This summer, I gave a presentation at Planned Parenthood about HPV. I wanted to present about an STI, and the coordinator suggested HPV because of Michael Douglas. For those of you unable to attend, here is the information from my presentation.
Not too long ago, Michael Douglas came out and said his throat cancer was from cunnilingus.
The throat cancer, I assume, was first seeded during those wild middle years, when he drank like a fish and smoked like the devil. Looking back, knowing what he knows now, does he feel he overloaded his system? “No,” he says. “No. Because, without wanting to get too specific, this particular cancer is caused by HPV [human papillomavirus], which actually comes about from cunnilingus.” From what? For a moment I think that I may have misheard. “From cunnilingus. I mean, I did worry if the stress caused by my son’s incarceration didn’t help trigger it. But yeah, it’s a sexually transmitted disease that causes cancer.” He shrugs. “And if you have it, cunnilingus is also the best cure for it.” Right, I say. OK. So what he is suggesting is that it all evens out? “That’s right,” says Douglas. “It giveth and it taketh.” (The Guardian)
…what? This quote was consistently misunderstood. Douglas meant this as a joke; that cunnilingus was enjoyable for him. But while we’re discussing HPV, let’s go further and really demystify this seldom understood STI.
In men, the most common cancer caused by HPV is throat cancer, and the chances of HPV developing into cancer is increased by smoking and drinking.
The slut-shaming culture we live in puts a huge stigma on STIs like HPV, even though 50-80% of the population will contract HPV at some point in their lifetime.
So anyway, let’s discuss the basics of HPV:
There are about 40 strains of HPV that cause cancer or warts. Types that cause cancer are called “high risk” and most cases of cancers (70% of cervical and vaginal cancers and 50% of vulvular cancers) are caused by strains #16 and #18. Types that cause warts are called “low risk” and 90% of cases of genital warts are caused by strains #6 and #11. 90% of cases of HPV clear without treatment within 2 years.
The most important thing for women to do is to Get Your Pap! Most cases of cervical cancer are in women who haven’t had a pap smear in the past 5 years. Since widespread screening started in the 1950s, new cases have decreased by 60%. Women over 30 usually get two results: the pap smear (normal/abnormal) and the HPV genotype test (positive/negative). Anal tests also exist, but aren’t common. See The Hairpin article for more information about what these results mean.
So if you have an abnormal pap result, you will have one or more of the following tests and treatments. The doctor will usually do a repeat pap smear and/or HPV genotype test, just to confirm the results. Then, they will conduct a colposcopy.
A colposcopy is basically where a doctor looks at your cervix through a sort of microscope. A solution may be applied to the cervix that makes HPV-infected cells turn white. Biopsies of infected areas may be taken at this point. If the biopsies find pre-malignant growths, the doctor will perform a Loop Electrical Excision Procedure (LEEP). Usually, only local anesthesia is required, as electrical currents on loops cut and cauterize lesions. LEEP complications are rare, and most commonly affect future pregnancy.
So how do you protect yourself against contracting HPV, or if you have HPV, how do you protect your partners?
Your best means of protection is the vaccine. Females should be tested regularly. Unfortunately, there isn’t an HPV test for men. Use condoms, though be aware that they only protect about 70%. Check regularly for warts on yourself and your partners. Small cuts in the genital region increase the changes of transmission, so use plenty of lube! Lastly, keep yourself healthy as best you can.
There are two vaccines against HPV. Cervarix is so far only approved for females and protects against the most common cancerous strains (#16 & #18). Gardasil is recommended for males and females and protects against the most common strains that cause both warts and cancer (#6, #11, #16, #18). These vaccines have made a significant impact in the spread of HPV. From 2006-2010, warts rates decreased 56% (among all women) and cancer strains decreased by 50% (among teen girls). At current vaccination rates, the vaccines will prevent 45,000 cases of cervical cancer and 14,000 deaths. Yet the vaccine is still controversial (because parents believe it will increase sexual activity) and vaccination rates are only around 40%.