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HPV on Pap Smear

Lissa Rankin's picture

On the road, answering anonymous questions during my Ask The Girlfriend Gyno chats on my book tour for What’s Up Down There?, questions about HPV -- human papillomavirus -- keep arising. With up to 80% of women destined to contract HPV at some point in their lives (if they haven’t been vaccinated), it’s no wonder this is such a big issue.

Many of the questions about HPV revolve around HPV diagnosed only on a Pap smear, without any symptoms, warts, precancerous changes of the Pap smear, or cervical cancer.

Because the HPV test is relatively new, these issues are too. For many years, we didn’t have an easy way to screen for HPV. And even when we did, it was often only used for women who had atypical squamous cells (ASCUS) on a Pap smear. But now, more and more docs are testing routinely for HPV, leading to a whole lot of confusion, panic, and issues of negative self image. So it’s no wonder these questions keep coming up.

Ask The Girlfriend Gyno

For those of you who haven’t been able to meet me in person and ask me the questions you’d only ask your gyno if she was your BFF, I thought I’d collect some of the questions and answer them here.

My doctor discovered that I had HPV during my routine Pap. I’ve never had warts or an abnormal Pap smear, and all other STD tests came back negative. My doctor told me to return in one year for another Pap test to see it’s still positive, but she didn’t recommend any other treatment. How can it be kosher to have an infection and not treat it? Is it just going to clear from my system?

Good question! When a doctor diagnoses you with HPV based on a Pap smear that is otherwise normal, this means that you’re carrying the virus -- and may be shedding it -- but that it hasn’t caused any damage to your body, usually because your immune system is keeping it in check. Because there virus hasn’t caused warts or an abnormal Pap smear, there’s not a whole lot to do about the HPV, at least not from a Western medicine perspective. At the Owning Pink Center, we do offer women herbal treatments to help support their natural immune response, so their bodies can help fight the virus. But unlike bacterial infections like chlamydia or gonorrhea, there is no antibiotic that can clear the infection. It’s all up to your immune system. And yes, if your immune system is strong, it can clear the virus. Maybe next year, when you get retested, the HPV test will come back negative. I’ll cross my fingers for you!

My doctor told me that I have a “high risk” HPV strain that puts me at risk for abnormal Pap smears and cervical cancer, but not warts. Does this mean I don't have to worry about having one of the other strains (like the ones that cause warts)? 

If your HPV was diagnosed on a routine Pap smear, your doctor probably didn’t test you for the strains of HPV that can cause warts, so it’s hard to say. Because Pap smears are screening for cervical cancer, they usually only test for the “high risk” strains -- the ones that can cause cancer -- and not the “low risk” strains, the ones that can cause warts. So no, unless your doctor specifically tested for “low risk” strains, you can’t assume that you’re clear.

Are there any recommended natural remedies to enhance clearing HPV from my system?

Anything you can do to support your immune system will help you clear the HPV. Eating a balanced, nutritious, whole foods diet is a great start. If you really wanna go all out, consider supplementing your healthy diet with green juice or trying a raw, vegan diet, which is very alkalinizing and helps rock your immune system into full gear. When your body is fed uber-healthy foods, it can focus less on digesting processed foods and focus more on healing. 

Additionally, when I see clients with HPV at the Owning Pink Center, I offer them the following treatment as an optional supplement to the traditional wait-and-see approach recommended by the American College of Obstetricians and Gynecologists.

  • Folic acid
  • Beta-carotene
  • Green tea
  • Vitamin C
  • Herbal vaginal suppositories
  • Immune- boosting mushroom formula (like 10 mushroom formula)

But I would recommend implementing these treatments under the care of a good integrative medicine doc or naturopath, so you know how to dose the supplements and can understand how to use them.

Everybody's got it?!

My doc made it sound like 75-80% of sexually active women have HPV and are not aware of it. And a friend told me the men basically act as carriers, often not knowing they carry it. If this is so rampant, and guys cannot take a test for it, how can I protect myself against getting HPV?

Yes, it’s true that HPV is rampant among sexually active people, and you definitely don’t have to be a slut to contract it. (If you do, then I’m one of those sluts, since I got HPV from my hubby). And yes, it’s true that men act as carriers for the high risk strains of HPV, because they don’t develop any symptoms -- and since they don’t get Pap smears or cervical cancer, they don’t know they have it. (When I told hubby that I had been diagnosed with HPV, he said, “Wow. That’s so weird. All my girlfriends have had HPV.” Duh, dude. It’s you!)

So how can you prevent getting it from some unsuspecting guy who is shedding the virus? Well, I hate to be Dr. Buzzkill, but the truth is that it’s very hard to prevent the transmission of HPV unless you’ve been vaccinated, and even then, the vaccine only protects you against the four most common strains -- but not all of them. Condoms definitely decrease the risk, but they don’t eliminate it. The virus can be shed from scrotal skin that condoms don’t cover, and that skin can touch vulvar skin -- and voila! You’ve got HPV.

Not to scare the bejesus out of you, but it’s important to understand that HPV is ubiquitous and that if you have a new partner, you might contract it, even if you do everything right. So take precautions. Ask your partner if any of their partners have ever had HPV or abnormal Pap smears, wear condoms, get tested. But if this happens to you, don’t beat yourself up over it. These things happen. Listen to your doctors advice, never skip Pap smears, take care of your immune system --then let it go. You can’t live your life in fear or regret.

