Caroline Smith* listened in disbelief to the nurse on the other end of the phone. Some abnormalities were found in her routine Pap smear, and additional tests that were performed with the Pap smear to determine the root of the problem revealed that Caroline tested positive for the human papillomavirus (HPV).
Caroline’s face went white, and she began to cry. Who had given her the virus? Would she have to share this information with future sexual partners? Was she going to die? Unable to shake the thought that she would live with this disease the rest of her life, her emotions spun out of control. What did it all mean?
What is HPV?
Caroline’s story is sadly not uncommon. In the past decade, HPV has gained more attention than ever from doctors and women’s foundations – and for good reason: each year, 14 percent of collegiettes are infected with the virus, which causes tissue growth and cell changes.
“HPV is the most common viral STD in our country,” says Dr. Jennifer Wider, women’s health expert and author of The Doctor’s Complete College Girls’ Health Guide. It can also be one of the most dangerous. There are more than 100 types of the HPV virus, which can infect cells in the mouth, throat or genital area. While some types cause warts, more serious strains can actually cause cancer. Long-term HPV infections are the leading cause of cervical cancer, making the virus a huge threat to females everywhere.
How is it transmitted?
HPV can be passed from person to person through various sexual activities. Vaginal and anal intercourse, oral sex and genital-to-genital contact all put you at risk of infection, or infecting others.
How do I know if I’m infected?
This is the tricky part. Many times, your body won’t give any warning that you’re carrying the virus, making it dangerously easy to pass it along without realizing it, says Wider. It’s no surprise more than half of sexually active people will have HPV at some point in their life.
There is, however, a potential physical symptom that may appear with the infection: warts. The warts are small white raised bumps that could form in the genital area and throat. Genital warts often go away on their own, but one common treatment is the use of topical creams applied directly to the warts and genital area. If you find warts on yourself or anyone you are sexually active with, get the situation checked out immediately at your campus health center.
Abnormal Pap smear? What’s that?
If you want to find out if you have HPV, get a Pap smear test. During this procedure, a tool is used to open the vaginal canal, and cells are then collected from the lining of the uterus. These cells are then put under a microscope. “A Pap smear helps detect pre-cancers or cell changes on the cervix caused by HPV that might eventually turn into cervical cancer,” says Wider.
Let’s break down the medical lingo. When a doctor says that the results of your Pap smear were “abnormal,” this means that during the test, some of the cells that were removed look different than they are supposed to, which could be the result of a variety of different things. An abnormal Pap smear could mean you have an infection, an STD such as HPV or Herpes, or you may be completely fine because the abnormalities could just be from recently engaging in sexual activity. You’ll need to have more tests done before knowing exactly what the problem is.
Wider says there are three follow-up tests you could have: a follow-up Pap smear that is the same as the first, an HPV test (again, cells from the cervix are removed to look for strains of the virus that could develop into cancer and determine what type of HPV is present) or a colposcopy (a closer look at the problem area with a lighted magnifying tool), which is the type of test Caroline underwent after she found out she was HPV-positive. Then, based on the results, you will know what the cause of the abnormalities is and you and your doctor can decide on the best treatment.
How can I protect myself?
Be smart – sexually!
The only totally foolproof way to prevent HPV is to abstain from sexual activity and genital contact. But if you know you’re unlikely to do so, then always practice safe sex. Condoms, spermicidal gels and other barrier methods of birth control can double as an HPV shield. The best part? While you’re lowering your chances of contracting the virus, you’ll also be protecting yourself from pregnancy and other STDs. However, Wider says condoms may not fully protect you because HPV can infect parts of the body other than just down there, such as the mouth and throat. Although Caroline says that she used condoms during sexual activity, she still contracted the virus.
“People can also lower their risk of getting HPV by limiting the number of sexual partners they have, getting tested and disclosing the info, and being in a faithful, monogamous relationship,” Wider adds. Having the “let’s get tested” talk with your boyfriend might seem awkward, but it’s important because you could still get HPV if your partner is infected and unaware.
Set a regular routine for Pap smears
The thought of getting a Pap smear may make you a little uncomfortable. We promise you’re not alone on that one! But when a simple, painless procedure could save your life, it’s totally worth it to put on a brave face and get tested. According to Wider, new medical guidelines say women should start Pap test screenings at 21, and get one every three years. If you’re about to hit that magic age, have your mom or doctor recommend a gynecologist you can visit. The sooner you set up an appointment, the quicker you can protect your body and put your mind at ease.
Check with your university health care center to see if it offers Pap smear screenings for students. Local women’s clinics also offer the test. Certain states require that insurance cover the test, so make sure to find out if yours is one of them.
Gardasil, a three-shot series for females 9 to 26, is the only vaccine that protects against four types of HPV (there are more than 100 different strains). Caroline’s HPV diagnosis shocked her the most because she had already completed the vaccination series, and didn’t know she was still able to contract the virus. It’s important to remember the trifecta of shots doesn’t cover every strain of the virus.
Don’t be afraid to encourage your brother, boyfriend or best guy friend to look into the Gardasil vaccination. Although the campaign for protection against HPV is primarily aimed toward women, males can also prevent certain types of HPV by getting the shots, too.
There is also a separate HPV vaccine for girls ages 13 to 26 who have not completed the vaccination series. Wider says the vaccine is more successful if given at an early age. “Therefore, it doesn’t always protect against HPV but it definitely lowers your risk!” Wider says.
How can I get treated for HPV?
Learning you’re HPV-infected can be shocking. But before you panic, take a deep breath and chat with your doctor. Based on your medical history and unique case, he or she will recommend the best treatment for you. There are four main options, Wider says.
Wait it out
Sometimes cells have a mysterious way of healing on their own. Following your doctor’s advice, it might be best to simply closely monitor the abnormal cells with regular Pap smears. However, if your cells show moderate to severe changes, you may have to remove or destroy the abnormalities with the treatments below.
It sounds like a crazy procedure, but it’s the same procedure that removes warts on external body parts, like feet. To kill cancerous and pre-cancerous cells, liquid nitrogen is used to freeze them. The process may cause cramping or pain, and like most surgeries, bleeding and infections are possible.
Also known as a cone biopsy, conization removes part of the abnormal tissue so that is can be looked at more closely. This process is definitely more invasive, but it also can be highly effective. The recovery time is usually about one week for most women.
Loop Electrosurgical Excision Procedure (LEEP)
Doctors use an electrical current to remove sample tissue for a cone biopsy. (Sounds super-futuristic, right?) LEEP can cause pain though, so make sure you block off a few days for recovery.
While there is no cure for HPV, many times the virus will clear up on its own. After a follow-up Pap smear a few months ago, Caroline received the results in the mail. Although her symptoms had cleared and her tests showed that her cervical cells once again appeared normal, she learned she would always be a carrier of HPV. It can remain in your system even if you don’t show signs. Therefore, you should always use protection if you or your partner has been infected with the virus at some point in time.
There are still many unanswered questions surrounding HPV. By staying educated about the virus and raising awareness, you can do your part to keep your best friends and fellow collegiettes safe and healthy.
*Name has been changed to protect privacy.