Tag Archives: Pap smear

Book Club: The HPV Vaccine Controversy

The HPV Vaccine Controversy: Sex, Cancer, God, and Politics: A Guide for Parents, Women, Men, and Teenagers
by Shobha S. Krishnan, M.D.

Praeger Publishers, 2008

The HPV vaccine, released in 2006, was ripe for controversy, at least in places like the United States. Here there is a strong anti-sex undercurrent from certain segments of society, and fears abound that a vaccine that protects against a common sexually transmitted infection — especially one whose symptoms disproportionately affect females — would encourage sexual promiscuity among our nation’s teenage girls. In addition, there is a segment of society that is deeply suspicious toward vaccines, a fear that is often fueled by misinformation or misunderstanding.


The HPV Vaccine Controversy is an excellent resource for anyone considering vaccination, as well as those who have already been exposed to human papillomavirus.


While Krishnan’s book is an invaluable guide for anyone considering the vaccine for themselves or their child, it covers much wider territory than just the vaccine and its attendant controversies. The first half of the book is devoted not to a discussion of vaccination but to a thorough and accessible description of female anatomy (although apparently her claim about the teenage cervix is controversial), the lifecycle and transmission of human papillomavirus (HPV), cancer screening techniques such as the Pap test, and the slow development of cancer caused by HPV infection. It also has good information on genital warts, which are caused by certain strains of HPV (such as HPV-6 and HPV-11) that often get overlooked in discussions of their cancer-causing cousins (such as HPV-16 and HPV-18). This makes the book an excellent resource for anyone who has had an abnormal Pap test and has questions — the detailed descriptions of the various cervical-cell abnormalities and the different stages of cervical cancer will assist the lay reader in making sense of her diagnosis. Continue reading

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HPV Vaccines: Separating Fiction from Fact

Gardasil is one of two HPV vaccines. It protects against two cancer-causing strains of HPV and two wart-causing strains.

Gardasil is one of two HPV vaccines. It protects against two cancer-causing strains of HPV and two wart-causing strains.

You’ve probably heard a lot about the HPV vaccine, which protects against the sexually transmitted pathogen human papillomavirus — which itself can lead to cancers of the cervix, anus, throat, and more. Unfortunately, there is a lot of misinformation about the vaccine, such as Michele Bachmann’s debunked claim that it causes mental retardation. But, even before Bachmann gave us her two cents, there have been plenty of falsehoods flying around about the HPV vaccine.

Myth: Vaccination against HPV will increase sexual promiscuity among vaccine recipients.

Fact: Studies show that this fear is unfounded.

A study published this month in the American Journal of Preventive Medicine contradicts this claim. In a group of more than 4,000 young females, there was no significant difference between the vaccinated and the unvaccinated in terms of number of sexual partners or the age at which sexual activity began.


There are around 150 strains of HPV, about 15 of which can cause cancer. Together, HPV-16 and HPV-18 cause about 70 percent of cervical cancers.


Besides, the vast majority of teenagers who choose abstinence do so for reasons other than a fear of contracting HPV. Additionally, HPV is one of many sexually transmitted infections (STIs); if fear of contracting an STI were the only factor in teenagers’ celibacy, a vaccine that protected against only one STI would not remove this fear.

(It might bear pointing out that when the HPV vaccine was approved for boys and men, fears about male promiscuity didn’t seem to run as rampant.)

Myth: Because the HPV vaccine only protects against two cancer-causing strains of HPV, it isn’t useful in cancer prevention.

Fact: The two cancer-causing strains of HPV that the vaccine protects against account for 70 percent of all cases of cervical cancer. Furthermore, Gardasil protects against two additional strains of HPV, which together are responsible for 90 percent of genital warts.

Continue reading

The Slow Journey from HPV Infection to Cervical Cancer

Healthy cervical cells as seen under a microscope. Image: National Cancer Institute

Healthy cervical cells as seen under a microscope. Image: National Cancer Institute

January is Cervical Health Awareness Month. The biggest threat to cervical health is human papillomavirus, or HPV, a virus that is transmitted through a wide variety of sexual activities. If you haven’t yet been sexually active, the best thing you can do to protect cervical health (whether you have a cervix or not) is to be vaccinated against HPV. If you have been sexually active, the vaccine could still be effective, assuming you haven’t already been infected with the strains of HPV against which it protects. And, if you are, or have been, sexually active and have a cervix, it is important to be screened with regular Pap tests (also called Pap smears). When caught in its precancerous stages, cervical cancer can be avoided.


The human papillomavirus may be tiny, but it packs a punch.


There are more than 100 strains of HPV, approximately 40 of which can be sexually transmitted; of these, 18 strains are thought to cause cancer. Chronic infections by cancer-causing HPV strains, such as HPV-16 and HPV-18 (which together are responsible for 70 percent of cervical cancers), can lead to the development of abnormal cells, which might eventually become cancerous.

In the United States, HPV is the most widespread sexually transmitted infection – 6 million Americans are infected with HPV annually, although most are asymptomatic and unaware they were infected. For most people, the infection clears up within 8 to 13 months, while for others, the infection can lurk undetected. If you are unlucky enough to develop a chronic HPV infection, then you are at increased risk for certain cancers — depending on the site of the infection, HPV can cause cancers of the cervix, anus, and other genitals, as well as the throat. Continue reading

What to Expect From Your First Pelvic Exam

You may be apprehensive about making your first gynecological appointment.

When should I go?  What will happen?  Why do I need to have a pelvic exam? How do I find a gynecologist?  But having a pelvic exam is a normal and responsible part of taking care of your body and keeping yourself sexually healthy.

