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Does Birth Control Worsen HPV?
Victoria Gasparini
If you’re reading this, you are likely one of the many people who are taking a closer look at their health and how their daily living impacts their experience with HPV. Well, I’m glad you’re here and I am even more glad that you are taking a proactive approach to your healthcare. This truly is the first step to healing.
Okay, so one of the most frequent questions I answer in the direct messages on Papillex’s instagram is “how does birth control impact HPV?” Well, the good news is, I did the research for you.
Let’s start with a brief background on how the pill works
To really grasp the connection between birth control and HPV, let's first explore the mechanisms behind contraceptive methods. From oral contraceptives to patches, injections and IUD’s, these methods primarily work by altering our natural hormonal levels, affecting the menstrual cycle and ovulation and therefore preventing pregnancy. But in today's day and age, many women take/use methods of birth control to suppress hormonal conditions like acne, hair loss, hair growth and irregular or painful periods.
Because of this, A LOT of women are on the pill (or some version of it). With the high prevalence of HPV and the extensive use of contraceptives, it is crucial we understand how one affects the other, namely - how birth control impacts HPV.
How birth control impacts HPV
Recent studies have explored the potential link between hormonal contraceptives and the persistence of HPV infections. While research is ongoing, there is evidence to suggest that hormonal contraceptives might influence the likelihood of HPV infections lingering in the body.
How can this be?
The interplay between hormonal contraceptives and HPV may be rooted in hormonal changes that affect the immune system. Understanding these mechanisms is crucial, as the immune system plays a pivotal role in combating and clearing HPV infections.
Studies have found that the long term use (i’m talking 10+ years) of oral contraceptives has a four-fold increased risk of developing cervical cancer. A study of over 46,000 individuals found that those who used OCP’s had a significant;y higher rate of cervical cancer and abnormal cervical cell growth than non-users. The research also suggests that the risk decreases after stopping the pill.
Considerations for Women Using Birth Control
Address nutrient deficiencies
Nutrient deficiencies are a real concern for those on OCP’s. The pill can deplete essential nutrients like riboflavin, B6, folic acid, vitamin C, and zinc. We know these nutrients are important players in supporting the immune system and some deficiencies in these nutrients have even been linked to persistent HPV.
Address gut health
Moreover the OCP is known to alter the gut microbiome. The pill may increase risk for intestinal permeability, dysbiosis and candida overgrowth. A healthy gut is another foundation for our immune and overall health, impairing this system can have a widespread impact on the rest of the body.
Keep up with your regular screenings
For women using hormonal contraceptives, it's essential to prioritize regular health check-ups. This includes screenings for HPV, ensuring that any potential infection is detected and addressed promptly. Open communication with healthcare providers is key, allowing for informed decisions regarding both birth control methods and overall reproductive health.
Try other methods of birth control that are non-hormonal
This may not be suitable for everyone and that is totally okay. If possible, condoms are a favorable form of birth control when it comes to protecting against both pregnancy and STI’s. Condoms form a barrier between mucosal contacts and are found to be 98% effective at protecting against STI’s like chlamydia and gonorrhea. However, because skin to skin contact can occur with condom use, they are less effective at preventing the spread of herpes, genital warts and HPV. Nevertheless, condom use is still warranted and recommended as there is still a reduction in risk of spread compared to no condom-use.
The IUD is another potential option. The hormonal IUD delivers a small amount of progestin to the local uterine tissue. Some individuals notice side effects such as mood changes, bloating, cramping and reduced menses. There is however a non-hormonal IUD option, the copper IUD. This prevents pregnancy by releasing copper in the uterus that is toxic to sperm. The copper IUD does not suppress ovulation and the most common side effect is heavier menstrual bleeds. The benefit is that the copper IUD has no hormonal impact, and therefore does not impact clearance of HPV.
Overall, we are still mostly unclear on how the IUD impacts cervical dysplasia. Please also keep in mind that the iUD does not protect against STI’s.
In navigating the complexities of reproductive health, awareness is our strongest ally. By understanding the potential interplay between birth control and HPV, you can make an informed decision about your contraceptive methods and overall health. Regular screenings and open communication with healthcare professionals are vital steps toward maintaining a healthy and informed reproductive life.
Nov 13, 2023
4 min read
HPV: Debunking Myths and Misconceptions
Victoria Gasparini
Human Papillomavirus (HPV) is a widespread infection, affecting more than 80% of sexually active individuals, both male and female. Despite its widespread prevalence, a stigma surrounds this topic, giving rise to numerous myths and misconceptions.These myths not only contribute to misunderstandings but can also hinder our efforts to manage HPV-related health issues. Many people with HPV struggle to access accurate information, and hesitate to consult medical professionals due to this stigma.
