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What is hpv?

What is HPV? HPV stands for Human papillomavirus. It is a viral infection that includes more than 100 different strains, at least 40 of which are sexually transmitted. They can infect both women and men, including the skin of the vulva, penis, anus, and the lining of the vagina, cervix or rectum. How common is it? Genital HPV infections are common in sexually active individuals. In fact, it is the most common sexually transmitted infection in the US. Most HPV infections go away on their own. How is HPV transmitted? HPV is common in sexually-active men and women. It can be transmitted via skin-to-skin contact such as sexual activity, sharing contaminated sex toys and, rarely, delivery from mother to baby. When transmitted, it is usually through a cut, abrasion or small tear in your skin.  Risk factors for HPV The number of sexual partners you have, the more likely you are to contract a HPV infection. Having sex with someone who has multiple sex partners also increases your risk. Age...
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Is hpv a STD?

Yes, HPV is the most common STD or STI among people.  Cancer Research UK has found that around 8 out of 10 people will be infected with the virus at some point in their lives.  Cervical cancer, one result of high-risk HPV strains, is one of the most commonly diagnosed cancer among women in Singapore.  However to be sure, often your body clears HPV on its own. Sometimes, it doesn't. Please work with your doctor to discuss your unique treatment plan.  Find out more about the different aspects of HPV by clicking around this site.  Resources: https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/infections-eg-hpv-and-cancer/does-hpv-cause-cancer https://www.channelnewsasia.com/news/commentary/hpv-cervical-cancer-vaccination-pap-smear-rates-singapore-11347050
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How is hpv contracted?

HPV is common in sexually-active men and women.  HPV can be transmitted sexually and non-sexually.  It can be transmitted via skin-to-skin contact via the genitals, mouth and throat, sharing contaminated sex toys and, rarely, delivery from mother to baby.  When transmitted, it is usually through a cut, abrasion or small tear in your skin.  Non-sexual transmission While rare, reusable metal medical instruments can transmit HPV despite rigorous attempts at disinfection.  Warts. Shaking the hand of someone who has a wart on their finger can spread HPV. For more information on the treatment of warts, please check out this Harvard Medical School article: https://www.health.harvard.edu/a_to_z/human-papilloma-virus-hpv-a-to-z  Common surfaces. The viruses carried on surfaces touched by someone who has warts e.g. inside of shoes, swimming pools, showers, can spread HPV.  Risk factors for contracting HPV The number of sexual partners you have, the more lik...
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The different strains of hpv

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There are more than a 100 HPV strains although about only 40 of them are dangerous to health.  A person may be infected with multiple strains at any time.  Strains are identified by a number and fall into the two categories: high-risk and low-risk.  High-risk strains Most HPV infections go away on their own without any treatment however sometimes the HPV can persist and cause abnormal changes to the cells. These cells may develop into cervical cancer over the course of many years.  Some HPV types are high-risk because they have the potential to cause cervical cancer. There are around 40 high risk strains including the most notorious strains 16 and 18, which cause the majority of cervical cancer. High risk strains can also cause other cancers in the throat, tongue, and tonsils.   Low-risk strains Low risk HPV types may cause mild pap test abnormalities or genital warts. HPV strains 6 and 11 are responsible for about 90% of genital warts. Other HPV strains ma...
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Testing for hpv

Testing for STD's, HPV included, is not a routine part of your regular OBGYN check up. You have to ask for it. Do not be afraid to ask!  Tests for HPV Pap smears find cell changes that are likely caused by HPV but do not detect HPV itself.  You can take a HPV test that can identify high-risk strains. You may consider or be advised to take a HPV test if you have an abnormal pap smear result.  If your test comes back positive, it does not mean you have cancer, it just means you have a strain of HPV that may increase your risk of getting cancer in the future. This means you'll need to develop a plan with your doctor to monitor your health accordingly.  Tests for HPV in males There is currently no test for HPV in males. Males should still consider getting the HPV vaccine to prevent infection, prevent reinfection, and transmission to others.  Where to get tested for HPV in Singapore  Set an appointment at: - Singapore Cancer Society - Polyclinics (call ahea...
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What is a pap smear?

