Human Papilloma virus (HPV) is a widely prevalent virus that is passed from person to person through skin-to-skin contact. Although these strains are spread through sexual contact, sexual intercourse is not necessary to spread HPV.  It may be spread through any sexual contact.  It has been suggested that about three out of four sexually active people may have a genital HPV infection  at some point in their lives.

How can we test for HPV?

There are over 120 known strains of HPV at present and only about 15 of those strains are linked to cervical cancer, and approximately 12 strains may cause genital warts.  For women over 30, a pap smear checks for any abnormal cells as well as detectable strains of high risk HPV.  In women under 30, high risk HPV is tested only if the pap smear reveals any abnormal cells.  This is because cervical cancer is very rare under the age of 30 and most women with HPV are able to clear the virus on their own.  Adolescents have an almost 80% clearance rate for high risk HPV.

What is an abnormal pap test and how do you proceed if you have an abnormal pap?

Abnormal pap results may be reported as “Abnormal cells of unknown significance (ASCUS)” , low grade intra-epithelial lesion (LGSIL) or high grade squamous intra-epithelial lesion ( HGSIL).  The next steps in care are decided depending on the results of the pap smear.  If you are positive for HR HPV ( high risk human papilloma virus) and don’t have any abnormal cells, you may just need to be watched closely for any cell changes.  You will be advised to have a test called colposcopy which includes examination of cervix under magnification and a cervical biopsy ( sampling). Depending on the results, you may need 6 monthly follow up or removal of abnormal cells by a small procedure called LEEP or cryo-freezing. It is important to remember that testing positive for HPV does not mean that you have cervical cancer.

Does HPV affect men? How can we test men?

HPV affects men as well as women.  HPV testing is currently not widely prevalent for males. Therefore, it may be hard to go back and figure out who the high risk HPV infection was contracted from. HPV can survive and lay dormant (asleep) inside the cervical cells for many years before detection.  Condoms may help prevent HPV transmission, but HPV can also infect areas that are not covered by a condom, therefore they may not prevent complete transmission. Here is some more information for HPV infection and testing in men. https://www.cdc.gov/std/hpv/stdfact-hpv-and-men.htm

How can we prevent HPV infection?

The current recommendations for prevention against high risk HPV infection include HPV vaccination. There are two such vaccines available. GARDASIL 9 is a vaccine indicated in females and males 9 through 45 years of age for the prevention of cervical, vulvar, vaginal, and anal cancers caused by human papilloma virus (HPV) Types 16, 18, 31, 33, 45, 52, and 58; precancerous or dysplastic lesions caused by HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58; and genital warts. The injection is given in a 3 shot series over 6 months. The vaccine has  minimal, if any, side effects.  Most insurances cover the vaccination series. The vaccination can be offered or prescribed by your gynecologist or pediatrician.

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For any additional questions or to schedule the Gardasil vaccination, please feel free to walk in or call us as Walk IN GYN Care (www.walkingyn.com).

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Colposcopy lets a doctor look at your vulva, vagina, and cervix. If the doctor sees a possible problem, he or she can take a small sample of tissue. Then another doctor studies the tissue under a microscope. This is called a biopsy.
Most women have this procedure after they have abnormal results from a Pap test.

How is the test performed?
During the test, your doctor puts a lubricated tool into your vagina. This is called a speculum. It gently spreads apart the sides of your vagina. This allows your doctor to see inside your vagina and the cervix. The doctor also uses a magnifying device to help him or her see better. This device does not go inside your vagina.
The doctor may put diluted vinegar or iodine on your cervix. This can help the doctor to see any areas that are not normal. Sometimes the doctor also takes photos or videos.
When the speculum goes in, it can feel a little uncomfortable. If the doctor does a biopsy, you may feel a pinch and have some cramping.

How should I follow up?
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.
What happens before the procedure?
Procedures can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for your procedure.
Preparing for the procedure
• Tell your doctor if:
o You are having your menstrual period. This test usually is not done during your period. This is because blood makes it harder to see your cervix.
o You are or might be pregnant. A blood or urine test may be done to see if you are pregnant. Colposcopy is safe during pregnancy. The chance of miscarriage is very small. But you may have some bleeding from a biopsy.
o You take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin.
• Do not douche, use tampons, have sexual intercourse, or use vaginal medicines for 24 hours before the test.
• Understand exactly what procedure is planned, along with the risks, benefits, and other options.
• Tell your doctors ALL the medicines, vitamins, supplements, or herbal remedies you take. Some of these can increase the risk of bleeding.
• Your doctor will tell you which medicines to take or stop before your procedure. You may need to stop taking certain medicines a week or more before the procedure. So talk to your doctor as soon as you can.
What happens on the day of the procedure?
• You may want to take a pain reliever 30 to 60 minutes before the test. This can help reduce any cramping pain from a biopsy. Ibuprofen (Advil or Motrin) is a good choice.
• Take a bath or shower before you come in for your procedure. Do not apply lotions, perfumes, deodorants, or nail polish.
At the doctor’s office
• Bring a picture ID.
• The procedure will take about 15 to 30 minutes.
Going home
• You will be given more specific instructions about recovering from your procedure.
When should you call your doctor?
• You have questions or concerns.
• You don’t understand how to prepare for your procedure.
• You become ill before the procedure (such as fever, flu, or a cold).
• You need to reschedule or have changed your mind about having the procedure.
Care instructions adapted under license by Adeeti Gupta Physician PC. This care instruction is for use with your licensed healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional.

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Be safe, be strong and be prepared.

Your friendly Walk In GYN Care team!

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