SalemNews.com, Salem, MA

August 2, 2013

Dr. Prusak: What women should know about HPV

Dr. Elizabeth Prusak
The Salem News

---- — When I graduated from my surgical fellowship, I had the misconception that because I was trained to do the fancy, lifesaving procedures like on “Grey’s Anatomy,” that it was what I would be doing in my practice. What I found was that gynecology is not like the sexy brain surgeries performed by “Dr. McDreamy,” but it is about helping women with their everyday sexual and gynecologic questions, problems, desires and concerns.

I hear similar questions from my patients every day, ranging from: Why do I have pain with sex? Am I already going through menopause? I just found out I am Human Papilloma Virus (HPV) positive, did my boyfriend cheat on me? You’re not alone. To encourage others to speak up, I’m sharing and answering some of the common misperceptions women have, starting with an issue that continues to spark national debate — HPV.

I recently found out that I tested positive for HPV. What does this mean?

HPV is one of the most common reasons women come to see me in the office. It is true that HPV is a sexually transmitted virus, not a sexually transmitted disease. It is acquired through skin to skin sexual contact. It can be transmitted from man to woman or woman to woman. Like any virus, it can lay in a dormant “sleeping” state for many years. At any point in a woman’s life — and especially during stress — the virus can reactivate and a woman can test positive for HPV. A positive HPV test means at some point a woman acquired the virus — and it could be from her very first sexual encounter right up until her most recent; therefore, making it impossible to pinpoint the exact person who’s responsible.

I have an abnormal pap with a positive HPV test. I’m extremely worried that I may have cervical cancer. What should I do?

Certain types of HPV can cause changes in the cervix that can progress to cervical cancer; other types cause common warts. There are different types of abnormal pap tests, and some are worse than others. The first step is to take a deep breath and realize that you likely do not have cervical cancer. Following an abnormal pap, your gynecologist will have you come in for another exam to take a better look at the cervix and possibly take a small sample. Most abnormal pap tests do not require any further treatment and revert to normal within two years. Cervical cancer used to be the leading cause of cancer death for women in the United States. However, due to the pap test, the incidence of the cancer has declined by 70 percent. The takeaway point for dealing with an abnormal pap is patience and regular screening.

What is the HPV vaccine and when should women get it? Will it prevent me from getting all sexually transmitted diseases?

The HPV vaccine is approved and recommended for all women ages 9 to 26 years old. It is a vaccine that decreases the risk of women acquiring the most dangerous strains of the virus. With the advent of the vaccine in 2006, the prevalence of abnormal pap tests in adolescent girls has decreased by half, even with only one-third of young girls completing all three courses of the vaccine. There is the belief that if a young girl gets the vaccine, she does not need to practice “safe sex.” This is entirely untrue. The best way to prevent abnormal paps and sexually transmitted diseases is to get the HPV vaccine, limit the number of sexual partners, always use condoms and to not smoke. To date, there have been no proven dangerous side effects from the vaccine.

Dr. Elizabeth Prusak is a gynecologist who specializes in minimally invasive pelvic surgery and sexual health. She is a graduate of the Yale University School of Medicine for her OB/GYN residency and completed her fellowship at Lahey Clinic in advanced pelvic surgery. She practices out of her Peabody office at Lahey Medical Center. To ask Dr. Izzy a question featured in her column, email her at doctorizzygyn@yahoo.com.