There are about 100 types of human papillomavirus (HPV)—13 of which are high risk for leading to cervical cancer. HPV is very common: about 80% of sexually active people are infected at some point, but most of them never know. It is spread by skin-to-skin contact with someone who has an HPV infection—some HPV types cause genital warts but many types produce no symptoms (and symptoms may appear weeks, months, or even years after infection).
It can be detected through Pap tests, colposcopy, or an HPV DNA test—usually done along with a Pap test. Certain HPV types cause changes in the cells of the cervix that can lead to cancer if untreated. HPV is almost always the cause of cervical cancer, but having HPV doesn’t mean you will get cancer. There is no cure for HPV, but 70% to 90% of infections are cleared by the immune system and become undetectable. HPV peaks in young women around age of sexual debut and declines in the late 20s and 30s. But women’s risk for HPV is not over yet: There is sometimes a second peak around the age of menopause. Why?
A study released early in 2013 of women 35 to 60 years old found that HPV in women at or after menopause may represent an infection acquired years ago. Think of it like chickenpox—that virus can lie dormant in the bodies of people who were infected as children, then come raging back as shingles later in life when the immune system weakens. It’s the same with HPV. The reactivation risk may increase around age 50. This is dangerous because of HPV’s link to head and neck, cervical, vulvar, vaginal, penile and anal cancer. It is the most common sexually transmitted disease in the US.
The findings may mean that women need to continue routine screening after age 40. Women who started having sex during and after the sexual revolution of the 1960s and 1970s have a significantly higher risk of HPV infection compared to women who did so before 1965. This is because the risk of HPV is related to the number of sexual partners women have. Baby boomer women, and all women who have had multiple partners, should not stray too far from their Pap smear or HPV test at menopause until we know more about the increased risk of HPV flare up at menopause.