Is There Treatment For HPV?

 " I've been told I have HPV and I wanted to know if there is any treatment for it?"

HPV is a virus that is acquired through sexual contact. There are over a hundred types of HPV. Some can cause visible condyloma (a growth resembling a wart) and other types infect cells internally. When the cells are infected internally, the virus can take over the cell & start causing tissue changes consistent with early signs of cancer. These early changes are called dysplasia, and are not cancer, but if left untreated can eventually become cancer.

Condyloma are seen on the labia majora and labia minora, mons pubis, vaginal opening and around the anus.  These can be treated with prescription solutions that can be applied at home. Many women choose to have them removed surgically using a CO2 laser. This is much quicker, less painful and works better when there are multiple condyloma in different areas.

When the HPV infection shows up on your pap smear, the virus cannot be seen as a visible lesion or a wart.  In this case, it has infected the cervical cells internally. When this happens, your OB/Gyn will call you to notify you of the abnormal pap test and the high risk HPV status.

At this point, further testing will be ordered. If your pap test is otherwise normal, but is positive for high risk HPV, it is ok to return to your doctor for paps every six months. If your pap test is positive for dysplasia (mild, moderate, or severe) then it is usually best to have a colposcopy done with a biopsy.

If this test returns from the pathologist showing no underlying cancer cells, then the next step would be to remove the infected tissue. This can be done in two ways: 1) If the biopsy and pap show only mild dysplasia, the tissue can be frozen off (cryotherapy), and a follow up pap done is in three months to make sure it has cleared and healed; 2) The other option is to perform a LEEP procedure, which is done by numbing the cervix with lidocaine and shaving off the abnormal tissue with small instruments that have wire loops on the ends . The tissue can then be sent to pathology for evaluation. If no cancer is seen, the patient can return in 3 months for a repeat pap and continued close survellence.

When these procedures are done, HPV can be completely removed, however there is always a chance of reinfection from the male partner. Many women worry because they have a misconception that HPV is in the blood and can circulate throughout their bodies, but in reality HPV can only infect the areas it comes in contact with.

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What is the Difference Between an STD and STI and How Can You Prevent Them?

Essentially, they represent almost the same thing. STD is an abbreviation for a Sexually Transmitted Disease and STI is an abbreviation for a Sexually Transmitted Infection. The best way to describe the difference between an STI and an STD is that you can have an infection without having any symptoms; however once symptoms appear, it becomes an STD.

STIs, like many infections,can be passed from one person to another, even when there are no symptoms. Examples include Herpes, HIV, HPV and Hepatitis. A mother can pass these to her infant through childbirth and breastfeeding when she is unaware of being infected. Other infections such as the flu, common cold and mononucleosis, can also be transmitted during sex from oral contact and kissing, but would not be considered to be 'sexually transmitted infections'.

It’s important to know that just having sex won't necessarily give you an STD or an STI. You have to have sexual relations with another person who is infected in order to receive the infection. Also, if a person is treated for a STD/STI and returns to the same sexual partner they can become re-infected if their partner has not been treated. So if you get an STD/STI it is important that your partner be checked and treated as well.

So how do you protect yourself from contracting an STD/STI?

Prevention through avoiding exposure is the best strategy for controlling the spread of STIs. We know that protected vaginal and anal intercourse carries the highest risks for the most dangerous sexually transmitted infections. Abstaining from sex is the only way to be 100% confident of avoiding Sexually Transmitted Infections but let's get real! If abstinence is not an option, then condoms, used properly, can reduce your risk  significantly. Condoms be used with each act of sexual intercourse. But even this practice not completely eliminate the risk of transmission of STIs. Condoms can fail, slip off, be punctured, or break down from spermacides or lubricants. In the best conditions, they provide great protection against HIV and Gonorrhea, but are less effective against Genital Herpes and Chlamydia. They provide no protection from HPV.

Nearly everyone has taken risks sexually, but please beware of the potential consequences which can impact your health and the course of your life. Many STDs can last a lifetime, put stress on relationships, cause sterility or birth defects and even lead to major illness and death. Know the risks! Sexually Transmitted Infections are not all transmitted the same way.

Unprotected Vaginal and Anal sex can lead to the transmission of:
-trichamonas
-gonorrhea
-chlamydia
-syphylis
-pubic lice, Hep B, HPV,HSV,HIV

Unprotected oral sex can lead to the transmission of:
-gonorrhea
-chamydia
-syphilis
-Hep B, HSV, HPV

Even sexual play without intercourse can lead to the transmission of:
-HSV,HPV
-pubic lice
-gonorrhea
-chlamydia
-trichamonas

The most important thing to remember is to take care of yourself, and if you feel that something isn't right, make an appointment with your doctor.

Always be safe when it comes to your health.

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Can Douching After Sex Prevent STIs?

No, douching after sex will not prevent STIs or STDs. In fact, there is no post-sex STD/STI protection, and even condoms won't protect against all infections. The only 100% fool-proof method is abstinence, and since that isn't likely to happen, knowing how to protect yourself is important.

