.
But warts are small potatoes, as far as HPV goes. HPV types 16 and 18 (the high risk types) can cause abnormal pap smears and cervical cancer.† Thatís why itís so important to get pap smears regularly. As long as you get your pap smear once a year, you will probably never get cancer. But you may very well wind up with an abnormal pap smear, the way I did. If that happens, youíll have to get a procedure called a colposcopy, which is a microscope we gynecologists use to get up-close-and-personal with your cervix to make sure thereís no cancer.
If I have HPV, what should I tell my sexual partners?
To keep your karma clean, itís not a bad idea to tell your past and future sexual partners. Chances are, more than half of them have already been exposed, and one of them was the one who gave it to you. Because many strains of HPV do not cause problems for guys, your partner may not even know he has it. But technically, anyone who may have been infected by you should tell future sexual partners that they may carry HPV and may be able to transmit it. It gets very complicated, because your immune system may clear HPV from your system and make it undetectable at some point. So will you still be infectious five years from now? Probably not. But maybe. This is why itís such a big problem. Some women seem to clear HPV, only to have it show up again when their immune system is suppressed, as it normally is during pregnancy.
What can I do if I have HPV?
Because HPV is a virus, thereís no real cure, the way there is for most bacteria. If you have warts, the warts can be treated. And if you have an abnormal pap smear, we investigate further with colposcopy, a test that helps us differentiate whether the abnormalities are mild or more severe. If theyíre mild, we focus on supporting your immune system, while we take a wait-and-see approach, which means pap smears every three to six months until things get better or worse. If they get worse, it means treatment, like a LEEP (Loop Electrosurgical Excision Procedure), which is the surgical procedure I had to have a few years back. Believe me. Itís no fun. But it beats the Big C.
Natural treatments aimed at supporting the immune system can help you clear the virus, but ultimately, youíre at the mercy of your immune system.† So if you get HPV, you may have it for years.† If you have access to an integrative medicine doctor or naturopath, they† may be able to help you with some herbs and supplements that can stimulate your natural immune response. †But otherwise, itís all about treating any problems the HPV causes. Unfortunately, thereís no magic pill that can erase HPV worries forever.
If I donít already have HPV, how can I prevent it?
You can use condoms, which reduces, but doesnít eliminate, the risk of contracting HPV.† You may also want to talk to your doctor about whether you are a candidate for Gardasil, the HPV vaccine. The vaccine is a series of three injections aimed at protecting you against the four most common strains of HPV- types 6, 11, 16, and 18, the types that cause 70% of cervical cancer and 90% of genital and anal warts. The vaccine is given as three injections over a six month period and is FDA approved for girls and women age 9 to 26. The Center for Disease Control (CDC) and the American Academy of Pediatrics currently recommend that all girls be given the vaccine between the ages of 11 and 12.† Thereís a lot of controversy about giving a young girl a vaccine against a sexually transmitted disease. But we do it already. Babies get vaccinated against Hepatitis B, which is another STD.† When patients ask me whether I will vaccinate my own daughter, I tell them sheís still young, so more information about safety and efficacy will exist by the time she is old enough to get the vaccine.† Assuming itís proven safe and effective, I will vaccinate her. If I didnít and she ended up with cervical cancer, how would I answer her if she asked, ďMom, why didnít you vaccinate me when you had the chance?Ē