What is HPV
HPV is NOT Herpes (HSV) or HIV. 79 million Americans in their teens and twenties are infected. There are over 110 types of this virus. 14 million people get infected every year.
How is HPV spread
You can get HPV by vaginal, anal or oral sex with someone who has the virus even without symptoms.
You can develop symptoms years after you have sex with someone who is infected, so you don’t know when you first became infected.
What can HPV do?
HPV can cause genital warts, condylomata. They look like bumps in the genital area, small or large, raised or flat or like a cauliflower.
HPV can cause cervical cancer or cancer of the external pelvic area, penis, anus and throat.
What can you do to prevent HPV?
Get vaccinated; Gardasil or the HPV vaccination is safe and is recommended for those 11 and up. It is a series of 3 vaccinations available at our clinic.
Get cervical cancer screening; for those with a cervix. Every year 12000 people with a cervix will be diagnosed with cervical cancer and more then 4000 die from cervical cancer every year.
Condoms do not fully protect you.
Any new sex partner is a risk factor for HPV. There is no “test”.
HPV in pregnancy
When you are pregnant you do not “pass on” HPV to your baby. Treatment is usually deferred until after you give birth.
What can we do for you at Rebirth Obgyn
We offer HPV vaccinations (Gardasil) if you have had one, two or no vaccinations at all.
We can diagnose you with genital warts and give you prescription medication or treat the warts with liquid nitrogen or cautery (under sedation) at the office.
Pap smears/screening tests are recommended for those 21 years old and up, every 2 or 3 years and typically require a pelvic exam.
What if you have had a bad experience or a history of sexual trauma?
We offer trauma informed pelvic examination or you can do your own pap smear.
This is not always successful.
What if I don’t want to have a pelvic exam or screening?
Your body belongs to you. We can only give you recommendations and do a pelvic exam/ screening with your consent. We will never force you to have an exam and neither should any other doctors office.
What is a trauma informed pelvic examination?
For patients with a history of sexual trauma, pelvic exams may trigger PTSD symptoms. The techniques of trauma–informed care can lead to an easier exam. Studies show that trauma survivors want providers to ask about sexual trauma before the exam (that is, while the patient is clothed and seated).
What if I am a transgender man or gender-nonbinary and have a cervix?
For people taking testosterone hormone therapy screening can come back with “not enough cells” because testosterone thins the cell layer on your cervix.
It takes at least 3 months to build a new layer of cells to get a valid test. We can repeat it when you are ready and give us consent. This is never a reason to withhold hormone therapy!
What if my pap smear/screening test is abnormal
An abnormal pap smear can show different types of abnormalities, like a different type of STD as trichomonas or gonorrhea, or internal infection as bv (bacterial vaginosis) or candida.
It can also show abnormal cells from the lining of your reproductive organs or the inside of your cervix.
There are different grades of abnormal cervical cells, sometimes we recommend a colposcopy.
What is a colposcopy?
This is a procedure where we look at your cervix with a microscope after we apply vinegar or Lugols (a betadine solution) and look for abnormalities. We may take a biopsy which can cause some cramping.
The pathologist looks at the biopsy to see if it shows healthy cells or not. If the cells show abnormalities it is graded as CIN 1, CIN 2, or CIN 3 (or worse but this is rare).
Depending on your age, health, if you smoke and the grade of abnormal cells we may recommend a LEEP.
What is a LEEP?
This is a procedure where we remove the abnormal cells from the cervix with cautery. We can do this with local numbing medication or offer a short anesthetic with an anesthesiologist at the office.
After a hysterectomy do I need a pap smear/screening?
No, a hysterectomy includes removing the cervix. If you have not had an abnormal pap test you don’t need them.
Further information for trans folx with a cervix:
Do I need a pap smear/screening when I want to come for testosterone therapy?
NO, pap test screening is not a requirement before we prescribe you testosterone.
Meet us first, maybe in time you will feel comfortable enough to do this.
For transgender women after vaginoplasty; you do not need a pap smear
Can I do my own HPV test at home?
Not yet, this is common practice in Australia. Hopefully soon we can offer you this in the USA.