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10 Things Your Primary Care Doctor Does That Should Make You Run for the Hills
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Dr Orrange received her BA in Biology at the University of California San Diego and a Masters Degree in Health Sciences at the Johns Hopkins University School of Public Health She received her MD from the USC Keck School of…
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Answers to your Human Papilloma Virus (HPV) Questions
Receiving a diagnosis of HPV is scary. Genital warts, an abnormal Pap smear or being told your boyfriend has it prompts anxiety and many questions. Human papilloma virus ( HPV) infections are common, annoying, but generally benign and can be treated to resolution in most cases. Here are the questions I have received many times on Dailystrength.
1) If my boyfriend had warts in the past but doesn't have any now, can I still get it? Yes and vice versa. If you had warts and the warts were treated you may still carry the Human papilloma virus (HPV). HPV types 6 and 11 are the most common cause of genital warts and most carriers are asymptomatic (don't actually have the warts or they are too little to see). In some studies they test partners of women with HPV and find 50 to 77% of the men had subclinical infection (were + for the virus but didn't have any lesions).
2) If I have oral sex with someone with a history of warts will I get it in my mouth? Yes you can, but it is rare. The HPV subtypes that cause anal or genital warts can cause warts in the mouth and nose. Finger/anal, oral/anal and finger/vaginal contact probably can also spread the virus.
3) I have had an abnormal pap, and had cryosurgery (or another treatment) does this mean I'm cured? Yes, for most people. Recent studies show that in women who had cryosurgery or a LEEP procedure for an abnormal pap only 8-10% of women had detectable HPV DNA two years after their procedures.
4) I've had an abnormal pap (ASCUS, LGSIL, etc) and a biopsy showed CIN I (or CIN 2) am I going to get cervical cancer? No, not as long as you get the proper surveillance (follow up pap smears after whichever treatment is indicated). These are PRE-CANCEROUS changes that can, rarely, lead to cervical cancer only if left untreated for many years.
5) I just found out I have HPV, will this affect my ability to get pregnant or affect the baby during pregnancy? HPV infection will NOT cause problems with fertility. An uncommon risk associated with vertical transmission (passing virus from mom to baby during delivery) of HPV types 6 and 11 is Respiratory recurrent papillomatosis (RRP). This can occur in children when vaginal warts are present at the time of delivery. RRP is rare and 7 of every 1000 children born to women who have vaginal condyloma develop pediatric RRP. It is interesting to note that cesarean section does not appear to protect from the development of juvenile RRP, so cesarean section is not indicated in the presence of HPV infection.
6) I just found out I have HPV, will anyone ever want to be intimate with me again and do I have to wear condoms for the rest of my life? Please remember you are not alone and HPV is very very common. In some studies on college students 70-80% of those tested have the presence of HPV DNA when screened. There is no question frequent use of condoms decrease the risk of transmission of all types of HPV (those that cause genital warts and those that cause abnormal cervical Pap smears). So, I advise my patients to use condoms with all sexual partners and if/when you become serious with the one person who may be your lifetime partner you can think about switching to another method.
7) I have genital warts from HPV, what are my options for treatment? Treatment of genital warts (condyloma acuminatum) depends on the number and size of the lesions. In general, all therapies for genital warts are somewhat unsatisfactory due to recurrence rates of 30 to 70 percent within six months of treatment. Options for treatment include trichloroacetic acid or podophyllin in the doctor's office and then imiquimod (aldara) at home. Either imiquimod or podofilox can be used at home. For very large condylomata referral to a gynecologist for surgical treatment is probably going to be needed. Remember genital warts will always resolve with treatment it may just take a while.
8) I am a teenager who had an abnormal pap followed by a biopsy which was abnormal and was told to do nothing other than follow- up Pap smears, is this ok? In adolescents the rate of regression is high and the rate of progression to cervical cancer is low so follow up of abnormal pap smears is different. After colposcopy and biopsy if CIN 1,2 or 3 is confirmed a reasonable approach is to repeat the pap in 6-12 months and if abnormalities persist after 24 months additional therapy is recommended. The reason for this is that procedures done on the cervix at a young age (like a LEEP) can lead to incompetent cervix and cause problems during pregnancy
9) I had an HPV test done on my pap smear and it was negative, does this mean I don't have genital warts? No. The HPV types that cause genital warts (warts in the penis, vulva, scrotum, and perianal region), are HPV types 6 and 11 and are not tested for on a thin prep pap smear. The types we test for on a pap smear are HPV 16 and 18, the two leading strains that lead to cervical cancer.