Let’s debunk these myths and misconceptions once and for all, shall we?
Myth 1: Only Women Can Get HPV
Fact: HPV does not discriminate based on gender. Both men and women can contract HPV through intimate skin-to-skin contact. While HPV is a leading cause of cervical cancer in women, it can also lead to various cancers and health issues in men, making it crucial for everyone to be aware of the risks.
Myth 2: HPV Always Leads to Cancer
Fact: HPV is a group of viruses, and not all of them lead to cancer. In fact, most HPV infections clear on their own without causing any health problems. While certain strains can cause cancer, regular screenings and vaccinations can significantly reduce the risk of developing HPV-related cancers.
Myth 3: Condoms Provide Complete Protection Against HPV
Fact: While using condoms can reduce the risk of HPV transmission, they do not provide complete protection. HPV can infect areas not covered by a condom. The most effective way to prevent HPV-related health issues is through vaccination. The HPV vaccine protects against the most common cancer-causing strains of the virus.
Myth 4: Only Promiscuous People Get HPV
Fact: HPV is incredibly common, and anyone who is sexually active can contract the virus, even if they have had only one sexual partner. The number of sexual partners does increase the risk, but HPV can be transmitted through even limited sexual contact.
Myth 5: HPV Is Untreatable
Fact: While there is no cure for HPV, most infections clear on their own without causing any health problems. HPV-related health issues such as genital warts or abnormal Pap smears can be managed with medical intervention. Regular screenings and early detection are crucial for timely and effective treatment.
Myth 6: If You Have HPV, You Will Always Have It
Fact: Many HPV infections clear from the body within a couple of years. The immune system often fights off the virus naturally. However, in some cases, the virus may persist. Regular screenings and follow-ups with healthcare providers are essential for managing persistent infections and preventing related health problems.
Knowledge is Power
Dispelling these myths is essential for promoting accurate information about HPV. Understanding the facts can empower individuals to take proactive steps, such as practicing safe sex and undergoing regular screenings. By debunking these myths, we can collectively work towards a world where HPV-related health issues are minimized and well-managed.
Remember, open communication with healthcare providers and sexual partners, along with staying informed, are the keys to protecting yourself and others from HPV-related health problems.
Nov 01, 2023
2 min read
Abnormal Pap? Here's What To Do Next
Victoria Gasparini
In 2022, an estimated 14,100 women in the United States have been/will be diagnosed with cervical cancer, caused by HPV. In 2020, over 600,000 women were diagnosed across the globe. While the HPV vaccine has drastically reduced cervical cancer rates as a direct result of preventing high-risk HPV, there are still approximately 4300 deaths per year in the United States alone, from cervical cancer.
Take comfort knowing that most HPV cases do not cause cancer, and that many strains of HPV can be controlled and suppressed naturally by supporting the body’s immune system and encouraging adequate viral clearance. The high risk strains of HPV are 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 66 and 68. HPV 16 and 18 are typically the higher risk types and are responsible for most types of HPV-related cancers.
What to do after receiving an abnormal pap smear
The Pap smear involves taking a cell sample of the cervix and assessing for any abnormalities. By monitoring cell changes, earlier treatment and interventions can be implemented which can prevent more severe disease. If you receive an abnormal pap smear result, it is best to talk to your doctor about what your next steps are. This may include more frequent tests, among other possible solutions. Unfortunately, from a conventional standpoint, the advice is typically to “watch and wait” at this point in the diagnosis.
Fortunately, more and more research is finding that there are ways to control and manage HPV naturally, with dietary and lifestyle changes. Let’s dive into your post-diagnosis plan, below.
First things first, know that you aren’t alone.
HPV is one of the most common sexually transmitted infections, affecting 80% of sexually active women. In fact, most sexually active men and women will contract some strain of HPV at some point in their lives. It is not uncommon to have an abnormal pap smear during routine testing. It is, however, important to do what you can to get HPV under control.
Talk to your doctor about follow-ups, strains and risk.
While Pap testing and increased screening have resulted in a decline in cervical complications, there remains some debate over how often early screening should take place. Considering 90 percent of HPV infections will regress over time, screening can also lead to harm such as unnecessary stress on the individual, additional follow-up testing and biopsy, and the potential of unnecessary treatment.
The chances of having an abnormal Pap smear are higher in young individuals and decrease with age. Around 10% of individuals with a cervix aged 20-29 years will have an abnormal test result while only 1.6% of those aged 60-69. Of these abnormal results, 1.5% of 20–29-year-olds will have high-grade lesions that lead to further testing and biopsy. However, more than 50% of these will undergo treatment. Many of these infections would clear on their own and lead to no complication of cervical cancer.
