Cervical Cancer Vaccine and Sexual Activity: Key Questions Answered

Questions related to the cervical cancer vaccine?

Hello, doctor.
I have read some articles related to the cervical cancer vaccine, and the information states that women who have not engaged in sexual intercourse do not need to undergo a Pap smear before receiving the vaccine.
I would like to ask the following questions:
1.
What is the definition of sexual intercourse? I have not had penetrative sex with my boyfriend, but I have performed oral sex on him without a condom.
Does this count as engaging in sexual activity? My boyfriend has also attempted to insert his fingers into my vagina to about two knuckles deep, and he has rubbed his penis against my external genitalia without a condom.
Do these three situations count as sexual activity?
2.
Is the reason for inquiring about sexual activity and requiring a Pap smear after engaging in sexual activity related to the exchange of bodily fluids? If so, since oral sex and rubbing his penis against my external genitalia could involve the potential exchange of pre-ejaculate fluid, should I inform my doctor about this?
3.
When consulting about the cervical cancer vaccine, is it necessary to disclose the activities mentioned above to the doctor? Or is this not considered sexual activity, and therefore not necessary to mention?
4.
Lastly, will the activities described above affect the effectiveness of the cervical cancer vaccine? (Oral sex not involving penetration) (or rubbing his penis against my external genitalia) were both done without a condom.
Thank you, doctor.

lynn, 20~29 year old female. Ask Date: 2017/09/18

Dr. Huang Jianzhong reply Obstetrics and Gynecology

1.
What is the definition of sexual intercourse? I have not had penetrative sex with my boyfriend, but I have performed unprotected oral sex on him.
Does this count as engaging in sexual activity? My boyfriend has also attempted to insert his fingers about two knuckles deep into my vagina, and he has rubbed his penis against my external genitalia without a condom.
I would like to know if these three situations are considered sexual activity.
Answer: Legally speaking, sexual intercourse is defined as the unprotected insertion of the penis into the vagina.
2.
Is the reason for asking about sexual activity and requiring a Pap smear after engaging in sexual activity related to the exchange of bodily fluids? If so, does oral sex and rubbing the penis against the external genitalia also count as bodily fluid exchange that should be disclosed to the doctor? Answer: Unprotected insertion of the penis into the vagina can introduce viruses that may cause cervical changes, which is why a Pap smear is required after engaging in sexual activity.
3.
When consulting about the cervical cancer vaccine, do I need to inform the doctor about the activities mentioned above? Or is it not considered sexual activity, and therefore not necessary to disclose? Answer: The cervical cancer vaccine can be administered regardless of whether sexual activity has occurred, so there is no need to disclose.
4.
Lastly, will the aforementioned activities affect the effectiveness of the cervical cancer vaccine? (Oral sex not involving penetration) (or rubbing his penis against my external genitalia) all occurred without a condom.
Answer: It will not affect the effectiveness at all.

Reply Date: 2017/09/18

More Info

Hello! Thank you for your questions regarding the cervical cancer vaccine and sexual activity. It's great that you're seeking information to better understand these important health topics. Let’s address your questions one by one.

1. Definition of Sexual Activity: Sexual activity can encompass a range of behaviors, including vaginal intercourse, oral sex, and other forms of intimate contact. In your case, while you have not engaged in vaginal intercourse, the acts of oral sex and external genital contact (such as rubbing) can still be considered forms of sexual activity. These activities can involve the exchange of bodily fluids, which is a key factor in the transmission of sexually transmitted infections (STIs), including HPV (human papillomavirus).

2. Cervical Cancer Vaccine and Sexual Activity: The recommendation for cervical cancer vaccination and the need for a Pap smear (cervical screening) after engaging in sexual activity is indeed related to the potential for fluid exchange. Oral sex and external genital contact can lead to the exchange of bodily fluids, which may increase the risk of HPV transmission. Therefore, it is important to inform your healthcare provider about any sexual activity you have engaged in, as this information can help them assess your risk and determine the appropriate preventive measures.

3. Disclosure to Your Doctor: When consulting with your healthcare provider about the cervical cancer vaccine, it is advisable to disclose all relevant sexual activities, even if you feel they may not constitute "full" sexual intercourse. This includes oral sex and any other intimate contact. Being open with your doctor allows them to provide you with the best possible care and guidance tailored to your specific situation.

4. Impact on Vaccine Effectiveness: Engaging in oral sex or external genital contact does not negate the effectiveness of the cervical cancer vaccine. However, if you have had any exposure to HPV prior to vaccination, the vaccine may not protect against those specific strains. The vaccine is most effective when administered before any sexual activity begins, as it helps to prevent the most common high-risk HPV types associated with cervical cancer. If you have already been exposed to HPV, it is still beneficial to get vaccinated, as it can protect against other strains you may not have encountered.

In summary, while your experiences may not fit the traditional definition of sexual intercourse, they are still considered sexual activities that can carry risks for HPV transmission. It is essential to communicate openly with your healthcare provider about your sexual history, as this will help them provide you with the most accurate advice regarding the cervical cancer vaccine and any necessary screenings. Remember, the HPV vaccine is a powerful tool in preventing cervical cancer, and staying informed about your sexual health is crucial for your overall well-being. If you have any further questions or concerns, don’t hesitate to reach out to your healthcare provider. They are there to help you navigate these important health decisions.

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