Understanding HPV

HPV stands for human papillomavirus, a common virus that includes over 100 different types of strains that infect the skin and mucous membranes. This group of viruses includes genital warts, vulvar dysplasia (VIN) and cervical dysplasia (CIN), some of which can lead to pre-cancerous cell changes in the cervix.

There are over 100 different types of HPV and approximately 30 of these are spread through genital contact. Around 12 “low-risk” strains of HPV that cause genital, hand, and foot warts. In addition, there are 15 “high-risk” strains that are responsible for various types of cancer, such as cervical cancer.

It is estimated that 80 percent of females – and 50 percent of the population – will get one or more types of “genital” HPV at some point in their lives.

Often, there aren’t any symptoms at all so you could have HPV without even knowing it. Low-risk strains affect the skin and mucous membranes of the body, leading to warts on the feet, hands or genitals. Other types of HPV cause changes in the cells of the cervix, leading to abnormal cells and the potential to progress to cervical cancer. Genital warts are flesh-coloured bumps that can be flat or raised, and can appear like small, cauliflower-type growths on the skin. Although genital warts may not cause symptoms, some females experience itching, vaginal discharge or bleeding after sexual intercourse.

Abnormal cells on the cervix don’t tend to cause symptoms and the best way to know if you have them is to get regular Pap tests. Pap tests are the most effective way to catch abnormal cervical cells and cervical cancer early, so that they can be treated more easily. Speak to your doctor about when you should have a Pap test.

Yes, you can catch HPV through both direct skin-to-skin contact or sexual contact with an infected person. Skin-to-skin contact can be as simple as contacting another person’s hand or foot warts, or sexual contact such as rubbing the penis against the opening of the vagina or anus, or oral contact with the genitals. You do not need to have sex, whether it’s oral, vaginal, or anal, to spread the infection.

There is no HPV cure but HPV symptoms can be managed. Additionally, a strong immune system can successfully suppress HPV from showing any symptoms for a lifetime.

Conventional HPV treatment includes the following surgical procedures: 

Conization: (aka cone biopsy) removes the abnormal areas by excision

Loop Electrosurgical Excision Procedure: (LEEP) abnormal cells are removed with an electrical current

Cryotherapy: freezing off the abnormal cells with liquid nitrogen

Naturopathic doctors have been successful in supporting patients with HPV, genital warts, and cervical dysplasia through screening, diet and lifestyle changes, nutrient supplementation and herbal formulations for decades.

Cervical cancer is by far the most significant concern. However, high-risk types of HPV also have been linked to less-common cancers of the vulva, vagina, anus and penis.

Some research also has suggested a link between high-risk types of HPV and other cancers, such as mouth and throat cancer. However, these other HPV-related cancers are still being investigated and are thought to be relatively rare.

There are 3 main ways to help reduce your risk of HPV infection:

1. Get regular sexual health checkups and Pap tests to screen for issues early.
2. Practice safe sex and limit your number of sexual partners. Consistent use of condoms will reduce your risk for HPV transmission, but it will not completely eliminate it.
3. Talk to your doctor to find out if HPV vaccination, which helps protect against certain types of HPV, might be right for you.

Anyone can get HPV. Males tend to have no symptoms until the HPV virus begins to cause abnormal changes in skin cells.

Although HPV infection has been linked to cancer of the penis and anus, these cancers are very rare. For this reason, as well as because a method of sample male genital skin cells has yet to be discovered, there is currently no FDA-approved HPV test for men.

In most cases, the body’s immune system fights off or suppresses the virus before abnormal cells develop. The Centers for Disease Control and Prevention (CDC) estimates that 70 percent of new HPV infections (including those that are “high risk”) revert to an inactive state within one year, and 91 percent revert within two years.

It’s only when high-risk types of HPV stay “active” for a long period of time that the risk of developing abnormal cells that can turn into cervical cancer increases significantly.

In one study conducted by the National Cancer Institute, 4% of females who had high-risk HPV developed pre-cancerous cervical disease (CIN 3) in the following three years. When watched for 10 years, about 7% of the females developed advanced cervical disease.

Overall, it’s estimated that females who have a long-lasting active infections with high-risk HPV are 200+ times more likely to develop pre-cancerous cervical disease.

Although risk factors like smoking, diet, lifestyle and the use of oral contraceptives can contribute to your chance of developing cervical disease, HPV must first be present before cancer can occur.

There is only a test for females to detect HPV. It’s important to note that an HPV test is not included in the regular sexually transmitted infection (STI) testing. The HPV test detects the high-risk HPV strains (the ones that are most likely to cause cancer) and, much like a Pap test, is done by sampling cells collected from the cervix.

The only sure way of preventing an HPV infection is to abstain from sexual activity. Since this is quite unrealistic, practicing safer sex will help lower your risk of getting HPV but will not protect you completely. It’s important to have an open conversation with your sexual partner(s) about their HPV status so that you can both make the best decision for your health.

You can also consider getting vaccinated against HPV. There are 2 HPV vaccines available that help to protect against 2 types of HPV that, together, cause 70% of all cases of cervical cancer.

As a female, it is important to get Pap tests done regularly, even if you have been vaccinated against HPV. Talk to your doctor to find out more about your options for protecting yourself against HPV.

An HPV vaccine exists to respond to the most common strains of “genital” HPV. However, the vaccination is only fully effective if it is given before an individual has been exposed to those types of HPV through sexual contact. In addition, the vaccine does not protect against all types of HPV that can cause cervical cancer.

It is important to get a regular Pap and – if you’re a female over 30 years of age – an HPV test, even if you’ve been vaccinated. A Pap can identify abnormal cells and help make sure abnormal cells are diagnosed and treated early.

An abnormal Pap result does not mean you have cervical cancer. About 4 to 5 million Pap tests are done every year in Canada and only about 350,000 get an abnormal result. Only a fraction of those (1,400) are cancerous.

Abnormal Pap results means there is a change in the cells of the cervix. Changes in the cells could be a result of a vaginal infection, a sexually transmitted infection (STI), HPV (a specific type of STI), or hormone level changes, among other causes.

Discuss your results with your doctor, who will let you know if further tests, such as an HPV or STI test, are needed.

Cervical dysplasia is the abnormal growth of cells on the surface of the cervix. Although this is not cancer, this is considered a precancerous condition. Cervical dysplasia is grouped into three categories:

1. CIN I — mild dysplasia (a few cells are abnormal and occupy the lower third of the cervix)
2. CIN II — moderate to marked dysplasia (abnormal cells occupy up to the middle third of the cervix)
3. CIN III — severe dysplasia to carcinoma-in-situ (precancerous cells extend to the upper third of the cervix).

Eighty to ninety percent of females with cervical dysplasia have an HPV infection.