Most women, according to the American College of Obstetrics and Gynecology  should have their first pelvic exam by the age of 21 or within three years of becoming sexually active, whichever comes first. Whatever your sexual orientation, pelvic exams are part of a healthy woman’s checkup.

So when should you schedule a pelvic exam? It can be part of your regular health check-up.  But you should also make an appointment if you have any of the following problems:

  • If you have abdominal or vaginal pain.
  • If you have a vaginal discharge that itches, burns, or smells.
  • If you have vaginal bleeding lasting longer than 10 days
  • If you have missed periods or have severe menstrual cramps
  • If you have not had a menstrual period by age 15 or 16

You also need a pelvic exam to be fitted for a diaphragm or have an IUD inserted.

How to get ready for your exam

You do not need to do anything special to prepare for your exam. It is usually best to schedule your appointment when you will not be having your period. Also you should not have sex, douche or use vaginal creams 24 hours before your visit.  Let your doctor or nurse practitioner know that this is your first pelvic exam.

PlannedParenthood.org provides ample information on well-woman and pelvic exams, including tips for finding doctors and making appointments.

You may be asked questions before your exam about your menstrual periods or your sexual activities.  It is always best to answer honestly so that the doctor is able to provide the best care for you and your lifestyle.

Your well-woman examination may also include other screenings such as a  breast exam, weight and blood pressure check – the pelvic exam itself lasts only a few minutes.

What happens during the actual examination;

You will be asked to undress and given a gown to wear.  You will be asked to lie down on an examination table and place your feet up in holders called stirrups which are connected to the end of the table.  You will need to slide to the end of the table and hold your knees open for the doctor to perform the exam. It is best to try to stay calm  and breathe steadily to relax your muscles and make yourself more comfortable. It is normal to be nervous.

The exam consists of three parts. First the doctor examines the outside genitals visually, looking for signs of infection or other problems.  Then a speculum, usually warmed, is inserted gently and keeps the walls of the vagina open so the doctor can examine the cervix and vagina. This may cause a feeling of pressure or some discomfort, but relaxing can help. While the speculum is in place, the doctor may swab some cells from your cervix for a Pap smear.  These cells are put on a microscope slide and sent to a lab to check for signs of precancerous or cancerous cells.

The speculum is removed and the doctor will use a lubricated gloved hand to put one or two fingers inside your vagina while pressing gently on your abdomen with the other hand.  This allows him or her  to feel your internal organs and  check for any abnormalities.  Sometimes the doctor will also insert one finger into the rectum to check for abnormalities or better feel the internal organs. Sometimes you might feel like you need to have a bowel movement but this sensation passes quickly.  You may have a tiny bit of spotting or bleeding after the exam.

All of this is over in just a few minutes and then you can get dressed  and meet with your doctor to discuss your exam results.  This is a good time to ask the doctor any questions you may have about your sexual health.  You may receive tests for STIs or prescriptions for contraceptives at this time.

Congrats! You’ve survived and made your sexual health an important part of your overall well-being!

STI Awareness: Human Papillomavirus and the HPV Vaccine

Virus-like particles, which mimic the outer shell of HPV, are used in the HPV vaccine to induce an immune response against the virus. Image obtained from cancer.gov.

January is Cervical Cancer Awareness Month, which gives us an opportunity to learn about the virus that causes most cancers of the cervix (as well as other cancers). More than six million Americans are infected with human papillomavirus (HPV) every year, making it one of the most common sexually transmitted infections. There are more than 100 different strains of the virus, some of which can cause genital warts and others of which can lead to cancer. In most cases, an HPV infection will clear up within eight to 13 months, but it can lurk undetected for years, which makes cancer screening very important for anyone who has been sexually active.

Most sexual activities – especially those involving genital-to-genital contact, i.e., vaginal and anal intercourse or simply rubbing genitals together, but also those involving oral and manual contact – can transmit HPV. Although HPV is best known for its connection to cervical cancer in women, it can affect either sex and cause cancers of the vulva, vagina, cervix, penis, anus, oral cavity, or pharynx.

Together, HPV-16 and HPV-18 cause about 70 percent of cervical cancers. Fifty percent of U.S. women who die of cervical cancer have never had a Pap smear; in countries without widespread access to Pap smears, cervical cancer remains a major cause of death.  Continue reading

Pro-Choice Book Club: Abortion In the Days Before Roe

For as long as people have been practicing medicine, rudimentary as it might have been for most of history, people have been performing abortions. In the United States, abortion was outlawed in the mid-1800s, the reason being that the procedure was too dangerous; before then it had been legal until quickening. This rationale dissolved as techniques improved and the procedure, when performed in sterile settings by a knowledgeable practitioner, became safer than childbirth itself, and abortion was legalized with the Roe v. Wade decision in 1973. For the century or so during which abortion was prohibited, women continued to seek them out. We’ve all heard the horror stories about the injuries and deaths that could result from illegal abortions. This image was widespread during those years as well, which makes it all the more telling that women still sought illegal abortions – a woman’s need to control her own destiny could outweigh a genuine fear of death.

The Abortionist: A Woman Against the Law by Rickie Solinger (1996) tells the story of Ruth Barnett, an abortionist in the Pacific Northwest who practiced from 1918 to 1968. Barnett’s success as an abortionist – she served tens of thousands of patients and never lost a single one – stands in stark contrast to the caricature of the back-alley butcher. Although incompetent, sloppy, and predatory abortionists did exist in the pre-Roe years, there were many, like Barnett, whose skilled work ensured that some women could obtain safe, albeit illegal, abortions. Continue reading