OBG(WHY)N: What Exactly is HPV?

“Abnormal” is not the word you want to hear when you’re getting your medical test results. Often times, when I call someone to tell them their pap smear or HPV test is abnormal, I am met with shock, disbelief, anger and tears.

The truth is many young women will be diagnosed with HPV (the human papilloma virus) in their lifetime.

I explain to my patients that while HPV is an STI (scary word), it’s not at all uncommon and it’s typically very treatable. Here’s are the facts:

• 50-80% of people will carry HPV at some point in their lives.
• The only group of women that have been shown to not carry HPV are women who have never had sex. Ever!
• There are no signs or symptoms of HPV and no clinically available screening tests for men, which makes it a very easy virus to unknowingly spread.
• Most importantly, while a diagnosis of HPV is distressing, with close follow up and a healthy immune system, most people will clear the virus within 18-24 months without any treatment at all.

So, let’s take a closer look. What’s is HPV?

HPV is a large group of viruses which is divided into 2 types. There are low risk HPV types which cause warts, and high risk HPV types which can cause cervical cancer. The high risk HPV types can also cause other cancers such as vaginal, vulvar, rectal and throat cancers, although these are far less common than cervical cancer. To make matters even more confusing, within the high risk types, there is a subgroup that we are more concerned with and those are types 16/18. It is theses 2 types which have been associated with an increased risk of cancer and therefore require closer follow up.

How does someone find out they have HPV?

Every year, when you go to see your gynecologist for your annual check up, you get a pap smear which is a sampling of cells from your cervix. If you are over the age of 30, you also get an HPV test. If you are under the age of 30, you get an HPV test only if your pap smear is abnormal. If you have an abnormal pap, or a normal pap but carry HPV type 16 or 18, you will be brought back to the office for a colposcopy procedure.

What’s a colposcopy?

A colposcopy is a more in depth study of the cells of your cervix. The doctor will look for areas that appear to be affected by HPV and take small biopsies and send them to the lab. Most of the time, the biopsies will show a low level of abnormality and your doctor will advise you when to come back for a follow up pap. You will repeat this process until your pap smear and HPV test return to normal.

In less than 5% of cases, biopsy results will show precancerous cells. In these instances, a second procedure must be performed to remove more cells from your cervix. We call this procedure a LEEP procedure (Loop Electricosurical Excision Procedure). Women who undergo a LEEP procedure will be monitored very closely for a two year period to make sure that their pap smears return to normal.

While both of these procedures can be uncomfortable, they usually require no pain medicine and can be done in the office.

What can we do?

There are a few things women can do to minimize the risk of carrying HPV:

• Get the Gardasil vaccine. It is protective against the most common strains of HPV including types 16/18.
• Use protection. While condoms are not perfect, they do reduce the risk of catching not only HPV, but a whole host of other sexually transmitted diiseases.
• Stay healthy. Our only defense mechanism against this virus group is our own immune system. We often will recommend a multivitamin, along with vitamin C and Zinc to help fight an HPV infection.

So, if you happen to get a phone call from your doctor about an abnormal pap smear, stay calm. Knowledge is power, and now you know that HPV is treatable and curable. While it’s OK to be nervous, it’s even better to remember that staying healthy and following up with your doctor are probably all you will need to do!