What is a pap smear for? A pap smear is a procedure to test for cervical cancer in women. Your doctor's goal during a pap is to collect cells from your cervix. A pap smear detects abnormal changes in cervical cells i.e. precancers. Detecting these changes early with a pap smear is the first step to early identification, halting or treatment of cervical cancer.  A pap smear may also be done in conjunction with a HPV test, especially if you are 30 years and older. The HPV test looks for the virus that can cause cell changes seen on a pap smear.  A pap smear is often done in conjunction with a pelvic exam so please do not worry if your doctor inserts a GLOVED hand with medical lubricant into your vagina while gently pressing on your abdomen with the other hand. This is a routine 5-second procedure meant to check the size, shape and position of your uterus, tenderness or pain, or enlarged ovaries, fallopian tubes, cysts or tumors.  *Please make sure to check if your doctor is...
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Let's talk about hpv-related warts

HPV does not always cause symptoms and many people do not even know they have it. However sometimes HPV infections can cause warts.  Warts from HPV can appear on your genitals, hands, or feet. Low-risk HPV strains 6 and 11 cause 90% of these warts.  Genital warts The Mayo Clinic states that there are more than 40 strains of HPV that affect the genital area. Genital warts appear mostly on the vulva but can also appear near the anus, on the cervix, or in the vagina. In men, genital warts appear on the penis, scrotum or near the anus.  Genital warts rarely cause discomfort or pain although they may itch or feel tender. They are almost always spread through sexual contact.  Note that warts do not have to be visible for you to spread the infection to your sexual partner. To see graphic pictures of the various warts or to read about risk factors for warts, please do further reading at https://www.mayoclinic.org/diseases-conditions/genital-warts/symptoms-causes/syc-20355234...
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Can you cure hpv?

The virus itself cannot be treated however often the body can clear HPV on its own without any treatment. When it doesn't, treatment is directed at HPV-associated conditions such as pre-cancerous lesions, cancers or genital warts. Regular cervical screening tests (pap smears) will detect changes in the cervical cells caused by HPV infection or to identify and monitor high-risk HPV strains.   Even if you have HPV, it is still advisable to get the HPV vaccine to prevent reinfection and also to protect against other high-risk strains. Read more about the HPV vaccine here . 
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The hpv vaccine

What is a HPV vaccine? A HPV vaccine protects against 70-90% of high-risk HPV strains that can lead to cervical cancer. The vaccine is most helpful when given before one starts any sexual activity. Even if you already have HPV, you should still get the vaccine to prevent reinfection and to protect against other high-risk strains.  Even if you have the HPV vaccine, it is still important to go for regular pap smears.  Vaccine efficacy HPV vaccines offer 90% protection against high-risk HPV infections covered by the strains listed by each vaccine. However none provide 100% coverage and none cover all the 100+ strains of HPV. Thus it is still important to go for regular pap smears to identify HPV infections not covered by vaccines.  What is Gardisil 9? The Gardisil 9 vaccine is available to women and men from ages 9 through 45. Some doctors will tell you it's for men and women up to the age of 26 however there is new research showing that people benefit from the vaccine up to...
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HPV vaccine for males

Males are eligible for the HPV vaccine in the same way females are.  HPV vaccines in men help to protect against high-risk strains that may cause neck or throat cancers. They also help to prevent infecting sexual partners.  HPV vaccines given to males and females helps to create herd immunity against HPV infection.  However please note that in Singapore the National Childhood Immunization Schedule (NCIS) only includes HPV vaccination for females.  Please speak to your doctor about seeking the HPV vaccine for males.  Resources:  https://www.singaporecancersociety.org.sg/get-screened/cervical-cancer/hpv-vaccination.html#8-should-my-son-go-for-hpv-vaccination
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When you should receive the hpv shot

You are eligible to receive the HPV shot (Gardisil 9) when you turn 9 years old! You may receive the shot any time until you turn 45 years old. The HPV shot is most effective when you take it before you become sexually active.  However you can still receive benefits of the vaccine at any time. Even if you already have HPV, getting the HPV shot ensures that you are protected against reinfection and also provides additional protection against other high-risk strains.  However if you are severely allergic to yeast, you may not be a good candidate for the vaccine. Please consult your doctor if this condition applies to you. Read more about the HPV vaccine here . 
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Where can I go to receive my hpv vaccine in Singapore?