But douching is not the answer. I know many of you douche for a variety of reasons, even though over the past few months we have talked about the many reasons you should not douche. Douching is not healthy, and regular douching can change the delicate chemical balance of the vagina, actually making a woman more susceptible to infections. Douching can introduce new bacteria into the vagina which can spread up through the cervix, uterus, and fallopian tubes. Researchers have found women who douche regularly experience more vaginal irritations and infections such as bacterial vaginosis, and an increased number of sexually transmitted infections.

We have discussed the WaterWorks vaginal cleansing system in past blogs. It is important to note that WaterWorks will also not prevent STI/STDs after sex. However, because it uses a unique medical grade stainless steel nozzle and plain tap water it will not destroy the natural flora or chemical balance which protect the vagina. It also uses a downward rinsing action unlike traditional douches and has been FDA cleared to safely eliminate vaginal odor. You can use it every time you bathe or shower after sex to safely clean the vagina of unwanted discharge or blood without the worry of pushing infection or sperm further up into your cervix and uterus.

Please, choose your sexual partners wisely, be careful and use protection against STDs.

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Sexy time and your cycle...

Dear KnowYourV, , my husband travels for his job right now and it seems like every time he comes home I'm on my period. Is it okay to have sex while I’m on my cycle?"
I know many of you have the same question and I encourage you to do whatever you and your partner enjoy. The only health risk is a slight increase in the chance of catching an STD, so if you are single and having ‘casual’ sex with more than one partner, be sure to practice “safe sex” precautions. The cervix is slightly open during our cycles, which puts us at a much higher risk for PID (pelvic inflammatory disease), and other ascending-type diseases.

Remember to use your WaterWorks feminine cleansing system after sex. It is the only FDA-cleared reusable vaginal cleansing device of its kind. Everyone I have recommended it to loves it because not only does it help rinse the vagina , but it also will help with odor. I would not recommend the use of WaterWorks on heavy flow days, but on light days it definitely help you feel more confident and clean.

WaterWorks uses only plain tap water and can be used daily or even more often, if used after sex to clean out semen. It is the unique reaction of water with the medical grade stainless-steel nozzle that clears odors and discharge. WaterWorks uses a gentle downward sprinkling/rinsing action instead of a forced pressure action, which keeps the flow of bacteria and discharge out, not back up inside your body.

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How soon can I have sex after giving birth?

Dear KnowYourV,  

"I know the standard rules for returning to vaginal intercourse after vaginal birth, but what is the real 411? How soon can we have sex or how long should we wait, really?" 

Well, Janet, so many women want to know the "real" answer to this question because the standard rules always seem so vague. What's really frustrating is grandma & auntie say one thing, I say another & the nurse says something else when you are discharged from the hospital. The truth is that no one can tell you when it is going to be alright, because it is different with each baby.

The basic post-partum rule, whether someone has had a c-section or vaginal birth, is that all women are given the standard “pelvic rest”, meaning nothing vaginally for at least 2 weeks. This means do not: use tampons, have vaginal intercourse, douche, or take tub baths (as fluid may get into the vagina). Bleeding after birth can be heavy for about 2 weeks (and sometimes last up to 4 weeks) and the uterus takes about 4-6 wks to go back to pre-pregnancy size. It can take up to 2 weeks for the cervix to close again. If the cervix is open, it's easy to get an infection after delivery. Of course, this is usually not a problem as most women aren't concerned about jumping right back into sex. In fact, the opposite is true, and I've had some patients who have been so afraid that they waited 3-4 months afterwards.

I think what most of you really want to know is, when is it really ok, and when is it better to wait.
Honestly, if you have an uncomplicated vaginal birth or c-section, with no tears or episiotomies, then 2 weeks is the minimum time to allow your body to heal. As for bathing and tampons, those are usually OK to use after about 4-5 days.

We never recommend douching, as it is known to cause infections and create more harm than good. However, using the WaterWorks feminine cleansing system, as we've mentioned before, is considered safe, and it can be used to cleanse the vagina around four weeks after delivery. It is nothing like douching in that it uses only plain tap water and a medical grade stainless steel nozzle, with no harmful chemicals. It also uses a gentle downward sprinkling action to rinse the vagina, instead of a forceful outward blast like traditional douches which can force infection upward into the vagina.

The other very important thing to keep in mind is that, if you did have an episiotomy or vaginal tear, it is best to wait at least 4-6 weeks to allow maximum healing of the tissues. When you do have sex for the first time after delivery, be sure to use lots of lubrication. It may feel tender where you tore, but that is normal. It is best to continue as much as you can tolerate, because the more it is stretched, the more elasticity that will return.

Just remember, everybody is different, and every delivery is different. So if this is not your first child don't expect the after-effects to be the same as the last one. Also, trust yourself and your own intuition. If you feel something might be wrong, make an appointment with your doctor, sooner than your post-partum visit.

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