10)How do I get tested for HPV? For women, testing for the HPV types that cause cervical cancer (HPV 16 and 18) can easily be done on your Pap smear specimen. For genital warts (caused by the strain of HPV not tested for on Pap smear) your doctor can look at the lesions and if there are warts present he/she can put a dilute solution of acetic acid which turns the warts white in appearance and aids in the diagnosis. If you are a male you can get tested for HPV DNA but it is not as accurate as in women. Studies have shown that HPV detection is highest when a swab of the penile shaft is done and is LOWEST in the urethra and in semen.
11) What is the story with the HPV vaccine (Gardasil)? The Gardasil vaccine will protect you from HPV types 6/11/16/18. The HPV vaccine is given by injection and requires three doses; the first injection is followed by a second and third dose two and six months later. In the United States, Gardasil is recommended for all girls and women who are between ages nine and 26 years. It is important to be vaccinated before becoming sexually active since the vaccine does not help to eliminate HPV infection after it has occurred.
Dr O.
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Displaying comments 12-1 of 12
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Dr O.
http://seekingalpha.com/article/92...
This is what Merck is pushing.
You are probably right about the CDC being taken out of context but if you could provide the actual quote and how it was taken out of context would prove helpful. However, I do see an alarming amount of doctors warning against this product. Would you trust your 9 year old daughter (hypothetically) with this potentially deadly vaccination that protects (possibly) against only a couple strains? Do you believe it should be mandatory as Merck is pushing for where a child or teen has to have it before going to school?
Vaccines are always an individual choice and always hotly debated. Nobody is forcing anyone to get this vaccine it is an option to be discussed with patient and doctor. The CDC quote is taken out of context...it is true that routine screening for HPV is not recommended (nor do any of us do it) but to say that it is unlikely to effect your health...not true and you can see the number of folks on DS who have had high grade cervical dysplasia from HPV...in fact Im in my office with one right now...it is not insignificant and should not be trivialized.
Dr O.
Here is an article about it:
“It looks as if an unproven vaccine with dangerous side effects is being pushed as a miracle drug,” says Tom Fitton, president of Judicial Watch, a public interest group responsible for investigating and prosecuting government corruption. The organization released significant documents today, obtained from the U.S. Food and Drug Administration (FDA) under provisions of the Freedom of Information Act.
The documents detailed 1,637 reports of negative reactions to Gardasil, a vaccination for human papillomavirus (HPV). Three deaths related to the vaccine were reported. One patient receiving the vaccine died of a blood clot only three hours later, and two other patients, girls ages 12 and 19, died of heart problems and/or blood clotting.
Of the 1637 negative reactions contained in the May 11th report, 371 were serious reactions. According to the Vaccine Adverse Event Reporting System (VAERS), out of 42 women who received the vaccine while pregnant, 18 of them – a shocking 42% - experienced serious side effects such as spontaneous abortion and fetal abnormalities.
Patients are warned of side effects such as pain, fever, nausea, dizziness and itching by the drug manufacturer, Merck & Co. These typical side effects account for 77% of the 1637 adverse reactions to Gardasil. But more serious side effects including paralysis, Bells Palsy, Guillain-Barre Syndrome, seizures, and blood clots are not mentioned, and account for the remaining instances of negative reactions to the drug.
Merk & Co is currently campaigning to make the HPV vaccine mandatory for young girls. Fitton warns state and local governments to take a look at these reports, which “reads like a catalog of horrors”.
Judicial Watch filed an information request on May 9, 2007 and received the VAERS report on May 15, 2007. They are posted on the Judicial Watch website at: http://www.JudicialWatch.org"
I hope this will not be another disaster like Vioxx. Merck new that it was killing people but being so greedy kept it on the market. How many will have to die before Gardasil is removed. The fact is, there are over 100 types of HPV viruses and how many will Gardasil protect you from??? It seems that it is a money related issue with these drug companies as they would like to make it mandatory and even have done so in Texas. They are even trying to make boys very young take Garasil that might one day engage in oral sex with a female having HPV?????????????????
