Saturday , November 28 2020

CIN3 with a 35-year-old woman. Should I take the HPV vaccine before or after the pregnancy?



It's a good thing to take cell samples on a regular basis. Women who screen 25-69 years apart every three years can reduce the risk of cervical cancer by up to 80% by following recommended abnormal findings. In Norway, there were 1 out of 100 women who developed cervical cancer before the age of 75, but half of them did not perform a cell test for the last five years prior to the cancer diagnosis. Only 2-3 women from 10,000 women with normal cell tests develop cervical cancer within 3.5 years.

HPV infections are common. 70-80% of all men and women are infected with HPV one or more times during their lifetime. About 25% of those with a positive HPV test only have HPV type 16. In general, 10 women out of 9 survive HPV infection within two years, but in some people infection continues for years. It takes an average of 10 years for HPV infection to detect coarse cellular changes (CIN3).

Previously, women with low-grade cell changes (ASC-US / LSIL) and positive HPV tests were asked to wait for 6-12 months for new cells and HPV tests. The updated guidelines recommend women who have low-grade changes to gynecologists with colposcopy and biopsy, if they have 16 or 18 HPV types, but women with low-grade changes "other" HPV types can expect 12 months before the new check.

If the tissue sample (biopsy) shows CIN2 or CIN3, treatment with the constitution is recommended to the woman, where the area of ​​cellular changes is eliminated. It is usually a small procedure performed by local anesthesia and is usually only 2-3 grams of tissue, often removed.

1. The gynecologist said that after conception, I had to take a vaccine. I see you recommend it before? Can I make a mistake by taking it before the constitution? Gardasil 9 Gynecologist Should Be Recommended?

In general, the HPV vaccine should be taken as early as possible. The only reason to postpone the HPV vaccine is pregnancy. There is a common misunderstanding that the person should wait until they get pregnant before the HPV vaccine is taken. While waiting for HPV test, negative studies were performed after conception before vaccination with HPV vaccine. Ongoing HPV infections or established cellular changes mean nothing to the protective effect of the vaccine for subsequent infections and new cellular changes, but will not affect the ongoing HPV infection or the cellular changes you already have.

Gardasil 9 is the newest HPV vaccine that includes nine different virus types (6, 11, 16, 18, 31, 33, 45, 52 and 58). It replaces the "old" Gardasil 4 vaccine, which includes four different virus types (6, 11, 16 and 18). Competitor Cervarix includes two HPV types (16 and 18), but has a partial effect on the other three HPV types (31, 33 and 45). Also, it is understood that "old" Gardasil 4 has a partial effect on 31, 33 and 45 HPV types, but studies on Gardasil 9 and Gardsil 4 are the best on Gardasil 9, HPV types 31, 33, 45 has an effect. , 52 and 58. There is no study comparing Cervarix directly with Gardasil 4 or Gardasil 9.

– Has no effect on Active HPV infection or established clinical disease in the community catalog.

This cannot wait for an HPV infection to disappear, because you cannot be cured for cellular changes if you take the vaccine or take the vaccine, but the vaccine has the same effect as new infections and new cellular claims. Vaccine can reduce the risk of resuscitation in a relationship and the vaccine may reduce the risk of transferring HPV from one mucosa to another or from the mucosa to another location in the same mucosa. It has been shown that cellular changes after trapping in women after taking several studies have reduced the risk of recurrence and reduced risk without regard to whether the vaccine is taken before or after conception. If the first dose is taken at least two weeks before conception, HPV in the wound area will have many antibodies against the constitution.

2. Should my wife get the same vaccine?

All three HPV vaccines have a good effect on HPV types 16 and 18, so it doesn't matter what one of the three vaccines you take or whether you take the same vaccine, but most people you pay for the vaccine include most HPV types, namely Gardasil 9.

– Shouldn't we avoid sex to prevent infection?

You infested each other repeatedly, less important than the constitution. After concentration, both can be a point of using a condom until they receive an HPV vaccine. The vaccine, after the first dose, already has a fairly good effect of two doses. Three doses are recommended because long-term immunity (possible life expectancy) is provided.

We've recently had a flu shot. If you recommend the Gardasil 9 vaccine in the near future, is there anything to say?

No. HPV vaccine and influenza vaccine may also be administered, but some doctors recommend that vaccines be placed in each arm.

3. Does the vaccine help prevent the development of HPV16 virus elsewhere in the body, even if the HPV16 virus is infected?

Yeah. The vaccine causes the body to form antibodies against the surface of the virus particles. This will neutralize the virus particles so that they cannot enter new cells. This will reduce the risk of infection from the cervix through 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 present in the cells. Fortunately, in most cases, the immune system will kill viruses with viruses. In addition, cell cervical cervix (cervix) area will be eliminated with conception.

4. I was worried about cancer elsewhere in my body because I was more vulnerable to HPV16. Can you tell us about cancer risk elsewhere in HPV16?

Although there are several types of cervical cancers (including HPV types 16, 18, 31, 33, 45, 52 and 58), HPV type 16 is mainly caused by cancer in other parts of the body (penis, vagina, vulva, anus). , oral cavity and throat). In women, this risk is much lower than the risk of cervical cancer. 100 women with cervical cancer throughout their lives, but 1 of 1000 women who develop cancer due to HPV in the oral cavity and throat, and 1 in 1000 women and 2 in 1000 women before the age of 75 gets. In comparison, 4 people from 1000 people suffer from cancer due to HPV in the oral cavity and throat.

– What is the likelihood of not having an active HPV infection elsewhere? Are there any signs I should be aware of?

HPV most commonly occurs in the genitalia (cervix, vagina, vulva) and then anal. 6.5% of all women in the 34-69 age group had positive HPV tests in the cervical test, 1.0% of all women with HPV in the oral cavity and throat. Compared, 2-3% of all males with HPV in the oral cavity and throat are. I don't think it helps much to feel symptomatic, but if you get a wound that doesn't grow, bleeding, or a hard coal that lasts more than a month, consult a doctor.

5. Sometimes there may be some fresh blood on the paper after the stool. This was a problem during pregnancy and particularly when the stool was difficult. Then there's blood in the toilet. The problem is currently rare, and sometimes there is some fresh blood on the paper. Could this be an anal cancer?

There are many people on paper, especially on hard stools with fresh blood. The most common cause is hemorrhoids or small mucosa. If this happens rarely, it is unlikely that you will have an anal cancer. If you're bleeding frequently, ask for the examination of anal anxiety (anoscopy). Men who have sex with men have a higher risk of anal cancer in women than women with cervical cancer. The risk of anal cancer increases with the number of anal sex partners, but men who do not have anal sex can develop anal cancer caused by HPV.


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