While we’ve all heard of Pap smears to test for cervical cancer, its directly related cause, HPV, has been getting lots of press lately, too. You may have gotten a test for it or been told to get a vaccine against it. But do you know what HPV really is and why everyone’s talking about it?
Despite the increased awareness of HPV, there are still plenty of misconceptions about what it is, how it gets transmitted, and what you can do to treat it. We consulted with some top-notch gynecologists to get the scoop for you.
01. HPV is a sexually transmitted disease, but you don’t have to have intercourse for it to be transmitted.
HPV is spread through sexual intercourse and other intimate skin-to-skin contact. Mayo Clinic notes that more than 100 strains exist. If you’ve never been sexually active or had any type of sexual contact, you have zero risk for contracting HPV; if you have had any sexual contact of any kind, you could have HPV.
02. Most people have HPV.
HPV holds the title of most common STD. Dr. Adrienne Lara, MD, a gynecologist in California, shares that over 90 percent of twentysomethings have HPV. On a broader scale, 79 million Americans have it, and another 14 million will get it within the next year.
Because it’s so common, the Center for Disease Control (CDC) states that practically all men and women who are sexually active where either partner has had sexual contact with someone else previously (basically, everyone except two never-sexually-active adults in a monogamous, lifelong relationship) will acquire HPV at some point. “HPV is everywhere and here to stay,” say Dr. Lara. “In fact, I tell patients to assume most people have HPV.” Even if you're not sexually active, your future partner may have been.
03. HPV is the number one cause of cervical cancer (and genital warts).
The National Cancer Institute states that HPV is responsible for almost all cases of cervical cancer. Two types, HPV-16 and HPV-18, are linked to a whopping 70 percent of cases. Cervical cancer is the second most common cancer in women, according to Jhpiego, an affiliate of John Hopkins University. So it’s one to watch out for.
Another forty types of HPV cause cancer of other genital parts. “HPV is also the leading cause of vaginal cancer and is responsible for half of vulvar cancers,” says Dr. Lynda Roman, MD, Associate Professor of Obstetrics and Gynecology at USC's Keck Medicine.
Two other strains, HPV-6 and HPV-11, cause genital warts. These lesions are transmitted by skin-to-skin contact, and can form in the mouth or genital area.
04. HPV is preventable.
It’s all about being proactive about your sexual health. The CDC reminds us that mutually monogamous relationships increase overall STD protection, including HPV. Like all STD’s, HPV can be prevented by abstaining from sex. If you’re sexually active, you can educate yourself on safe sex practices and available screening tools such as a routine HPV test.
05. Cervical cancer is, too.
A Pap smear, or a Pap test, is the primary screening tool for cervical cancer. Your gynecologist can perform this test right in her office. She’ll scrape some cells from your cervix to examine for abnormalities. Along with a physical exam, this test makes sure your lady parts are healthy and well.
If there aren’t abnormalities, your Pap will be negative. Cell abnormalities will yield a positive Pap smear. These pre-cancers, or cell changes, have potential for turning into cancer. However, it takes years for HPV to result in cancer. Catching abnormalities at an early stage makes all the difference.
06. A positive Pap doesn’t necessarily indicate cancer.
Was your Pap smear abnormal? Cell abnormalities don’t mean you have cervical cancer. It also doesn’t mean you will necessarily develop it. Remember, cervical cancer takes several years to manifest. Getting a Pap is half the battle. Your doctor will require more frequent checkups of every six months to one year. From there, you’ll be guided through exams that best fit your situation. Your next steps will also depend on factors such as your age, lifestyle, and HPV tests.
07. A Pap is separate from an HPV test.
Because a Pap smear examines the abnormalities caused by HPV, it doesn’t specifically screen for HPV. The latter is diagnosed by a separate test. Together, a Pap and an HPV test is known as co-testing. Some doctors practice co-testing and some may not. Don’t be afraid to ask yours whether an HPV test is included.
08. You can have a negative Pap but test positive for HPV.
This is where it gets a bit confusing. If your cells look good, your Pap result will be normal. But that doesn’t always mean you don’t have HPV. HPV can be present without changing your cells. This is how a negative Pap smear can co-exist with HPV and why it’s crucial to get an HPV test if you've had any sexual contact.
09. Paps depend on a bunch of factors unique to every woman.
A woman should get her first Pap smear at age 21, regardless of sexual activity, according to the National Cancer Institute and the CDC. Until age 29, she should get another Pap every three years. For a woman ages 30-65, the recommendation is longer—every five years. “Women ages 29 and younger have a higher risk for contracting HPV,” explains Dr. Linda Burke-Galloway, MD, MS, FACOG, a Florida gynecologist.
10. There’s no HPV test for men.
Currently, there is no approved HPV screening test for men for two main reasons: 1) the significance of test results are unclear as associated health complications with HPV are extremely rare for men and 2) it's not known which part should be tested! Since there is no way to determine if a male has HPV, it all comes down to staying on top of your Pap smears.
11. There’s a vaccination, but it may not be right for everyone.
A vaccination called Gardasil protects women against the four main types of HPV that cause cervical cancer and genital warts. It doesn’t protect women against less common HPV strains.
Gardasil protects best before a woman becomes sexually active. The American Congress of Obstetricians and Gynecologists reports, "Studies show that getting all three doses of the HPV vaccine before you are sexually active can reduce your risk of getting certain types of HPV-related cancer by up to 99 percent."
Can a sexually active woman get the vaccine? Technically, yes. But it will be much less effective. By then, she will likely have been already exposed to the most common HPV strains, according to the CDC. The vaccination will not cure HPV or “fix” cell abnormalities.
Dr. Burke-Galloway adds that it can be administered up to age 26. The CDC states, "HPV vaccination is not currently recommended for women over age 26 years. For women over age 26 years, the best way to prevent cervical cancer is to get routine cervical cancer screening, as recommended."
Recently, the American College of Pediatricians expressed concern regarding Gardasil's potential to cause premature ovarian failure (POF), a condition that causes early menopause. These speculations stem from unclear lab trials in Gardasil's initial safety tests and 213 public reports since 2006 involving amenorrhea (abnormal absence of menstruation), POF or premature menopause, 88 percent of which have been associated with Gardasil. Additional studies examining this possible side effect are in the works. While a definite correlation has yet to be proven, it’s something to keep in mind if you’re considering Gardasil for yourself (or your daughter).
12. Your body might fight HPV on its own.
For some women, their body can fight off HPV within two years. We don’t know why this happens; every strain and woman is different.
Your best bet is to keep your immune system in excellent shape. This increases the chances of your body kicking HPV butt and preventing gynecological cancers. Maintain a healthy weight through exercise and a well-rounded diet. To promote cervical health, fuel up on folate, probiotics, and vitamins C and D.
With this HPV overview, hopefully you’re feeling more confident and in tune with your feminine health and how to take care of it for the long run.
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