This is messed up! This is something that every female should thoroughly study before taking. Don't rely on simply the drug companies like Merck to conduct their flawed tests that they have been known for but really do your investigation first. It's not worth dying for over some drug that only possibly protects against about 4 strains out of over a 100.
Here is another article:
"I am not against making insurance companies and state benefit programs pay for vaccinations, Gardasil included. I am appalled though, by the possibility that all of our girls will be required to get it...as dictated by legislators and governors across the country..who have no medical backgrounds.
First, the safety of the vaccine is still not proven. It had less than 2000 girls in its clinical study and serious side effects have been reported in the short time it has been on the market. Go to http://www.medicalnewstoday.com/me... for the facts noted by the National Vaccine Information Center......neurological reactions, seizures, loss of consciousness, arthritis, dizziness, muscle weakness, tingling and numbness of extremities, slurred speech, and more, occurring in a significant number of children receiving the shots.
Second, parents should have the right to decide if they want to subject their child to something that has no hard and fast guarantee to help them and carries a guaranteed risk. Sure, Gardasil may work, but it is not your responsibly to invade parental authority on a matter that does not relieve society of a clear and imminent danger, such as the polio or smallpox vaccines do.
All the mandate does is guarantee money for Merck. Merck is trying to get its product into doctors' offices before GlaxoSmithKline's Cervarix comes out later this year. Merck stands to make billions of dollars on Gardasil. It may take years before we know the long-range damage or effect of the vaccine and the CEO's of Merck will be long gone. Even if bills across the country mandating Gardasil vaccinations were to fail, Merck has benefited from free publicity due to the controversy. It's a win-win for Merck. And any legislator who puts drug companies over the health and welfare of our children should be voted out of office."
Here is an article from a well known doctor:
http://www.canadianactionparty.ca/...
Another article:
Gardasil is Dangerous As Well As Unproven
Merck's Gardasil vaccine is supposed to prevent young women from getting cervical cancer. Now the FDA has approved a claim for two less common cancers as well. But whether it will actually prevent any kind of cancer is unknown.
As of July, the federal government's Vaccine Adverse Events Reporting System has received over 9,700 reports of problems since the vaccine's introduction in 2006. These include paralysis, seizures, and miscarriage. Twenty deaths have been reported, although the government has not acknowledged a link yet.
Vaccines were originally developed to protect the public from extremely contagious diseases. Now dangerous and unproven vaccines are being mandated in the hope they will guard against diseases that require very intimate contact to transmit. Where will it end?
If it does become mandatory doesn't mean you have to do it. You can fight and win easily in court for an assault with a deadly weapon.
You say Gardasil will protect you Doctor but where is the actual proof? From Merck? It doesn't protect you as even Merck said, "GARDASIL may not fully protect everyone and does not prevent all types of cervical cancer, so it is important to continue regular cervical cancer screenings."
Facts to keep in mind ladies taken from elsewhere:
1. Even without the vaccine, the number of cervical cancer cases is trending downward and has been for years.
2. Merck will not be liable if Gardasil turns out to be harmful some time in the future. (How's that one for you as you are only a guinea pig).
3. There have been no long-term studies done on the effect of the vaccine after 5-10 or more years, and testing on young girls has been extremely limited.
4. It is unknown how long the immunity provided by Gardasil actually lasts.
5. The studies done on Gardasil were not set up to investigate whether the vaccine itself has the potential to cause cancer.
6. Gardasil is one of many vaccines containing aluminum, and there is increasing evidence suggesting that aluminum-based vaccines can have harmful effects.
From the Centers for Disease Control and Prevention website:
"There is no clear health benefit to knowing you have this virus—since HPV is unlikely to affect your health and cannot be treated. For most men, there would be no need to treat HPV, even if treatment were available— since it usually goes away on its own."
Do your homework ladies and read other doctor reports before subjecting yourself or your daughter to this stuff being dished out.