What about oral sex and/or kissing? Can you transmit the high risk HPV during a makeout session or oral sex?

Not easily. Kissing is safe. If you have HPV on your Pap smear, that means that, if you are shedding the HPV virus, you’re shedding it from your genitals, not your mouth. So you’re not going to give it to your partner through kissing. And the risk of transmission via oral sex is exceedingly low, bordering on impossible. While some strains of HPV can very, very rarely lead to laryngeal warts, this is extremely uncommon (in 19 years of medical training and practice, I’ve never once seen a patient who had it). And the high risk strains are not usually the ones that cause warts. Can HPV of the mouth increase the risk of oral cancers? Maybe. But the risk is still very low. If you’re worried about it, have oral sex with a condom (if you’re going down on him). Or use a dental dam (if he’s going down on you). But kiss away. You should be safe there.

I had HPV on my Pap smear last year, but now my latest Pap says the HPV is gone. Does that mean that it’s totally gone, like a cold? Or could it come back to bite me in the future? Do I still have to tell future sexual partners I had it?

This part of HPV can be confusing. Like many other viruses, HPV may lie dormant for an indefinite period of time. Your negative HPV test on your Pap smear means that your cervix isn’t currently shedding the HPV virus, but that doesn’t mean that, at some point in the future, your immune system won’t be weakened, causing the HPV to shed again. We see this often when women get pregnant. They’ve had HPV 10 years ago and everything has been copacetic. They’re in monogamous relationships without any symptoms, then they get pregnant and BAM. Because pregnancy is a natural time of immune suppression, the HPV is back.

So no, I’m afraid that doesn’t mean you’re totally in the clear. Hopefully, your immune system will take care of the HPV forever and you’ll never see it again. But you never know. To keep your karma clean, you’re better off telling future partners the truth, just in case.

Deep breaths - don't let it sap you of your mojo.

My doctor told me not to freak about the HPV that came up on my Pap smear, but I’m pissed that she was so blasé about it. The truth is that I AM freaking out. What should I do?

I’m sorry your doctor wasn’t sensitive when she broke the news that you were carrying a type of STD. I admit that I’ve been guilty of this myself. As docs, we see so much HPV that we’re informing people every day of their diagnoses. And frankly, when we get busy, sometimes we get snippy and fail to realize what a big deal this may feel like when you first hear the news.

I suggest you let your doctor know how you feel. Hearing how you feel may remind her to be more sensitive next time she delivers the news. But keep in mind that the reason we may seem blasé is because most of these time, asymptomatic HPV goes away without ever causing any health consequences. That doesn’t mean it doesn’t cause social consequences -- like having to confess it to your partners. And it doesn’t mean that it’s not scary to hear that you might be at risk of cervical cancer. So I honor your feelings. Allow yourself to feel them. Talk to a trusted friend or therapist, write in your journal, make another appointment to discuss it with your doctor (or pick another one!), and then let it go. It’s not worth letting it sap you of your mojo.

Not to diminish your real feelings, but keep in mind that contracting HPV isn’t the end of the world. (I’m speaking from experience here. I swear, I’m still living a happy, joyful, healthy life, in spite of my run-in with HPV.) But I know it can feel like it. Make sure you take care of yourself to prevent cervical cancer from wreaking havoc with your life. But don’t let it rob you of your mojo. You’re beautiful and perfect, even if you have HPV. And you’re SO not alone. Don’t ever forget it.

Want more info about HPV? Read this post I wrote a while back.

What about the rest of you? Have you had HPV? How did you handle it? Did it make you feel icky? Are you cool with it?

Right there with you, sisters,

Dr. Lissa

Note: Because you deserve more than an internet doctor, Dr. Lissa Rankin will not be able to answer questions that might arise in the comments section of this post, but feel free to talk amongst yourselves or see her as a patient at the Owning Pink Center.

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This blog, and the book on which it is based, is a complement to - not a substitute for - professional advice and intervention, and is not intended to replace the advice of a gynecologist or medical professional, who should be consulted about any health care issues that may affect the individual reader. The information contained in this book is the product of observations made by the author in her practice, as well as her review of relevant literature in her field of expertise. The literature at times reflects conflicting opinions and conclusions. The views expressed herein are the personal views of the author and are not intended to reflect the views of any group or organization with whom the author is affiliated.

Comments

Lissa Rankin's picture

Christa, you always crack me up!

Now that I've quit giggling, I heartily second everything you just wrote!
Love you
Lissa

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Christa's picture

Don't beat yourself up, treat yourself.

I have HPV, had a couple bad schmears (that's what I like to call 'em - kinda makes it sound easier to handle, like whipped cream cheese schmeared on a bagel...but I digress). I had a procedure about 5 years ago to get rid of some nasty cells but all-and-all, it was no big deal.

Yes, I freaked the hell out when I found out I had an STD (catholic school guilt no doubt) but when I realized how common it is and how difficult it is to avoid getting it, I only had to say three Hail Mary's and Two Our Fathers. I washed it all down with a cold beer and I was good to go. Amen.

As a matter of fact, I think I know where I got the "HPV"....it was 1989, I was in Germany and there was this gorgeous British soldier with blue eyes, his name was Paul. Oh...my...GAWD. Paul was HAWT! *giggle* Great nite but no one wants to hear my losing virginity in Europe HPV story. *laughing*

Life happens. HPV happens. Don't beat yourself up, treat yourself. That's my 4 cents worth. :-)

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