Anja van den Berg
Because gynaecologists deal with personal and sensitive health issues, the thought of making an appointment – especially for the first time – may be troubling to some women. You may be nervous or embarrassed, reluctant to discuss your most intimate issues with anybody.
You see your primary-care doctor once a year for that annual check-up. You’ve got your preventive health-care needs covered, right? Maybe not. Should you be seeing a gynaecologist annually, too?
Yes, says gynaecological specialist Dr David Rojas. “It may be useful for women to see a gynaecologist in addition to a primary-care doctor.” Over and above more general health checks, gynaecologists also screen for cancer, treat infections and perform surgery for pelvic-organ or urinary tract problems, he adds.
‘You may not even know that you are infected’
The most prominent reason for making that appointment is to prevent cervical cancer, a malignancy that almost exclusively develops due to an infection that is sexually transmitted by the human papiloma virus (HPV). The HPV can cause cervical and other cancers, including cancer of the vulva, vagina, penis or anus. It can also cause cancer in the back of the throat, which mostly involves the base of the tongue and tonsils, say the Centres for Disease Control and Prevention (CDC).
Johannesburg gynaecologist and obstetrician, Dr Peter Koll, states that cervical cancer caused by the HPV is the second most prevalent cancer among women in South Africa.
Doctors who tell patients that if they are not promiscuous, they won’t be exposed to the virus, are talking absolute nonsense, Dr Koll explains. “Women don’t have to be promiscuous, they don’t even need penetrating intercourse, they just need close sexual contact with one person who’s carrying the HPV and they are going to get it.”
The most common sexually transmitted infection
According to the CDC, infection by the HPV is the most common sexually transmitted infection – so common, in fact, that nearly all sexually active men and women get it at some point in their lives. In most cases, the HPV is cleared by the body’s immune system and doesn’t cause any significant health problems. However, when the body does not rid itself of the virus, it can cause malevolent health problems such as genital warts and cancer.
Anyone who is sexually active can get HPV infection, even if you have had sex with only one person. You also can develop symptoms years after you have had sex with someone who is infected, which makes it hard to know when you contracted the virus.
Hundreds of viral strands
There are approximately 14 million newly diagnosed cases of HPV infection annually. The HPV is comprised of approximately 100-150 viral strands, with more than 40 affecting the genitals.
According to Amanda Dorkes, clinical director and specialist in pharmacology, certain types of HPV strains can increase the chance of developing cervical cancer, especially types 16, 18, 31, 33 and 45. “These are called ‘high-risk types’. At least one of these HPV types is present in the cervix cells of the vast majority of women with cervical cancer. Types 16 and 18 cause about 70% of cervical cancers, while the other three cause the most of the remaining 30%.”
Early detection can save your life
There is no treatment available for the virus itself, but cervical precancer can be treated. Women who undergo routine Pap smear tests and follow up as needed, can identify problems before cancer develops. Prevention is always better than treatment, the CDC confirms. Routine screening for women aged 21 to 65 years old can prevent cervical cancer from developing.
Gynaecological experts recommend that women specifically request their gynaecologist to perform an HPV DNA test, as well as a pelvic exam, as a precise and all-encompassing means to check for cervical cancer. Although there is no cure for HPV, vaccines against certain strains of the virus are available.
Andrea Benda, 2015, Do you really need a gynaecologist?, Advocate Health Care, http://www.ahchealthenews.com/2013/04/16/do-you-really-need-a-gynecologist/
Amanda Dorkes, 2016, HPV, Lloyds Pharmacy, https://onlinedoctor.lloydspharmacy.com/uk/hpv-human-papillomavirus
Centres for Disease Control and Prevention (CDC), 2016, Genital HPV Infection – Fact Sheet, http://www.cdc.gov/std/hpv/stdfact-hpv.htm
Lori Smith, 2016, Human Papillomavirus (HPV): Causes, Symptoms and Treatment, Medical News Today, http://www.medicalnewstoday.com/articles/246670.php?page=2
Medical Chronicle, 2012, “HPV Vaccines: SA’s Doctors Asleep at the Wheel?”, http://www.medicalchronicle.co.za/hpv-vaccines-sa%E2%80%99s-docs-asleep-at-the-wheel/
Regina Wheeler, 2012, “When to Call Your Gynaecologist”, EverydayHealth, http://www.everydayhealth.com/womens-health/signs-you-need-to-visit-your-gynecologist.aspx