Depending on where you live and your unique, individual case - your screening guidelines may differ. It is best to work with your physician to develop a plan that is right for you. Find out the screening guidelines in your country here.
Adopt a healthy immunity plan.
We dive into the research on building your immune system to help prevent and clear infections like HPV. Here are some of our favorite, evidence-based tips for building and adopting a healthy immunity plan to help you take control of HPV.
Find movement that you enjoy
Consistency is key when it comes to exercise and movement - so if it does not come naturally, know that you probably won’t stick with it. Try finding a daily movement you enjoy such as walking outdoors, weight lifting, kayaking, swimming, hiking, rock climbing - anything that gets you up and going.
Eat a wide array of colorful vegetables and fruits.
The more variety you consume with regards to veggies and fruits, the better. Nutrients like carotenoids, sulforaphane, folate, vitamin C, selenium and more, have all been shown to boost immunity and increase clearance of HPV.
While all foods are welcome in a healthy, balanced diet, it is best to focus on anti-inflammatory, antioxidant and phytonutrient-rich foods, with limited intake of starches and sugars. You can find out more about diet and HPV here.
Practice mindfulness
Addressing stressors in our lives is often the biggest barrier to healing, and also often the most important barrier to knock down. The connection between stress and persistent infections is clear which is what makes mindfulness such an integral part of your healing. Studies continuously find a connection between stress and its impact on immunity, which is supported in pathogenesis and persistence of HPV infections. You cannot always control stressful events from occurring, but you can manage perceived stress through methods of talk therapy, finding good friends to chat with, getting adequate sleep and nutrients, and getting outside in nature. Reducing perceived stressors can help with HPV disease management and progression and is an important part of any HPV treatment plan. Other things you can do to manage stress include, positive self-talk and reinforcement, surrounding yourself with positive people, trying acupuncture and/or massage, and more. Click here for more stress-management tips.
Most of all...
It's crucial to remember that abnormal pap smears are extremely common, and in many cases, they resolve on their own. Be gentle with yourself during this process. While a "watch and wait" approach is typical, being proactive about your health is essential. There are options available, empowering you to take charge of your healthcare journey. By staying informed and proactive, you can navigate this experience with confidence and assurance, ultimately ensuring your health and peace of mind.
Oct 02, 2023
4 min read
Perineum Sunning & HPV: A Trend with Scary Consequences
Victoria Gasparini
Social media can be a beautiful place of empowerment, knowledge, community-building and sharing of experiences that help bring us closer together, but there are downsides. Access to information at our fingertips invites the potential of dangerous trends disguised as “health” or “wellness” advice.
One newer trend circulating the web is called “perineum sunning” and it comes with a set of dangerous potential complications, especially for those with HPV.
What is perineum sunning?
The perineum is a small area of thin skin between the anus and the vulva in females, and the anus and the scrotum in males. This thin patch of skin is highly sensitive and delicate to the sun, with many blood vessels and nerves that provide both nutrition and sensation to the genitals.
Because this skin is so incredibly delicate, it is fairly controversial to expose it to the sun (especially without sunscreen), even for just short periods of time.
So, why are people doing it?
The trend of exposing the perineum to direct sunlight was popularized by influencers and even some celebrities online, and is said to be derived from a taoist practice. These influencers claim that by exposing such a delicate area of skin to UV light, you can give your body an intense dose of natural vitamin D, which in turn gives you a massive energy boost - "better than coffee." They have also mentioned that from a traditional Chinese medicine perspective, perineum sunning can stop "qi" (life force energy) from leaving the body, helping us to store this energy in the body instead.
Is there any research to support these claims?
Absolutely none.
Our bodies do create vitamin D from the sun which is necessary for supporting the entire body and its many complexities. But we can (and do) get this exposure without stripping down and exposing our backsides to the sunlight. In fact, just 15 minutes in the sun (without sunscreen) gives us a boost of vitamin D. We can also safely get these doses or “boosts” of the essential vitamin through safe and effective supplementation at the recommendation of your doctor.
The energy boost that these influencers claim comes from perineum sunning will come from just regular sunlight exposure, regardless of the location on your body. There is no evidence to support perineum sunning has any health benefits. There is evidence, however, that it comes with a host of dangerous potential risks - especially for those with HPV, which we discuss below.
At Papillex®, we believe in using health and wellness with an evidence-based lens which focuses on safety, research and ancient practices. With that being said, this trend is not something we recommend.
Perineum sunning and HPV: What’s the connection?
In addition to the potential for a painful and unsightly sunburn, skin cancer is among the greatest risks of tanning the perineum, even for just a short period of time. In fact, according to dermatologist, Angelo Landriscina, MD., “it compounds on the skin cancer risks presented by Human Papillomavirus (HPV) infection.
