2006: the year of the Wii, The Devil Wears Prada, and, of course, Gardasil. This is when younger you may have been one of the millions of people who got the Gardasil vaccine, which protects you from harmful strains of the human papillomavirus (HPV). 

Since many of us received the vaccine and first learned about HPV testing, medical guidelines around how often you should get tested and/or receive a Pap test have been updated shifted. So that you’re fully equipped with the most up-to-date information needed to monitor your cervical health, we’ve outlined the details of HPV and when you should schedule your next tests. 

 What is HPV?

With approximately 14 million new cases a year, Human papillomavirus is the most common sexually transmitted infection (STI) in the United States. There are over 100 strains of HPV, and around 40 of them spread through direct sexual contact. Given the prevalence of HPV, the majority of sexually active people will contract some form of it throughout their lives. This said, in 90% of cases, people with HPV will feel completely fine and not experience any symptoms. In these instances, thanks to your immune system, your body will likely clear the infection on its own.

Of these 40+ sexually transmitted types, two (types 6 and 11) can cause cases of genital warts. These strains are referred to as “low-risk HPV” because they don’t typically lead to any serious health problems. 

On the other hand, there are about a dozen “high-risk HPV” types that can lead to the development of sometimes cause particular cancers in the cervix, vulva, vagina, throat, penis, or anus. Of these 12 HPV types, two (16 and 18) cause most of the yearly 35,900 HPV-related cancer cases diagnosed in the U.S. Approximately 11,000 of these yearly cases are diagnosed as cervical cancer.

There is currently no cure for HPV but preventative measures like the Gardasil 9 vaccine, routine Pap tests (also referred to as a Pap smear), and HPV tests can drastically reduce your chances of developing long-term infections and HPV-attributed cancer. 

Does HPV impact fertility? 

In the vast majority of low-risk cases, HPV does not impact fertility or your ability to conceive. 

However, if in the small chance you do have abnormal or cancerous cervical cells that your doctor says need to be removed, be sure to talk with them about your pregnancy plans first. Since some of the techniques used to remove abnormal cells can impact your likelihood of conceiving or carrying a pregnancy to full term, being open with your doctor to figure out the right method for removal is essential. Deep breath here - thankfully, due to the Gardasil 9 vaccine as well as routine testing and our strong immune systems, most HPV cases do not lead to necessary cervical cell removal. 

What is Gardasil 9? 

Gardasil was first approved by the FDA in 2006, with Gardasil 9 approved in 2014. Gardasil 9, the only HPV vaccine currently available in the U.S., is a two or three-dose (depending on your age when receiving the first dose) vaccine that protects you from the strains that cause cervical cancer, anal cancer, and/or genital warts. 

Since approximately half of the yearly 14 million HPV infections are in people between the ages of 15 and 24, The Center for Disease Control (CDC) currently recommends that all individuals between the ages of 9 and 15 get the vaccine. This is because the vaccine is more effective if received before any sexual contact and possible exposure to HPV.

With this being said, if you didn’t get the vaccine as a young person, you can still receive it through the age of 26. In some cases, you can get it until the age of 45. If you’d like to know more about receiving the vaccine at an older age, talk to your doctor about what options you may have.!

How often should I get tested?

When Gardasil and then Gardasil 9 first became available in the U.S., it was standard for people with vaginas to get a Pap test every year, in order to which identify any abnormal or precancerous cervical cells that could lead to cancer. However, since then, the medical community has come to better understand cervical cancer and how it takes many years to develop. Today,Because of this, instead of recommending a  getting a Pap test every year, The American College of Obstetricians and Gynecologists (ACOG) now recommends the following, whether you received the Gardasil/Gardasil 9 vaccine or not: 

• Women between the ages of 21 and 29 should get a Pap test every 3 years. HPV testing can be considered for those in this age group, but Pap tests are preferred

• Women who are 30 to 65 have three options for testing: 

• They can get a Pap test and an HPV test (referred to as co-testing) every 5 years; OR 

• They can have a Pap test alone every 3 years, with an HPV test alone every 5 years

• Women over 65 who don’t have a history of abnormal cervical cells and who have had 3 negative Pap tests or 2 negative co-tests in the past 10 years can stop getting screened for cervical cancer 

Though these are the blanket recommendations, there are some exceptions, so be sure to discuss what’s best for you with your doctor. In addition to this, even though these are the current recommendations for Pap and HPV tests, the ACOG still encourages women to have a yearly ob-gyn appointment to discuss health goals and to address any questions you may have.

--

As a reminder, with With almost 80 million people currently diagnosed with HPV, it is the most common STI in the United States; there is absolutely no shame in having it! Thanks to a lot of research and a growing understanding of HPV, we’re all able to work with our doctors to understand this STI as well as our cervical health. Be sure to get that next Pap test on the calendar and, in the meantime, don’t hesitate to reach out to your doctor with any HPV or cervical health-related questions.