HPV Infection and Its Implications for Post-Menopausal Women

HPV virus infection

I am 54 years old and have gone through menopause.
My Pap smear results were abnormal, indicating CIN1 (7).
The doctor has scheduled a colposcopy and biopsy, as well as an HPV test.
The biopsy results showed only inflammation.
The doctor mentioned that we should focus on the more severe findings, but I tested positive for high-risk HPV types 35, 52, and 58.
The doctor advised that I should return for follow-up testing in six months.
I have a few questions for the doctor:
1.
If we are focusing on the more severe findings and I have CIN1, can the virus be removed? After all, I am infected with high-risk HPV, and I still have concerns.

2.
At 54 years old, is it necessary for me to get vaccinated? If I still want to have a sexual life, would getting vaccinated make it safer?

luna, 50~59 year old female. Ask Date: 2020/11/03

Dr. Wu Xianghui reply Obstetrics and Gynecology

1.
Electrosurgical excision can be performed to remove cervical lesions, but the virus may continue to infect the remaining cervical tissue that has not been excised.
2.
The cervical cancer vaccine can be administered, but since the individual is above the recommended age for vaccination, the production of antibodies will depend on the person's immune system.
3.
It is advisable to use condoms during sexual intercourse, as men often serve as asymptomatic carriers of HPV.

Reply Date: 2020/11/03

More Info

Understanding HPV Infection and Its Implications for Post-Menopausal Women
Human Papillomavirus (HPV) is a common sexually transmitted infection that can lead to various health issues, including cervical cancer and other anogenital cancers. As a post-menopausal woman, your concerns regarding HPV, especially after receiving a diagnosis of CIN1 (Cervical Intraepithelial Neoplasia 1) and being found positive for high-risk HPV types (35, 52, and 58), are valid and important to address.

1. CIN1 and HPV Management: CIN1 is considered a low-grade lesion, which means that it is not typically associated with an immediate risk of progression to cancer. In many cases, CIN1 can resolve on its own, especially in women with a competent immune system. Your doctor’s recommendation to monitor the situation with follow-up tests in six months is standard practice. The focus on "serious" findings refers to the need to keep an eye on any changes that might indicate progression to a higher-grade lesion (CIN2 or CIN3).
Regarding the possibility of "cutting out" the virus, it is essential to understand that HPV is a viral infection, and there is currently no method to eliminate the virus from the body entirely. Instead, the goal is to monitor the cervical cells for any changes and allow your immune system to clear the virus naturally. If you were to develop a higher-grade lesion in the future, more invasive procedures, such as a cone biopsy, might be necessary. For now, maintaining regular follow-ups and discussing any changes in your health with your healthcare provider is crucial.

2. Vaccination at 54: The HPV vaccine is primarily recommended for younger individuals, typically those aged 9 to 26, as it is most effective when given before the onset of sexual activity. However, recent studies suggest that vaccination can still provide benefits for older women, particularly those who may not have been previously exposed to all HPV types covered by the vaccine.
Since you are already infected with certain high-risk HPV types, the vaccine will not clear existing infections but may help protect against other strains of HPV that you have not yet encountered. If you are considering resuming sexual activity, getting vaccinated could potentially provide an additional layer of protection against other HPV types and related diseases. It is advisable to discuss this with your healthcare provider, who can assess your individual risk factors and health history to determine if vaccination is appropriate for you.

In conclusion, while your diagnosis of CIN1 and the presence of high-risk HPV types can be concerning, it is essential to follow your doctor's recommendations for monitoring and management. Regular screenings and open communication with your healthcare provider will help ensure that any changes are detected early. Additionally, consider discussing the HPV vaccine with your doctor to understand its potential benefits in your specific situation. Taking these steps can help you maintain your health and peace of mind as you navigate this phase of your life.

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