National School-Based HPV Vaccination Programme in Singapore Happily, in April 2019 the MOH launched school-based HPV vaccinations as an opt-in scheme to all secondary 1 female students (age 12-13 years old). According to the SCCPS, Cervarix is the chosen vaccine for this programme. However Cervarix only covers high-risk types 16 and 18. Please consider looking into Gardisil or Gardisil 9 for greater high-risk coverage. Public Hospitals Call your doctor to discuss which vaccine they have available plus associated cost.  Private Doctors Private doctors tend to offer Gardisil 9 however getting inoculated with a private doctor is the most expensive option.  General Practitioners at Polyclinics  Note that polyclinics may only offer Cervarix and won't inoculate women or men above the age of 26. If you are older than 26, you may consider going to a public hospital or private doctor to receive the Gardisil 9 vaccine.  Cost of Vaccination Depending on where you go, the cost ...
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Dicey decisions with hpv

Having sex with HPV First off, having HPV doesn't mean you're a bad person. You can contract HPV from just shaking the hands of someone with exposed warts on their fingers. Furthermore, HPV is incredibly common and many people continue having sex without knowing they have HPV or have transmitted HPV.  In fact, HPV is so prevalent that it makes more sense to assume anyone you're having sex with has HPV.  In most cases, doctors don't even test for HPV unless you're above 30 years old. When you're in your teens and 20's, your body is likely to clear HPV on its own.  Finally, there is no way to test HPV in males. The only way to identify HPV in males is via the examination of warts.  Preventing the transmission of HPV  Depending on your own special set of circumstances, having sex with HPV may not change your sex life significantly.  Or, it might make sense to tell your current or previous partners about the HPV infection and decide collectively from there. For...
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The hpv vaccine does NOT encourage promiscuity

If you had the opportunity to protect your relative from cervical, throat or neck cancers, would you do it? I am sure the answer is yes.  Care is precisely the reason we readily encourage our children to get vaccinated against hepatitis A, B and C; we agree the vaccines do not cause them to share needles or drink contaminated water.  The HPV vaccine does not encourage increase or encourage the sexual promiscuity in women and men, in fact its purpose is to protect them from high-risk HPV strains that can cause cervical, throat or neck cancers. This is further underscored by government and health-body guidelines which state that you may receive the vaccine as early as 9 years old.  The aim of the HPV vaccine is to reduce the chance of HPV-related cancers in our population.  HPV/Cervical cancer statistics in Singapore A MOH survey showed an increase in Singaporean women aged 30 and above diagnosed with late-stage cervical cancer, with no improvements in the uptake of ce...
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What is a colposcopy? When do I need one?

What is a colposcopy A colposcopy is a doctor's office procedure that closely examines your cervix, vagina and vulva using a colposcope for signs of abnormal cells. If a doctor finds an unusual area of cells during this procedure, s/he will collect a sample of tissue to examine in the lab, this process is known as a biopsy.  What is a colposcopy for A colposcopy can be used to diagnose genital warts, precancerous changes in the tissue of the cervix, vagina or vulva, and inflammation of the cervix (cervicitis). When do I get a colposcopy A colposcopy is typically recommended by a doctor if your Pap test result is abnormal, or even borderline abnormal.  What to expect at the doctor's office A colposcopy, while only between 10-30 minutes, can often cause anxiety. As you would during a pap, you'll lie on your back with your feet in supports. Your doctor will then use a metal speculum to keep the walls of your vagina open and then use a colposcope to examine your vagina, vulva a...
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What are the differences between CIN 1, 2 and 3?

 After a colposcopy, your doctor will take a/multiple biopsies to determine the nature of abnormal cells in your cervix. Normal result  If you get a normal result, this means no abnormal cells are present and you do not need immediate treatment. Continue with your regular pap smears and HPV tests, of course. Abnormal result If you have an abnormal result, it means there are abnormal cells prevent in your cervix, otherwise known as cervical intra-epithelial neoplasia (CIN). CIN is graded between 1 to 3, with 1 being the mildest and 3 being the most severe. Receiving a CIN result does NOT mean you have cancer, however it assesses the risk of the abnormal cells turning into cancer if untreated. CIN 1 It is unlikely the cells become cancerous and may go away on its own. Your doctor may recommend another colposcopy in 6-12 months to monitor the cells. Note that the practice in Singapore is to monitor the cells every 6 months, however in the US and UK the practice is to monitor ever...
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