HPV is a significant risk factor for squamous cell carcinoma (SCC) in the genital region. Combining the presence of HPV with sun exposure to the genital area, specifically the perineum, greatly increases your risk for the development of SCC - which also tend to be more aggressive when in the anogenital region, compared with elsewhere on the body. This is because SCC in this region has a greater chance of metastasis (or spread) which means that they can move to other organ systems, leading to potentially more serious complications and even death.
What can we do instead?
If you’re looking for lifestyle changes you can implement for better energy, sleep, mood and creativity - look no further then the following evidence-based lifestyle practices that have worked for years:
Meditation and breathing exercises
Yoga, pilates and stretching
Regular exercise
Walking in sunlight
Forest bathing
Grounding (barefeet in the grass or sand)
Supplemental vitamin D and B vitamins
Avoid excessive caffeine, especially in the afternoon
Eat lighter meals later in the day
Opt for higher protein and fibre-rich foods
Herbal remedies like rhodiola or ginseng
Rest
To conclude:
Exposing your derriere to UV light carries potential risks that significantly outweigh any benefits reported by influencers with no scientific background. For the sake of your health, choose sure-fire lifestyle practices like the ones listed above, instead.
And if you really still wanna try it, please use plenty of SPF.
Jul 10, 2023
3 min read
5 Steps to a Healthier "Down There"
Victoria Gasparini
Many of us have come to accept that womens health issues such as dryness, infections, cervical dysplasia and pain in the vaginal canal are all normal parts of being a female. But what if I told you this does not have to be your reality? There is a great deal you can do to control and prevent vaginal infections, make intercourse and sexual experiences less or not painful at all, and even heal and prevent cervical dysplasia.
Some issues commonly experienced by women are, vulvovaginitis, vaginismus, bacterial vaginosis, and yeast infections. Women may also experience cervical dysplasia caused by HPV, and gential lesions from HSV.
Because the above issues are so common in society, they are rarely taken seriously in the medical community, but for most of us women, they do impact our quality of life and our ability to be our true authentic selves.
Here are 5 steps to a healthier “down there”
Lifestyle
Oral contraceptive use
Many women rely on oral contraceptives for a variety of hormonal-related issues, as well as for contraception. While the pill is an important part of many of our personal lives, there are some negative implications to our vaginal and cervical health that come with taking them. For example, oral contraceptives that contain estrogens can increase incidence of yeast infections. Additionally, oral contraceptives increase your risk for worsening HPV-related symptoms. Though the research is still blurry when it comes to how birth control can increase cervical cancer risk, we do know that taking oral contraceptives depletes many key nutrients that are required to help us keep our HPV inactive. The pill can deplete riboflavin, vitamin B6, folic acid, vitamin C, and zinc. We know these nutrients are important players in supporting the immune system and some have even been specifically linked to HPV.
Moreover, the birth control pill is also known to alter the gut microbiome. The pill may increase leaky gut, dysbiosis, and candida overgrowth. A healthy gut is another foundation for our immune and overall health. Impairing this system can have a widespread impact on the rest of the body. Finally, certain types of birth control pills can affect your sex drive, impacting your intimacy, sexual health and ability to feel lubricated.
Vaginal ecology disruptors
Antibiotics, sanitary products like tampons and pads, and steroid-use can all impact our vaginal health and microflora. The good news is we can reduce or avoid these environmental triggers. Antibiotics, while incredibly necessary and helpful when needed, can do immense damage to the vaginal microbiome. By keeping our immune system healthy (by using the tips from our blogs), you can hopefully prevent chronic infections that require antibiotics.
Sanitary pads and tampons typically contain harmful ingredients such as bleach, and can be avoided by purchasing organic 100% cotton ones, or switching to a menstrual cup or menstrual underwear.
Never, ever douche.
It’s 2023, let’s stop trying to convince women that their vagina’s should smell like flowers. Our vaginas are self-cleaning machines. All you need is water or a gentle soap on the vulva area (the area surrounding the vagina), and that is it. In fact douching your vagina changes the pH and can actually result in more infections and even a foul smell down the line.
Safe sex is enjoyable sex
We are all for practicing safe sex as a way to reduce viral transmission, the incidence of BV and UTI’s but also to prevent unwanted pregnancies. However, typical latex condoms and chemical laden lubes might be the sneaky reason behind your vaginal infections that seem to pop up every time you get intimate.
Skip the traditional brands and go natural where possible. Many lubes and condom companies are now offering “spermacide-free” condoms, and chemical-free lubes. Typical lubes can disrupt the vaginal flora and pH leaving us at a higher risk of developing vaginal infections.
