That astonishing figure doesn’t take into consideration the number of reported sexually transmitted diseases in the US. At least half of all sexually active men and women acquire genital HPV at some time during their lives. High-risk forms of HPV can cause growths on tissues of a woman’s cervix that, over time, can lead to cervical cancer.

The most common test for detection of cervical abnormalities is the Pap Test. The Pap is generally performed by a physician at least once in every three-year period for females under the age of 21 who have been sexually active for three years and for all women over the age of 21. The Pap is generally discontinued once a women reaches the age of 65; however, that decision is best left to the primary care physician performing the test.

There are newer tests available for human papillomavirus (HPV) that can be used in conjunction with a Pap in women 30 years of age or in older women when a Pap is found to be even slightly abnormal. The purpose of the new HPV testing is to collect cervical cells that can be examined under a microscope in a laboratory for better analysis. HPV is rather common in women under the age of 30, while cervical cancer is extremely rare at this age. And, most women with HPV will be successfully treated by eradicating the virus. After 30, HPV is uncommon. Positive testing in women is often simply an indication they acquired it years prior but their immune systems didn’t overcome it. Therefore, testing for HPV is extremely helpful in identifying high-risk types commonly found in cervical cancer.

Interestingly, numerous studies have linked douching with a 73% increased risk of pelvic inflammatory disease and an 86% increased risk of cervical cancer. According to the American College of Obstetricians and Gynecologists, women should avoid douching because it can hide symptoms of an infection or can push the infection higher into the reproductive tract.

Practice safe sex to prevent both unwanted pregnancies and sexually transmitted diseases. Both heterosexual and homosexual couples are at risk and while condoms aren’t 100% effective, they go a long way toward preventing the spread of HPV. The HPV vaccine Gardasil can protect against common sub-strains of HPV that is known to cause cervical cancer. The vaccine is currently FDA approved for females between the age of 9 and 26, with a target age of 11 to 12. If you have a child in this age group, ask her physician if the vaccine is right for her.

It’s the beginning of a new year. All women should make a resolution to have regular Pap smears if they don’t already do so. If abnormalities are detected, be guided by what your physician is recommending. Be proactive in your good health. Don’t let a lack of insurance coverage, a busy schedule or other seemingly important issues keep you from remaining healthy. There’s simply nothing more important that remaining healthy. If you receive a clean bill of health, you can relax; but be certain to ask your physician when you should have a follow-up appointment. You’ll be glad you made the effort.

I had a complete hysterectomy when I was 28 because of cancer. I was lucky it was caught early. I am 65 years old.

About six years ago I started to “spot”. It is like a light menstrual period. I have seen three gynecologists who all say it is “normal”. I wear panty liners every day because I never know when it is going to start. Since I don’t have a uterus anymore, why am I bleeding?

DEAR READER:
Vaginal bleeding in a post-menopausal, post-hysterectomy woman is never normal. This is not to say that the cause of your bleeding is necessarily serious, however.

A complete hysterectomy is a surgery that removes both the uterus and cervix. The ovaries and fallopian tubes remain intact.

Without knowing more, I cannot guess what is causing the bleeding. Do you have pain just prior to or associated with the onset of the bleeding? Have you had a pelvic exam? Have you had any testing? These are all important questions that need to be answered (and followed up on, if appropriate).

The cause of your bleeding needs to be discovered. I urge you to find a gynecologist who will listen to your concerns and order appropriate testing. Perhaps you will have better luck beginning with your primary care physician. He or she can listen to your concerns and symptoms and then direct you to a resource for appropriate help. If your local gynecologists refuse to take the appropriate steps, asking your PCP to speak with them directly. This may yield favorable results, testing and a diagnosis. If not, consider a different gynecological group outside your local area, a teaching hospital or a specialized clinic, such as is available at Mayo Clinic or the Cleveland Clinic.

Your bleeding may be perfectly harmless, but given your history of cancer, you need to know definitively. Let me know how this turns out.