Thanks for this detailed analysis Jen! I also second having the HPV vaccine after the recommended age, (I just got it at 45), especially if you’re single and might have potential partners into the future. And ask the men in your life to do the same and help to prevent the spread of HPV.
There is also evidence that vaginal estrogen resolves an abnormal vaginal Pap. Whether that is because the Pap was misread due to atrophy or whether that is truly a regression is not clear.
I thunk the other thing to consider for menopausal women is to consider condoms with new partners. It’s not just HPV but also HIV you can get. Additionally syphilis is on the rise.
Also, while getting told you have HPV is never great, HPV does NOT equal cervical cancer. The majority of HPV infections resolve spontaneously and are transient. Furthermore, the progression from HPV infections resolve spontaneously to can er takes years if not decades. This is not meant to minimize anybody’s distress, just to keep things in perspective.
Had HPV infection in my 40´s. New sexual partner now married to him & mutually monogamous. ASCUS pap (HR HPV+), CIN 1 on biopsy, not treated, resolved. Normal paps/HPV x 20 yrs. On estrogen patch, vaginal estrogen, Mirena for progestin. Just turned 65. Can I still stop paps?
Yes, those are the guidelines age 30-65. Guidelines say OK to stop at 65. (Have assumed that applies with no new high-risk exposures.) In context of this article wondering if estrogen therapy changes that for people with history of resolved HPV infection.
Yes, again asking in the context of this article if estrogen therapy changes that. Given no actual evidence of harm from estrogen probably doesn’t change it, just curious if it’s a question that should be asked.
Question about vaginal estrogen. What is the safest option for women with history of hormone sensitive breast cancer. Feels like oncologist is minimizing the impact of symptoms try coconut oil but also worried about return of cancer. Having to remove mirena used for very heavy periods and stop Premarin for atrophy and uti feels distressing.
Vaginal estroegn should be fine, as the dosage is so small that it probably will not contribute to recurrence of breast cancer. Although the literature is all over the place on that one.
Wow 60% increase from long term use of BCP! Had no idea. I'm grateful for the pill but this is def something to consider. I'm very skeptical about this statement you make: "Remember systemic MHT doesn’t protect against bladder infections, but vaginal does". How can something that acts systemically in all body tissues not have an impact on the bladder tissue? Not that anyone cares but this is also directly in contrast with what I have experienced - vaginal estrogen did not eliminate my UTIs but systemic MHT did. It is also why I never once experienced a UTI while on BCP, the systemic effect of hormones. Thanks for this article.
Can’t believe timing of this! Started MHTs (transdermal) for bones only and 3 mos later test positive for HPV at annual exam. Never have before. Monogamous relationship for 30 yrs (truly trust this guy). Doc says to check in a year and go from there, depending on results. Now I feel extra worried!
I have a question unrelated to HPV. Can you take a look at the association between menopause and adult-onset asthma in women? I was diagnosed with “cough variant asthma” last year and now I seem to be developing exercise-induced asthma as well. (still need to see a doc about that but I’ve had what feels like an asthma attack during recent bike rides and I’m kind of freaked.) I love to blame everything going on with my body these days on menopause, but I didn’t think there would be an association with asthma. But a brief perusal of Dr. Google linked to reputable sites (like the NHS) that discussed a potentially causal association. Also, it looks like menopause hormone therapy might contribute or make it worse?? Which, I really don’t want to stop taking. I would deeply appreciate your insights on this!!!
Thanks for this detailed analysis Jen! I also second having the HPV vaccine after the recommended age, (I just got it at 45), especially if you’re single and might have potential partners into the future. And ask the men in your life to do the same and help to prevent the spread of HPV.
as always, great information and thank you!
There is also evidence that vaginal estrogen resolves an abnormal vaginal Pap. Whether that is because the Pap was misread due to atrophy or whether that is truly a regression is not clear.
I thunk the other thing to consider for menopausal women is to consider condoms with new partners. It’s not just HPV but also HIV you can get. Additionally syphilis is on the rise.
Also, while getting told you have HPV is never great, HPV does NOT equal cervical cancer. The majority of HPV infections resolve spontaneously and are transient. Furthermore, the progression from HPV infections resolve spontaneously to can er takes years if not decades. This is not meant to minimize anybody’s distress, just to keep things in perspective.
Had HPV infection in my 40´s. New sexual partner now married to him & mutually monogamous. ASCUS pap (HR HPV+), CIN 1 on biopsy, not treated, resolved. Normal paps/HPV x 20 yrs. On estrogen patch, vaginal estrogen, Mirena for progestin. Just turned 65. Can I still stop paps?
Yes. Or get one every 3 to 5 years. Or just get an HPV test that you can self-administer.
Yes, those are the guidelines age 30-65. Guidelines say OK to stop at 65. (Have assumed that applies with no new high-risk exposures.) In context of this article wondering if estrogen therapy changes that for people with history of resolved HPV infection.
The guidelines say 3 normal Pap and HPV tests, or 10+ ofnormal screening. The only time this does not apply is for CIN2/3+
Yes, again asking in the context of this article if estrogen therapy changes that. Given no actual evidence of harm from estrogen probably doesn’t change it, just curious if it’s a question that should be asked.
estrogen therapy doesn't change the guidelines for cervical cancer screening
Question about vaginal estrogen. What is the safest option for women with history of hormone sensitive breast cancer. Feels like oncologist is minimizing the impact of symptoms try coconut oil but also worried about return of cancer. Having to remove mirena used for very heavy periods and stop Premarin for atrophy and uti feels distressing.
Vaginal estroegn should be fine, as the dosage is so small that it probably will not contribute to recurrence of breast cancer. Although the literature is all over the place on that one.
Thank you Dr. Jen!
Wow 60% increase from long term use of BCP! Had no idea. I'm grateful for the pill but this is def something to consider. I'm very skeptical about this statement you make: "Remember systemic MHT doesn’t protect against bladder infections, but vaginal does". How can something that acts systemically in all body tissues not have an impact on the bladder tissue? Not that anyone cares but this is also directly in contrast with what I have experienced - vaginal estrogen did not eliminate my UTIs but systemic MHT did. It is also why I never once experienced a UTI while on BCP, the systemic effect of hormones. Thanks for this article.
Can’t believe timing of this! Started MHTs (transdermal) for bones only and 3 mos later test positive for HPV at annual exam. Never have before. Monogamous relationship for 30 yrs (truly trust this guy). Doc says to check in a year and go from there, depending on results. Now I feel extra worried!
I have a question unrelated to HPV. Can you take a look at the association between menopause and adult-onset asthma in women? I was diagnosed with “cough variant asthma” last year and now I seem to be developing exercise-induced asthma as well. (still need to see a doc about that but I’ve had what feels like an asthma attack during recent bike rides and I’m kind of freaked.) I love to blame everything going on with my body these days on menopause, but I didn’t think there would be an association with asthma. But a brief perusal of Dr. Google linked to reputable sites (like the NHS) that discussed a potentially causal association. Also, it looks like menopause hormone therapy might contribute or make it worse?? Which, I really don’t want to stop taking. I would deeply appreciate your insights on this!!!