Food
Food truly is medicine, and can help us prevent and handle all kinds of women's health issues. Phytonutrients can help us with healthy vaginal tissue, lacto-fermented foods can help nourish our microflora, and balancing our blood sugar can help support vaginal ecology while also preventing recurrent HPV related flare-ups. Though I know it can be tempting to reach for the bottle of wine after a long day of work, we recommend skipping that glass when possible and opting for a sparkling water, or alcohol-free, low sugar option.
Herbs & Nutrients
Supplementation can be incredibly individual, however, Papillex was made with the intention of correcting the most common nutrient deficiencies found in women with HPV. These nutrients like folate, green tea extract and vitamin C have all been found to be extremely beneficial in women's and general health, too. We also really like to add an omega 3 to our routine for reducing inflammation, and inhibiting the growth of HPV cervical cells. Finally, AHCC has been shown to clear even high-risk strains of HPV after several months of use. Talk to your health provider about what supplementation is right for you.
Mind-body connection
When it comes to starting your holistic healing journey, we believe the best approach includes a strong mind-body connection. More and more studies are finding a link between past traumas, adverse childhood events, and high levels of stress with vaginal infections and conditions like vaginismus. Dealing with these issues is likely the hardest but most important part of true healing.
If you had the chance to tune in to our instagram LIVE last week with women's integrative health coach, Denell (@cervicalwellness) and founder of Papillex, @drgoldspink, they had an incredible and inspiring conversation about the psycho-emotional aspect of healing conditions like HPV and cervical dysplasia. If you did not get a chance to see it, head to our instagram this week to check it out.
Therapy
We are big advocates for talking it out. Therapy, a good partner, good friendships, online or in-person support groups, a good primary care provider, naturopathic doctor, pelvic floor therapist or healer of any kind can really help you with these intense but important breakthroughs that can hopefully kickstart your healing from all sorts of problems we see happening “down there”.
Sadly, there is a stigma around many of these conditions, so much so that I had to avoid using the term "vagina" in the title of this blog post. It's time we start talking about these issues that so many of us face.
Interested in more tips of healing vaginal infections, cervical dysplasia, HPV and/or HSV? Follow us on instagram to continue the conversation.
Feb 06, 2023
5 min read
Pap Screening Guidelines for Cervical Cancer
Adrienne Hill-Strathy
The Pap smear is a dreaded appointment for many but, thanks to this handy screening tool, cervical cancer rates and complications from HPV have seen a decline.
Increased screening has led to earlier detection of cervical cell changes and with it, led to earlier treatment. Today, Pap smears are incorporated into regular screening for individuals with a cervix. However, when and how often you get tested can differ depending on your country, age, and past HPV status. Read on to learn more about screening in your location.
First, what is a Pap smear?
The Papanicolaou-stained (Pap) smear was introduced in 1949 by a pathologist named George Papanicolaou. The Pap smear is now the primary screening tool used to assess abnormal cervical changes and screen for the risk of cervical cancers.
The Pap smear involves taking a cell sample of the cervix and assessing for any abnormalities. By monitoring cell changes, earlier treatment and interventions can be implemented which can prevent more severe disease.
While Pap testing and increased screening have resulted in a decline in cervical complications, there remains some debate over how often early screening should take place. Considering 90 percent of HPV infections will regress over time, screening can also lead to harm such as unnecessary stress on the individual, additional follow-up testing and biopsy, and the potential of unnecessary treatment.
The chances of having an abnormal Pap smear are higher in young individuals and decrease with age. Around 10% of individuals with a cervix aged 20-29 years will have an abnormal test result while only 1.6% of those aged 60-69. Of these abnormal results, 1.5% of 20–29-year-olds will have high-grade lesions that lead to further testing and biopsy. However, more than 50% of these will undergo treatment. Many of these infections would clear on their own and lead to no complication of cervical cancer.
For this reason, many countries recommend screening at a later age. Here is what is recommended in Canada, the UK, and the US.
Screening Guidelines Differ Depending on Country
Canada
The Canadian Task Force on Preventive Health Care recommends the following screening for asymptomatic individuals with a cervix without a previously abnormal test and who are sexually active.
Screening is not recommended for individuals under 24. The potential harms in this group out weight the benefit of early screening.
For individuals with a cervix aged 25-29 screening is weakly recommended every 3 years. The concern for cervical cancer increases in this age group, therefore there are benefits to screening.
For those aged 30-69 routine screening every 3 years is strongly recommended. In this age group, the risk of cervical cancer is greater, and screening offers preventative benefits.
At the age of 70 regular screening may be ceased.
In Canada, the recommendations are used as guidance to be used in discussions with patients. Some women may place a higher value on avoiding cervical cancer and would want to undergo more frequent or earlier screening. While others may prefer to follow the screening guidance.
