HPV Vaccination and Cervical Health Concerns for Asexual Individuals

Individuals who are sexually inactive receiving the cervical cancer vaccine, undergoing Pap smears, and addressing discharge issues?

Hello, doctor.
I would like to inquire about the following:
1.
I am 27 years old and have not engaged in sexual intercourse.
I am considering receiving the HPV vaccine before marriage, but the doctor at the clinic advised that it is unnecessary, which has left me a bit confused about whether I should get vaccinated.
If it is still recommended, are there any tests I need to undergo beforehand? Can I receive the vaccine while experiencing menstrual irregularities?
2.
I have had irregular menstrual cycles in the past, and last year I experienced abnormal bleeding a few days before my period.
After diagnosis, it was determined to be due to hormonal imbalance, and I have been taking hormone medication, which has helped restore my cycle to normal.
However, it seems I still have some luteal phase insufficiency (as noted by my doctor during an abdominal ultrasound last month), so I continue to take medication for regulation.
If the medication is effective, when can I consider stopping it to observe my condition? Is it necessary to undergo a Pap smear? I am a bit apprehensive about the Pap smear since I have not had sexual intercourse.
3.
I have had yellow discharge since my student days, sometimes accompanied by mild itching and sometimes without any sensation.
Recently, I felt something was off, so I consulted a doctor.
The examination was verbal without an internal exam, and the doctor diagnosed me with bacterial vaginosis.
After taking antibiotics for 2-3 days, I expelled a lot of yellow discharge.
Is this a normal phenomenon? Is it the dead bacteria? By the seventh day, the discharge had significantly decreased, with only occasional yellow discharge remaining.
The doctor advised me to continue taking antibiotics for another week.
Is it normal for the treatment to exceed seven days? Could the discharge issue be caused by other factors? If I have not engaged in sexual intercourse, can vaginitis ascend and cause severe changes in the cervix? Since I cannot undergo an internal examination, I am a bit distressed.
Lastly, is it normal for the vulva to become drier after taking the medication?
Thank you for your time, and I look forward to your response!

111, 20~29 year old female. Ask Date: 2023/08/10

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, based on your description, it is recommended that you can proceed with getting vaccinated, and start regular Pap smears after becoming sexually active.
It would be more appropriate to follow your physician's advice regarding any discharge and other symptoms.
Thank you! Wishing you peace and health.
Dr.
Chang

Reply Date: 2023/08/10

More Info

Your inquiry regarding HPV vaccination and cervical health concerns, especially as an asexual individual, raises several important points that deserve thorough discussion.

1. HPV Vaccination Necessity: The HPV vaccine is recommended for individuals up to the age of 26, and it can still be beneficial for those aged 27 and older, particularly if they have not been previously exposed to the virus. While your doctor may have indicated that vaccination is unnecessary due to your asexuality, it is essential to understand that HPV can be transmitted through skin-to-skin contact, not just through penetrative sexual intercourse. Therefore, even if you are not currently sexually active, receiving the vaccine can provide protection against potential future exposure. It is advisable to consult with a healthcare provider who specializes in sexual health or infectious diseases to discuss your specific situation and any necessary pre-vaccination screenings.

2. Menstrual Irregularities and Pap Smear: Given your history of irregular menstrual cycles and the diagnosis of hormonal imbalance, it is crucial to maintain regular check-ups with your healthcare provider. If your hormonal treatment is effective and your cycles have normalized, your doctor will guide you on when to consider stopping the medication. As for the Pap smear, it is generally recommended to start cervical cancer screening at age 21, regardless of sexual history. The Pap test is a vital tool for detecting precancerous changes in cervical cells, and it is a routine procedure that can be performed safely. If you have concerns about discomfort or anxiety regarding the procedure, discussing these with your healthcare provider can help alleviate your fears.

3. Bacterial Vaginosis and Discharge: The symptoms you describe, including yellow discharge and occasional itching, are consistent with bacterial vaginosis (BV). It is common for individuals undergoing treatment for BV to experience changes in discharge, including an increase in yellow or greenish discharge as the bacteria die off. This discharge can indeed be a result of the dead bacteria, and it is not uncommon for the treatment to last longer than a week in some cases. Your healthcare provider will monitor your progress and may adjust your treatment plan if necessary.
Regarding your concern about the potential for a vaginal infection to ascend to the cervix or uterus, it is important to note that while infections can spread, the risk is generally lower in individuals who are not sexually active. However, maintaining good hygiene and following your doctor's treatment plan is essential to prevent complications.

4. Vaginal Dryness: Experiencing dryness after taking antibiotics is not uncommon, as antibiotics can disrupt the natural flora of the vagina. If this dryness persists or becomes bothersome, discussing it with your healthcare provider may lead to recommendations for vaginal moisturizers or other treatments to alleviate discomfort.

In summary, while your asexuality may influence your perception of HPV vaccination and cervical health, it is still advisable to consider vaccination for future protection. Regular screenings, including Pap smears, are essential for monitoring cervical health, and addressing any concerns about discharge and dryness with your healthcare provider will ensure you receive appropriate care. Always feel empowered to seek second opinions or further information from specialists if you feel your concerns are not being adequately addressed.

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