The Skinny on Sexual Health – HPV and Beyond

By: DEBORAH AUGUSTIN

Edited by: KELSEY CRUZ

Going to the gynecologist can be scary and uncomfortable. I remember feeling anxious the first time I went in for a pap smear, but fortunately my gynecologist understood my discomfort. She reassured me by walking me through what she was doing and what I could expect during my exam. However uncomfortable the idea is of a gynecological exam, it is something we should all be thinking about.

I had always thought that it was necessary to have an annual pap smear to detect signs of cervical cancer, but according to new guidelines published by the American Cancer Society and the U.S. Preventive Services Task Force, women between the ages of 21 to 29 should only be tested every three years after first testing at 21.

“We now know that cervical cancer is caused by the human papillomavirus (HPV),” says Dr. Stephanie Faubion, director of the women’s health clinic at the Mayo Clinic. “Up to fifty percent of young women have a positive HPV test within 36 months of initiation of sexual activity, and most will clear the virus without consequence. For those that do not, the cervical changes can be treated easily, even years later as progression to cervical cancer takes years of persistent infection.  In addition, aggressively treating young women with early HPV changes may damage the cervix, leading to difficulty carrying a baby later.”

If you have never been vaccinated against HPV, you should ask your gynecologist about receiving a HPV vaccination next time you see her. Although it is usually recommended that women be vaccinated before they are sexually active, it is still a good idea to receive the vaccination after you have been sexually active.

“While there is evidence to suggest that immunization with HPV vaccine is most effective for those who have not been infected with the HPV virus, the Advisory Committee on Immunization Practices (ACIP) suggests ‘catch up’ vaccination for those females ages 13-26 who have not been previously vaccinated or who have not completed the vaccine series,” Dr Faubion explains.

In addition to the HPV vaccination, you may also want to have additional tests run next time you see your gyno. The Center for Disease Control (CDC) lists chlamydia and gonorrhea as two of the most common sexually transmitted infections in the United States (1,307,893 cases of chlamydia and 309,341 cases of gonorrhea were reported to the CDC in 2010). All sexually active women below the age of 25 are at risk of being infected with chlamydia and gonorrhea and should be screened annually. And since they can have serious effects on a woman’s long-term fertility, it is important to be regularly screened for them.

The CDC also recommends opt-out screening for HIV, meaning that everyone should be tested for HIV unless she chooses not to be screened. Sexually transmitted infection (STI) screenings are also especially important if you are using oral contraceptives (birth control pills, for example) as your sole method of birth control since condoms are the only form of contraceptive that prevent sexually transmitted infections. Once you have both been tested for STIs, be sure to consider all of the factors involved before going on the pill.

“Oral contraceptives are a very effective means of contraception when taken properly,” Dr. Faubion says. “In addition to the prevention of pregnancy, the use of an oral contraceptive may offer additional benefits such as control of heavy menstrual bleeding and decreased menstrual pain.  They can also help treat acne, ovarian cysts, and menstrual migraine.

“The oral contraceptives used today contain much smaller doses of hormones than those used in the 1950s and 1960s, but are still associated with a slight increased risk of blood clot, heart attack and stroke. Women with a history of blood clot or multiple risk factors for heart attack or stroke such as diabetes, high blood pressure, high cholesterol or smoking may want to consider other options for contraception. Similarly, women with a history of breast or uterine cancer may need to consider alternatives for contraception.”

Sexual health is an important (and often overlooked) part of your wellbeing. Most of us feel secure about our sexual health if we are not feeling any discomfort or not displaying any symptoms of an STI. But remember, ladies, it’s better to be safe than sorry. Take care of your body and stay up-to-date on your gyno visits!

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