HPV—more than half your friends have it, but for some reason you’ve never heard of it. According to my doctor, the human papillomavirus affects something on the order of seventy percent of sexually active adults. According to the American Social Health Association, it’s more like eighty percent. That’s a lot of people, and yet, up until the last year, you rarely heard anything about it. In fact, I even remember my mom about five years ago having an irregular pap, being told it was “pre-cancer,” which freaked all of us out, and having to go in for this “procedure” that was described as no big deal turned out being what she described as one of the worst things she’d ever been through. This is a woman who gave birth to twins, each nearly eight pounds, without knowing she was even carrying two babies.
Even now, the facts are a little fuzzy. Trust me, I just went through the whole process, and it went roughly like this: phone call from doctor telling me that my pap was irregular, but it was nothing to worry about it, just something worth following up on; she referred me to an ob-gyn to do a more extensive test, called a colposcopy; I call a couple of friends, and one tells me, “Oh, that’s HPV—I had that too and had to do just the initial procedure, and it was awful. I was shaking so badly after, I could barely walk, and I couldn’t drive for two hours. BUT, at least it’s not the one that causes genital warts.”
Totally. But how sad is it that we were glad we had the more aggressive, cancer-causing strain than the milder, wart-causing variety?
Another friend tells me she had to do it too, and it was no big deal—that the friend who told me it was bad was probably one of those girls who thinks papsmears are the worst thing ever. A little on edge, I go to the ob-gyn. She tells me it is HPV but not to worry because it’s very common (that’s when I got the seventy percent statistic). She tells me what the “colp” will entail—you’ll have a speculum in, just like a regular papsmear, and then I’ll have to put a vinegar mixture on your cervix. This allows me to see if there are any irregular cells. If there are, I will take a biopsy of those. We’ll send it in, and then I’ll know in seven to ten days if we need to perform another procedure.
Okay, doesn’t sound too bad. I saddle up. Speculum? Check. Vinegar? Okay, a little stingy but not unbearable. She sees some irregularity but nothing excessive. She takes one snip (not too terrible—it’s painful but quick). Then she goes for snip two. You know how when you cut string or fabric and it doesn’t quite cut through you have to wiggle it a bit? Yeah, okay that one hurt like a bitch. But not in the usual way things hurt because, as my doctor explained while I was sweating and shaking on her table, the cervix doesn’t have the normal pain sensors, which is why you can do a biopsy with no anesthetic to begin with. So instead of feeling pain, it hurts in a totally bizarre way and then you have this reaction (a “vaso TK reaction,” apparently) that makes your heart speed up like crazy, you sweat profusely, shake, feel faint, and incredibly nauseous.
The doctor left the room to let me get it together, and when I sat up, I was so nauseous I actually spewed up a bit in her sink. The pamphlet she’d given me said I should be able to carry on my normal activities with no problem. I spent the rest of the day in bed. Luckily, I have one of those jobs where I can work from bed (precisely where I’m writing this).
That was on a Monday. By Wednesday morning, I figured I’d be alright going to the gym. I’m on the treadmill for about fifteen minutes when I feel something seriously off. I jump off the treadmill and bolt to the bathroom. All I can say is that something was definitely trying to get out. I sat down and leaned forward and out comes a huge mass of something—I honestly thought I’d lost an organ. What the hell was it? Of course, the doctor wasn’t in yet, but luckily one of my HPV pals answered her cell on the way to work.
“Uh, I have a question for you. I was just at the gym on the treadmill, and I felt like something was moving out of me and I went to the bathroom and I think I just gave birth to a baboon heart. Did, uh, anything like that happen to you?” Trying not to laugh, my friend explained that when they do the colposcopy, they leave some sort of packing up there to stop the bleeding, and eventually it passes out. Whew, that would have been nice to know ahead of time. My doctor had told me to expect unusually colored discharge for a few days but no baboon hearts. My friend told me her doctor hadn’t warned her either and she’d been at home thinking she just passed a few chunks of reproductive organs, but luckily her roommate had been through the whole thing too and explained what it was.
So there you go ladies, luckily you have me to tell you. Maybe doctors get a kick out of patients calling up when it comes out? I, for one, had kept mine and wrapped it up in tissue paper to bring to the doctor, thinking she should probably see it. Yeah, imagine finding that in your gym bag after a few days. Not cool.
My personal experience aside, here are the facts:
• There are over 100 types of HPV.
• About thirty of these types are sexually transmitted and cause genital HPV.
• Genital HPV is spread through skin-to-skin contact, not through an exchange of bodily fluid.
• Genital HPV cannot be entirely prevented by condom use (which is why so many people have it).
• This virus is often asymptomatic—people usually don’t know they have it.
• About 5.5 million new genital HPV cases occur each year. This is about 1/3 of all new STD infections.
• About 20 million people—men and women—are thought to have an active HPV infection at any given time.
• Nearly three out of four Americans between the ages of 15 and 49 have been infected with genital HPV in their lifetime.
• HPV can be contracted from one partner, remain dormant, and then later be unknowingly transmitted to another sexual partner, including a spouse.
• Though usually harmless, some types cause cervical cancer if not detected in time; other types cause genital warts, which can be treated easily. Men only exhibit symptoms of genital warts. To date, there is no cancer risk associated with HPV in men.
• About 14,000 cases of cervical cancer are diagnosed in the United States each year.
• Over 5,000 women each year die of cervical cancer in the United States.
• The best way to screen for cervical cancer is a Pap test, which may be done alone or in combination with an HPV DNA test.
• Certain high-risk strains of HPV cause cervical lesions which, over a period of time, can develop into cancer if untreated.
• Cervical cancer most commonly takes ten to twenty years or more to develop. Women who are no longer sexually active should continue to be screened.
• Cervical cancer is the first cancer in women to be identified as being caused almost exclusively by a virus.
• If an HPV infection is persistent past the age of thirty, there is a greater risk of developing cervical cancer.
• 30% of “negative” Pap smears are falsely negative (abnormal cells are present on the cervix but not detected on the Pap). These abnormal cell changes may lead to cervical cancer in some women.
• Cervical cancer is completely preventable if precancerous cell changes are detected and treated early, before cervical cancer develops.
After the medical explanation and the procedure itself, there’s a whole other aspect to HPV. Let’s call a spade a spade here—it’s a sexually transmitted disease. It doesn’t manifest itself as much of anything in males, but in females it can be quite damaging. So, if you have sex with women, you definitely need to tell them, and if you have sex with men, who may at some point have sex with other women, you need to tell them too. Even if you think they won’t, you should tell them. If you’re lucky, you have the kind of partner I did (and still do), and their main concern will be you, albeit with an afterthought of, “How does this affect me?” Other friends of mine have had mates get really angry and act as though they’ve just been told their partner has HIV. These people are, well, lame. Of course, it’s understandable to be upset, and I don’t really agree with the “it’s no big deal” camp either, but it doesn’t have to be the worst thing that’s ever happened to you.
One very important thing to keep in mind—just because you’ve had it once and it turned out to be no big deal doesn’t mean you can’t get it again. In fact, you may already have a different strain that’s just waiting to rear its ugly head. Regular pap smears are a must of course—yearly for those who’ve had no problem, and generally every six months for those who have had a strain of HPV, more often for those who have had more aggressive strains.
So there you go, the dirty secrets of HPV revealed. It’s not pleasant, but it’s not certain death either. Just follow the rules we all know—be smart, make intelligent decisions, get regular checkups, and if something is irregular, don’t put off having it checked out. You wouldn’t drive your car around with the engine light on for months, so don’t ignore your body’s warning signs either.
By Amy Westervelt
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