Part 3: HPV, cancer and contraceptive methods.

Welcome to part 3 of sexuality for teenagers and parents. (The second part is here) This time we will talk about HPV, cancer and contraceptive methods. And as #KnowledgeIsSuccess we will give permission to schools and students to use this video in full or in parts.

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Topic 5: HPV or Human Papillomavirus

El virus del papiloma humano o VPH es la infección sexual más común, de hecho se cree que todas las personas sexualmente activas llegan a tener VPH a lo largo de su vida. Afortunadamente 9 de cada 10 personas se curan de la infección en 1 o 2 años sin siquiera presentar síntomas, pero esto significa que en 10% de las personas este virus permanece y puede generar problemas graves.

El síntoma más evidente del VPH son las verrugas genitales, aunque dichas verrugas pueden presentarse en distintas partes del cuerpo no solo en el pene y la vagina y además se calcula que solo una de cada 100 personas infectadas desarrolla verrugas, así que tener o no tener verrugas no sirve para determinar si una persona tiene o no tiene VPH. Además existen unos 100 tipos de VPH distintos y algunos solo se transmiten al tener relaciones sexuales pero otros pueden transmitirse al estar en contacto con las verrugas y de hecho sabemos bien que el VPH 6 y 11 tienen riesgo muy bajo de convertirse en cáncer pero los VPH 16 ,18, 31, 33, 45 y 52 tienden a desarrollar cáncer. Así que realmente la mejor forma de disminuir riesgos es vacunarte contra el VPH, en general a mayores de 25 años ya no se les vacuna porque lo más probable es que ya hayan tenido contacto con el papiloma y la vacuna es más efectiva antes de haber tenido contacto con el virus por eso la recomendación es vacunar a todos los niños y niñas alrededor de los 11 años ¡Así es! Tanto niños como niñas deben vacunarse.

Topic 4: Cervical cancer

There are many types of cancer. But today we are going to talk specifically about cervical cancer, that is, the one that develops in the cervix because it is directly related to papilloma.

As we said previously, not all HPVs cause cancer, however, 100% of cervical cancer cases originate from HPV. Yes! Just as you hear, 100% of the cases of cervical cancer that have been studied had HPV, so if they had not been infected with papilloma, they would not have developed cancer. Now, even if you have a high-risk HPV, that does not mean that you automatically have cancer, we are talking about a condition that develops little by little and usually takes around 10 years to manifest and of course the best way to combat it is early detection. It doesn’t matter if you are a man or a woman, if you have warts and suspect that they are HPV, you can go to the doctor to have a biopsy, that is, cut a small piece of skin and do genetic studies, although this takes a few days and fortunately For women today, a faster and cheaper study can be performed that we call liquid cytology or thin pap smear, there is also colposcopy and genetic HPV typing.

In a traditional pap smear, a special swab is used to collect tissue samples from the cervix and that tissue is checked using a microscope. Healthy cells usually look large, round with well-defined edges and contain a single small nucleus. When we observe cells of irregular shape or with several nuclei or that seem to fuse with each other, we can suspect that they have been infected by HPV and begin to develop cancer. Now, the problem with the pap smear or traditional cytology is that the swab collects a thick sample of tissue and when we put it under the microscope we see many layers of overlapping cells, so it takes a lot of experience and time to exactly determine the health of the tissue. So to make things easier, what we currently do is that we no longer put the tissue directly into the microscope, but first it is introduced into special liquids to preserve it, we filter it and now when we spread it on the plate, a very thin layer remains, in fact It is the thickness of a single cell so we can observe the health of each one very well. Observing a few diseased cells is normal, but when there are too many, the threat should begin to be combated either through surgery, radiotherapy, chemotherapy, or a combination of these treatments.

FAQS or Frequently Asked Questions

Please search on YouTube for “Creafam contraceptive methods” and you will find a video in which we already explain a little about condoms, patches, injections, surgeries and even the rhythm method. This video focuses on explaining the advantages and disadvantages of each method, but this time we would like to focus on the myths and the most common questions we are asked about the use of contraceptives.

