6 Things All Moms Need To Know About HPV and Cervical Health
- HPV is incredibly common. If you have it, it doesn’t mean you’ve been promiscuous! According to the National Cancer Institute, the majority of both men and women will be infected with HPV at some time in their lives, and that may be true even if you’ve only had one sexual partner. In fact, a 1997 article in the American Journal of Medicine, reported that nearly 3 out of every 4 Americans has been infected with HPV at some point in their lives. While HPV is a sexually-transmitted disease, it can be transmitted via non-intercourse sexual contact. So it’s even possible to be a virgin and have HPV.
- Some HPV infections resolve themselves, but others can “hide” in the body. So for example, you could get HPV the very first time you have sex, but then it could go undetected for years. And while some strains of HPV can cause warts on the genitals, hands, or feet, many show no symptoms at all, and this includes several of the aggressive, cancer-causing variety. After the abnormal Pap I had last winter, my health care provider suggested that my husband was having an affair because I “suddenly” had HPV!! But when I dug into the research, I found that an HPV infection can lie dormant for many years and it does not indicate that your spouse has been unfaithful. (Needless to say, I left that practice!) There is no need for blame or guilt when dealing with the already-stressful circumstance of finding out you have or had HPV. It’s so common that it would be more surprising to learn that you and your spouse had not ever had it.
- Pregnancy and childbirth can cause cervical changes that alter the results of a Pap smear. The tissue trauma cased by childbirth can lead to false positive or inconclusive Pap smear results, but it can go the other direction, too. For over a decade, my Pap smears followed a predictable pattern: I’d have an abnormal Pap while pregnant (usually the results came up as ASCUS, or “atypical squamous cells of unknown significance”), but then at my six-week checkup, I’d get the all-clear. Several health care providers told me that the process of labor and birth can “slough off” the abnormal cells on the surface of the cervix, possibly leading to my negative postpartum Paps. But it’s also possible that, below the surface, the abnormal cell changes were still happening (and the HPV infection that was causing them had not gone away.) Since I was having babies every 2-3 years, and got the majority of my screening either during pregnancy or immediately postpartum, I was never really screened during a ‘normal’ time. When you’re in the baby-making phase of life it’s easy to get into the routine of scheduling your routine checks around your pregnancies and postpartum visits, but if I had it to do over, I’d schedule a follow-up Pap at least 6 months after giving birth to make sure my “negative” result was real.
- Having many children can make a recurrent HPV infection more likely. So can cigarette smoking, using oral contraceptives for many years, and anything that taxes the immune system. If you fall into one of these groups it’s even more important that you get regular screening!
- Dysplasia and “carcinoma in situ” – cancerous cells that are still on the surface of the cervix – can often be treated in a way that preserves fertility. In my case, because the cells had begun to invade the cervix, hysterectomy is the recommended treatment (and, fortunately, my family is complete.) But had my case been less developed, the LEEP procedure would likely have taken care of it for good. Cone biopsy and cryosurgery are two other options for treatment of cervical dysplasia that still allow for future pregnancies.
- Guidelines have recently changed. You might have read about the recent new guidelines that suggest spacing out Pap tests in healthy women with clear backgrounds from yearly to once every 3-5 years.