Which HPV Vaccine to use?

This post was originally written in 2010, the best vaccine now is clearly the Gardasil 9 and all the current questions on HPV vaccination are nicely summarized by the CDC at this link.

When deciding which HPV vaccine to get, be sure to use the one that will offer you the most protection. That is the Gardasil. Vaccine for Cervical Cancer the Cervarix by GSK was approved for use in the US in October of 2009. Thus joining the more than 100 countries worldwide that already had this vaccine in use. It is a vaccine only for Cervical Cancer protection and it is known as a bivalent vaccine active against HPV viruses 16 and 18. About 30 to 40 types of HPV affect the genital tissues, so complete protection from either of these shots is not possible. Some cross protection for other viral types has been shown, mostly 31, 33 and 45.
HPV types 16 and 18, which together are thought to be responsible for about 70% to 80% of all cervical cancer cases, and also responsible for a similar percentage of cervical dysplasias. Women can expect the duration of immunity to last at least 6.4 years, according to a recent HPV study in Lancet
Women can also note that antibody levels from vaccination are much better than the antibody levels from natural infection.
Gardasil is a quadrivalent vaccine with activity against 4 HPV types: HPV types 16 and 18, which cause cervical cancer, and HPV types 6 and 11, which cause genital warts. This extra activity means that this vaccine is also indicated for the prevention of genital warts in girls and women, and it has now been recommended for that same indication for boys and men (up to age 26 is the data submitted so far to the FDA). However, the current data on Gardasil in males extends only out 2 to 3 years, and in women extends only out 5 years.
Would Cervarix or Gardasil be Better at Protecting Against Cervical Cancer?
In the USA we prevent cancer by regular pap smears and then the treatment of precancerous disease. The main purpose behind the development of these HPV vaccines was to prevent ever getting the infection, therefore even impact on pre-invasive disease before it should ever reach cervical cancer. Gardasil has published more information on protection regarding the various infections: cervical, vaginal, vulvar and their preinvasive disease. And protection has been shown to start as soon as you get your first shot. However some physicans have proposed, just for cervical cancer protection, Cervarix is the better of the 2 vaccines. Cervarix might have better cross protection and one of the viruses that Cervarix protects against is one of the causes of adenocarcinoma of the cervix a very difficult cancer to detect. As for antibodies, although some studies say you might form better antibody response against Cervarix, not all those antibodies are important for disease fighting. No one knows if either vaccine will offer permanent protection or need boosters over time, but current evidence is that Gardasil is working with fewer cases of abnormal paps and fewer cases of genital warts in young women and young men

. Other vaccines are in development right now. So it is important for patients and their Gynos to keep up on this important topic.

Passing Your Uterine Lining, Menstrual Period Norms

Decidual Cast Periods can be fairly easy, passing some tissue at a time, or off can come the whole lining in one piece called a decidual cast. Generally the lining of the uterus is only 6-8 mm thick at the time of the menstrual period, and it is shed gradually, a few cells at a time. The decidual cast is when the entire lining passes spontaneously. It's not uncommon, but it usually both uncomfortable, and alarming to some. But us women are designed to have some sort of periods Or Not? We have to pass tissue each month. Or Not? Are they good for us? Or Not? Do we want them? Or Not? Is this something that is individual? Or Not? It's a complex topic that I will be discussing a lot over my time in this blog. So lets start with basics: How much do we bleed and what are we loosing, and just what was this that the patient passed? And another basic: track your periods, and the Women's Health Practice site http://www.womenshealthpractice.com/media/pdf/menstrual_chart.pdf you...

Post-Endometrial Ablation Syndrome

If you have had an endometrial ablation and have developed symptoms of pelvic pain you might have post endometrial ablation syndrome. What is post-endometrial ablation syndrome? It is a constellation of symptoms due to entrapped blood or tissue within a uterus that has previously undergone an endometrial ablation. We are able to diagnose this at Women's Health Practic e but occasionally other conditions are causing similar symptoms. Other complications of endometrial ablation include pregnancy, risks from pre-existing conditions such as a polyp or fibroid, an infection of the uterus, or a pregnancy. If you have had a tubal ligation then it is possible that the condition could be post-ablation tubal sterilization syndrome. The ablation procedure is designed to destroy all lining tissue, but in fact there is no way to confirm the completeness of the ablation. It is thought that either residual or regrowth of the tissue is producing the symptoms of post-endometrial ablation syndrom...

You Have an IUD: But a Positive Pregnancy Test

Fortunately IUD pregnancy failures are rare. But if you have an IUD for contraception, and you get a positive pregnancy test, you probably ask yourself, what next? Well, make your gyno appointment promptly, this is a condition that is not typically an emergency, but it can be and it’s not handled over the phone or on a blog, or through self diagnosis! That being said, some researchers from University of Texas Southwestern Medical Center in Dallas decided to look back at over 4100 women who had IUDs and of those 42 cases who became pregnant in their institution, over about a year period of time, to help understand what these women could expect when they got to their gyno and what actually happened to their pregnancies. Accurate pregnancy diagnosis, pelvic examination, and pelvic ultrasound were the cornerstones of the evaluations. They had very specific ways they looked at their ultrasound to prove there was no pregnancy in the fallopian tube, or partially in the fallopian tube...

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