  • Is it common for a condom to break? The condom is one of the most effective barrier methods and it is not common for it to break when used correctly and by “using them correctly” I not only mean how it is placed but how it is stored, opened and used. . If you put the condom in your purse to always have it on hand, the only thing you are doing is mistreating it. If you leave it in the glove compartment of the car, the heat can affect it and if you have long nails you should be careful when placing it so as not to scratch it. Condoms are used only once, you cannot reuse them nor because it is on the same night, they must be placed throughout sexual penetration. When used correctly, it is unlikely to break but it can still happen, so the ideal is to combine different contraceptive methods.
  • What contraceptive methods can be combined? There are barrier methods like condoms, hormonal methods like the pill, behavioral methods like the rhythm method, and permanent methods like vasectomies. The ideal is not to use methods of the same type, for example, taking pills and getting the implant at the same time. It is better to combine different types, so if he uses a condom and she takes the contraceptive pill and they have intercourse in the days just before or after menstruation, the lowest chance of pregnancy will be achieved.
  • Can it cause defects in the baby if I get pregnant using the pill? No, fortunately hormonal methods only contain hormones, they do not have harmful substances to the human body and for this reason they do not cause problems with the baby, in case there is a pregnancy.
  • What happens if I leave the IUD or implant in for too many years? Hormonal intrauterine devices and the hormonal implant usually have an expiration of three years, however, it is very common to receive patients who have had the intrauterine device for 5, 10 or 15 years and never had it removed, the most common reason is that when they wanted To remove it they could not find it because it implanted too much in the uterus or in the skin. In theory, once they reach their expiration date, the hormones should run out and fertility should return to normal, but the recommendation would definitely be to do everything possible to find and remove the implant or IUD.
  • Can the penis get stuck with the IUD? Don’t worry, that doesn’t happen. The IUD is placed inside the uterus and during sexual intercourse the penis only penetrates the vagina and may come into contact with the cervix but never passes through to the uterus.
  • Does the pill protect against sexually transmitted diseases? No! The pill and other hormonal methods only prevent pregnancy, they do not serve to protect against viruses such as AIDS, papilloma, herpes or other diseases. To avoid these diseases it is better to use barrier methods such as condoms.
  • Are there positions that can reduce the risk of pregnancy? No.
  • Is it safer to use two condoms at the same time? No, the ideal is to use only one condom. Putting on two can be uncomfortable, and the friction between the latex layers can cause the condoms to break.
  • What should I do if I vomited or forgot to take my pill one day? If for some reason you vomited one or two hours after taking the pill, the ideal would be to take it again. If you forgot and less than 24 hours have passed, you can take it as soon as possible and continue with your normal schedule to take the next pill. But if more than 24 hours have passed, you should stop taking the leftover pills, wait for your period to return and start a new pack of pills. Obviously you should not have sex on the days the method was discontinued.
  • Can the emergency pill be taken at any time? In theory they can be effective up to 5 days after having unprotected sexual intercourse, but the greatest effectiveness is obtained by taking it as soon as possible, so the recommendation is not to wait and take it before the first 24 hours have passed.
  • How long does it take for my fertility to return after stopping the IUD pill or implant? It doesn’t matter if you used pills for many years, as soon as you stop using the IUD, pills or implant, fertility returns almost immediately. We have cases of patients who became pregnant the same week that they removed the IUD, so if you stop using your contraceptive method and more than six months go by without achieving a pregnancy, the ideal would be for both you and your partner to go to Creafam to query to check what is happening.

And well, with that we conclude the third video of this series. If you have any questions about these topics, we invite you to leave your questions in the comments. See you in the next video that will discuss menopause and andropause. Remember, knowledge is success.

Dra. Liliana de la Rosa Pérez
Dra. Liliana de la Rosa Pérez
Gynecology and Obstetrics

Reproductive Medicine Specialist
Universidad Autónoma de Barcelona

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