United States
The US Preventive Services Task Force sets the screening guidelines in the United States. The US recommendation incorporates high-risk HPV testing, which can help detect high-grade cervical lesions by identifying strains more likely to cause cervical cancers. They recommend the following:
Screening begins at age 21-29 and should be followed up every 3 years with cervical cytology.
In women aged 30-65, it is recommended to screen every 3 years with cervical cytology and every 5 years with high-risk human papillomavirus testing or every 5 years HPV testing in combination with cytology.
The USPSTF recommends against screening in those under the age of 21 and over the age of 65 and those who have had a hysterectomy.
United Kingdom
The UK has its own set of recommendations through the NHS Cervical Screening Programme. The NHS has also begun including HPV testing in its assessment. Cervical samples will be tested for high-risk Human Papillomavirus to help identify individuals more at risk for developing cervical cancer and implement treatment earlier. Their screening is recommended to begin at age 25 to 65.
For those aged 25-49, screening is offered every three years.
For those aged 50-64 years of age, it is recommended every five years.
What about for those who have had an abnormal Pap previously?
Screening guidelines differ if you have previously had an abnormal Pap and HPV has been detected.
If your Pap test was abnormal, you were likely referred to a gynecologist for a colposcopy. A colposcopy allows for a better view of the cervix and biopsy. Depending on your level of cell changes and health history, your doctor will recommend a treatment course of action or to watch and wait.
In those that have previously tested positive for HPV or had abnormal Paps that turned normal, your doctor will likely recommend follow-up testing a year after a normal result. HPV infections can recur, so it is important to stay on top of testing to see if cell changes recur over time.
The Benefit of Early Detection
Deciding when and how often to screen for cervical cancer and HPV, should be discussed with your medical doctor. Early detection has been beneficial in reducing our overall rates of cervical cancer. However, extra screening has also added anxiety and unnecessary procedures to those whose infections would have regressed within 12-36 months.
Moreover, detecting infection early also allows for earlier intervention with immune supports like Papillex and lifestyle changes like an anti-inflammatory diet, stress reduction, and exercise.
May 02, 2022
4 min read
How to Support Your Metabolic Health for HPV
Adrienne Hill-Strathy
What do you know about Metabolic health? If the answer is not much, that’s okay! Today we’re talking about how your metabolic health supports our overall health and wellbeing. Our metabolic health not only impacts our energy, but our memory, mood, skin, fertility, sexual health, and immune system.
By understanding the basics of how our body uses energy and how we can support it, we can optimize our ability to defend against the persistence of viral infections like the human papillomavirus (HPV).
Let’s dive in.
What is Metabolic Health and Why Should you Care?
Metabolism is the process by which we convert food into energy. When our metabolism is healthy, we have energy, normal blood pressure, blood sugar regulation, and limited inflammation. When our metabolic process becomes impaired our cells don’t function optimally and we are more vulnerable to developing disease.
It is important to pay attention to our metabolic health because poor metabolic health underlies many chronic diseases, including persistent HPV infections.
Unfortunately, poor metabolic health is more common than you think--you likely know friends or family members with diabetes, hypertension, obesity, or high cholesterol.
It is estimated that 88% of the American population shows some signs of metabolic dysfunction. Around 33% of adults in the United States have metabolic syndrome. Metabolic syndrome is characterized by increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol and triglyceride levels. Metabolic syndrome is associated with an increase in chronic inflammation and oxidative stress, two factors that increase the risk of cancer and persistent HPV infections.
Where Things Can Become Imbalanced
The modern lifestyle is largely to blame for the high rates of metabolic dysfunction. Our diets are higher in processed and sugary foods, we are more sedentary than ever, get less quality sleep, and many of us live with chronic daily stressors that cause further hormonal and metabolic imbalance. All these factors and more, make it important to be aware of our metabolic health and how we can actively work to support it.
One of the main ways our metabolism can become impaired is through our diet. When the body is taxed with large amounts of dietary carbohydrates, it can throw off our hormone balance and metabolism.
Blood sugar is one of our best markers to monitor metabolic health daily. Glucose is the primary fuel source for our cells. We obtain glucose when we break down carbohydrates and proteins from the diet. Glucose then signals the pancreas to secrete a hormone called insulin. Insulin is responsible for shuttling the glucose into our cells to be used as energy. The body stores some of this glucose in the muscles and liver for a backup energy supply. Some glucose also is stored in fat cells and processed by triglycerides.
One of the impacts high blood sugars can have over time is a process called insulin resistance. Insulin resistance occurs when our cells become desensitized to insulin, preventing glucose from getting into our cells. Instead, the sugar remains elevated in the bloodstream. Excess glucose in the bloodstream leads to inflammation, oxidative stress, and can harden blood vessels over time.
