Sunday , June 13 2021

35 year old with CIN3. Should I take the vaccine against HPV before or after conception?

It is good that you take samples of cells with regularity. Women who attend screening every three years when they are 25-69 years old, following the recommended abnormal results, can reduce the risk of up to 80% in cervical cancer. In Norway, there are usually 1 in 100 women who develop cervical cancer before 75 years of age, but half of them have not performed a cell test during the last five years before the diagnosis of cancer. Of 10,000 women with normal cellular tests, only 2-3 women develop cervical cancer in 3.5 years.

HPV infections are common. 70-80% of all women and men are infected with HPV one or more times during life. About 25% of those with positive HPV tests have only HPV type 16. In general, 9 out of 10 women eliminate HPV infection for two years, but in some people the infection persists for many years. It takes an average of approximately 10 years of HPV infection to detect sudden cellular changes (CIN3).

Previously, women with low-grade cell changes (ASC-US / LSIL) and positive HPV tests ask us to wait 6-12 months before new cell and HPV tests. The updated guidelines recommend women with low-grade changes for gynecologists with colposcopy and biopsy if the HPV types 16 or 18 are available, but women with low-grade changes "other" types of HPV can wait 12 months before the new control .

If the tissue sample (biopsy) shows CIN2 or CIN3, the woman recommends a treatment with a constitution where the area of ​​cellular changes is eliminated. It is a small procedure usually done in local anesthesia, and is usually only 2-3 grams of tissues that are removed.

1. Gynecology meant that you should take a vaccine after conception. I see what you recommend before? Can I make a mistake by taking it before the constitution before? Should Gardasil 9 be taken as recommended by the gynecologist?

In general, the vaccine against HPV should be taken as soon as possible. The only reason to postpone the vaccine against HPV is pregnancy. There is a widespread misunderstanding that should be expected until after conception before the HPV vaccine. There are even studies with the HPV vaccine where waiting for the HPV test is negative after conception before giving the vaccine. Ongoing HPV infections or established cellular changes have nothing to say for the protective effect the vaccine has for subsequent infections and new cellular changes, but it will not affect a permanent HPV infection or the cellular changes you already have.

Gardasil 9 is the latest vaccine against HPV that covers nine different types of viruses (6, 11, 16, 18, 31, 33, 45, 52 and 58). Replace the "old" Gardasil 4 vaccine that covers four different types of viruses (6, 11, 16 and 18). The Cervarix competitor covers two types of HPV (16 and 18), but has a partial effect on three other types of HPV (31, 33 and 45). It also seems that the "old" Gardasil 4 also has a partial effect on the types 31, 33 and 45 of HPV, but in studies comparing Gardasil 9 and Gardsil 4, Gardasil 9 has the best effect on the types of HPV 31, 33, 45, 52 and 58. There are no studies comparing Cervarix directly with Gardasil 4 or Gardasil 9.

– In the community catalog that has no effect on active HPV infection or established clinical disease.

That's the way in which HPV infection can not be expected to disappear because it takes the vaccine or can not be treated for cellular changes if you take the vaccine, but the vaccine has the same effect on new infections and new mobile claims, it does not matter when you take it The vaccine can reduce the risk of resuscitation in a relationship, and the vaccine can reduce the risk of transferring HPV from one mucous membrane to another, or from a mucous membrane to another site of the same mucosa. Several studies show a reduced risk of recurrence of cellular changes after pregnancy in women who took the vaccine and that the risk is reduced regardless of whether the vaccine was taken before or after conception. If the first dose is taken at least two weeks before the conception, there will be many anti-HPV antibodies in the area of ​​the wound by constitution.

2. If my husband has exactly the same vaccine?

The three HPV vaccines have a good effect on types of HPV 16 and 18, so it does not really matter that one of the three vaccines you take, or if you take the same cow or not, but most people who pay for the vaccine He chooses himself that encompasses most types of HPV, that is, Gardasil 9.

– Should we refrain from sex to prevent infection?

You have repeatedly infected several times, in a constitution way, it is less important. After conception, it may be a point of use of a condom until both have an HPV vaccine. The vaccine has a reasonably good effect and two doses after the first dose. The reason to recommend three doses is to guarantee long-term immunity (probable life expectancy).

"We have two recently taken a flu vaccine. Do you have anything to say about the Gardasil 9 vaccine being recommended in the near future?

No The HPV vaccine and the flu vaccine can be taken at the same time, but some doctors recommend that vaccines be placed on each arm.

3. Will the vaccine help me to prevent the HPV16 virus from developing elsewhere in the body even if they are already infected with HPV16?

Yes The vaccine causes the body to perform antibodies against the surface of the virus particles. This will neutralize the virus particles so that they can not enter new cells. This will reduce the risk of cervical infection to the anus, oral cavity and throat. It also reduces the risk of restarting in a relationship. However, the vaccine has no effect on the virus particles already in the cells. Fortunately, in most cases, the immune system will kill cells with viruses. In addition, the area of ​​the cervical cervical cell (cervix) will be eliminated by conception.

4. They had cancer anxiety in another place in my body since they are more vulnerable to HPV16. Could you tell me about the risk of cancer elsewhere if the HPV16?

Although there are several types that can cause cervical cancer (including types of HPV 16, 18, 31, 33, 45, 52 and 58), it is mainly the type HPV 16 that causes cancer in other parts of the body (penis, vagina, vulva , year, oral cavity and throat). In women, this risk is much lower than the risk of cancer of the cervix. Although there are 1 in 100 women with cervical cancer during their lifetime, only 1 out of every 1,000 women who develop HPV cancer in the oral cavity and throat and 2 out of every 1,000 women have ankle cancer before 75 years. In comparison, 4 of 1,000 men receive HPV cancer in the oral cavity and in the throat.

– What is the probability of having an active HPV infection elsewhere? Is there any symptom that should be taken into account?

The HPV most commonly occurs genitalmente (cervix, vagina, vulva) and then anal. While 6.5% of all women 34 to 69 years old have HPV tests positive in the cervical test, 1.0% of all women with HPV in the oral cavity and throat. In comparison, 2-3% of all men who have HPV in the oral cavity and throat. I do not think it helps so much to try to feel symptomatic, but if you get a wound that will not grow, bleeding or a hard coal that persists for more than a month, consult a doctor.

5. Sometimes there may be some fresh blood on the paper that I dare after the stool. This was a problem during my pregnancies and especially when the stool was difficult. Then there could also be blood in the bathroom. The problem is rare now and sometimes just a little fresh blood on the paper. Could it be anal cancer?

There are many who experience fresh blood on paper, especially in hard graves. The most common cause is the hemorrhoid or the small mucous membranes. If this only happens rarely, it is unlikely that you have anal cancer. If you frequently bleed, ask for an anal anxiety exam (anoscopy). Men who have sex with men have a higher risk of anal cancer than the risk of women in cervical cancer. The risk of anal cancer increases with the number of analog sexual partners, but men who have never had anal sex can develop anal cancer caused by HPV.

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