For optimal health, we want steady blood glucose and insulin levels over time.
How Does Metabolic Health Impact HPV?
You might wonder, how does this all play into HPV? Well, turns out the health of our cells influences many of the factors that put us at risk for HPV.
As we’ve mentioned, inflammation and oxidative stress are increased when metabolism is dysfunctional. Metabolic dysfunction can also throw off our hormones and immune system. We know the immune system is so important for HPV clearance so when the system is impaired, it will be harder for the body to defend against viral invaders.
Research has found some associations between poor metabolic health and HPV. A study looking at the relationship between blood glucose levels and cervical cancer cases found higher blood sugar was associated with a poorer prognosis of cervical cancer. There is also some evidence that suggests individuals with diabetes require more treatment for genital warts from HPV.
How do I Assess my Metabolic Health?
We typically measure our metabolism using five biomarkers: blood sugar, triglycerides, high-density lipoprotein (HDL) cholesterol, blood pressure, and waist circumference. Your doctor has probably screened you for some of these at some point.
Many metabolic assessments are included in regular screening and medical check-ups. Obtaining regular blood pressure screening and labs is the best way to assess metabolic health over time.
Basic blood tests to help assess your metabolic health:
Cholesterol Panel: A cholesterol panel is commonly used to assess cardiovascular risk. The panel measures cholesterol levels and triglycerides. Triglycerides are a part of lipid or fat, when elevated they can be a sign of prediabetes. High sugar and carbs intake can impact cholesterol levels.
HbA1c: This measure captures a 2–3-month average blood sugar level and is used to assess risk for developing type 2 diabetes.
Fasting insulin and fasting glucose: these measures can be used to calculate HOMA-IR, a measure of how well your cells are responding to insulin.
What to do to support our metabolic health
Supporting our metabolic health is just like training a muscle. It is the consistent things we do every day that add up to the overall picture of metabolic health. Supporting our metabolic health involves making smart dietary choices, getting adequate sleep, managing stress, engaging in physical activity, and reducing exposure to environmental toxins.
Reduce intake of refined carbohydrates: these can quickly spike blood sugar and insulin levels, leading to a crash later in the day.
Pair carbohydrates with proteins, fats, and fiber to reduce glucose spike: Always combine starches with protein, fat, and fiber to help maintain a level blood sugar. If you plan to eat something sugary, have it after your meal instead of on an empty stomach to lower the glucose spike.
Eat fiber-rich foods: Fiber helps slow the breakdown of glucose into the bloodstream. Fibers also help feed the beneficial microbes that live in the gut. Supporting the gut microbiome can help improve insulin sensitivity and our response to glucose-rich foods.
Engage in regular exercise: Exercise can help regulate our blood sugar levels and improve our insulin response. Aim for 150 minutes per week or 30 minutes on most days. Even taking a 10–15-minute brisk walk after meals have been found to help regulate blood sugar levels.
Get 7-8 hours of adequate sleep per night: Sleep can also play a role in our metabolic health. Poor sleep can lead to less clearance of glucose from our blood stream and higher insulin levels. When we don’t get good sleep, we may be more likely to make poor dietary choices and crave simple carbohydrates.
Meditation and Stress management: Stress can also impair our metabolism and throw off our insulin levels. When we are stressed, we produce more of the hormone cortisol. Cortisol can attract glucose stored in the muscles and liver into the bloodstream, increasing blood glucose levels. It also shuts off insulin production. As a result, we have more sugar floating in the bloodstream. Meditation is a great way to help reduce your overall stress.
Mar 29, 2022
5 min read
Adrienne Hill-Strathy
If you have previously had an abnormal Pap or tested positive for the human papillomaviruses (HPV), your doctor might have recommended a procedure to help clear the abnormal cells. Several conventional interventions are available to address HPV and cervical changes. These procedures aim to remove abnormal tissue and cells in order to prevent progression into cancer.
An HPV diagnosis can be confusing. Adding a potential surgical procedure into the mix may add to your concern, confusion, and anxiety. We hear you; we would want to know the risks, potential harms, and procedural effectiveness as well. Here, we lay out the pros and cons of LEEP and other common conventional treatments for cervical dysplasia so you can be better informed about your options and what is best for your health.
First, a bit about HPV
HPV is the most common sexually transmitted infection around the world. So common that up to 80 percent of sexually active individuals will contract HPV at some point in their lives. Out of the hundreds of different strains of HPV, around 15 have been identified as high-risk. These high-risk strains are associated with cellular changes on the cervix. If these cell changes persist over time, there is a risk that they may lead to cervical cancer.
If you have contracted HPV, do not worry. Up to 90 percent of individuals that contract an infection will clear it within about two years. In individuals that fail to clear the infection, there is an increased risk of developing persistent cell changes that may progress into cervical cancer.
Cervical cell changes are monitored using Pap testing. Interventions have been developed to address cell changes before they can occur in individuals who have had abnormal Pap tests and persistent high-grade cervical intraepithelial neoplasia (CIN). Depending on your situation, your gynecologist may recommend a LEEP, conization, cryotherapy, or laser.
Here we lay out the pros and cons of each of these procedures.
LEEP- Loop electrosurgical excision procedure
The LEEP is an excision method used to remove abnormal cellular changes from the surface of the cervix. LEEP is typically recommended in cases of CIN2/3 or persistent CIN 1. During the procedure, you will assume a similar position as you would for a regular pelvic exam. A thin wire loop with an electric current will be inserted into the vagina to remove cells from the cervix.
Pros of LEEP
LEEP can be performed in-office. It is quick and generally painless with local anesthesia. The procedure generally takes only 10 minutes.
LEEP removes less tissue than other methods, leaving less scarring and changes to the cervix than other methods.
The tissue removed during the procedure can be used to confirm the degree of cellular changes.
Risks of LEEP
LEEP can cause cramping and light bleeding during and after the procedure.
The procedure increases the risk of infection, cervical scarring, and changes in sexual function.
It is associated with an increased risk of preterm labor and low birth weight. The risk of preterm delivery increases with the depth of LEEP exceeding 10 mm.
Effectiveness of LEEP
The recurrence rate of CIN 2, 3 after treatment varies depending on one’s age, the severity of the disease, the treatment. The five-year recurrence rate of LEEP is estimated at around 8.1%.
Cold Knife Conization
Cold knife conization is another surgical excision method used to remove abnormal tissue from the cervix using a scalpel or laser knife.
This procedure allows your doctor to further examine the cervical tissue to determine cancerous changes. Conization is used to treat cervical dysplasia and very early cervical cancer. The procedure involves the removal of a cone-shaped portion of the cervix to remove a cervical lesion and the transformation zone. Conization may be used when there are conflicting Pap smear and biopsy findings, there is severe dysplasia, or in the early stages of cervical cancer.
Pros of Conization
Conization also allows for histologic review of extracted tissue to assess HPV infection and cervical changes.
The cone biopsy is used to effectively diagnose abnormalities of the cervix and treat the early stages of cervical cancer.
Risks of Conization
Side effects of cone biopsy include risk of infection, cramping, and bleeding during and after the procedure.
Conization has a higher hemorrhage rate compared to LEEP.
The procedure removes more tissue than LEEP and therefore a greater risk of scarring and damage to the cervix.
Conization is also associated with an increased risk of preterm labor and low birth weight.
Effectiveness of Conization
Conization has been found to have the lowest recurrence rate compared to other procedures. The five-year risk of recurrence is estimated at around 4%.
Cryotherapy or Laser
Cryotherapy and laser are ablative methods used to destroy abnormal cervical tissue. Cryotherapy uses a freezing gas or liquid nitrogen to remove precancerous cells on the cervix. With laser surgery, carbon dioxide is used to destroy abnormal cervical cells.
Pros of Cryotherapy or Laser
The procedure is quick and can be done in-office, usually taking between 10 and 15 minutes.
The risk of preterm labor is not increased as it is with excision methods.
Removes less tissue than excision methods.
Risks of Cryotherapy or Laser
Tissue isn’t available for histologic evaluation, so cells cannot be examined for degree of changes.
Can cause mild cramping during the procedure.
The procedure may cause vaginal bleeding and lead to infection.
Cryosurgery can cause scarring of the cervix, cervical stenosis, which may lead to risks to getting pregnant, staying pregnant, and vaginal delivery.
Effectiveness of Cryotherapy or Laser
Cryotherapy was to be least effective at reducing cervical cancer long-term. It was found to have the highest risk of recurrence of CIN 2/3 and invasive cancer after treatment compared to other methods.
While each procedure carries some risk, there are benefits to each procedure in reducing rates of cervical dysplasia and cancer. We recommend talking to your doctor about your options and what is best suited for your unique situation. Following any procedure, your doctor will schedule a follow-up Pap smear to monitor cell changes over time.
It is important to remember that while the procedures are effective at removing abnormal cellular tissue, they do not remove or suppress HPV activity. Without suppressing the underlying infection, cellular changes can always return, so it is important to continue to monitor the cervix. This continued HPV activity is why supporting the immune system still plays a pivotal role in addressing HPV and preventing long-term complications of the virus.
Mar 04, 2022
5 min read
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