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10 Things about HPV (Video)

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HPV stands for human papillomavirus. HPV is usually harmless and goes away by itself, but some types can lead to cancer or genital warts.

 Here are 10 things about HPV.

1. HPV is incredibly common.

and It is estimated that 8 out of 10 people will get HPV at some point in their lifetime

2. Next… How is HPV spread?

HPV is one of the most common STI and is spread through genital or skin-to-skin contact. The virus can be spread even when no symptoms are evident.

3. The third point is that HPV doesn’t necessarily stay with you forever.

Patients commonly assume that HPV is a lifelong infection that will stay with them always. Most HPV infections clear up on their own and do not cause any problems. However, overtime persistent infection by certain HPV types can cause cancer and other diseases such as warts.

4. There are many strains of the virus.

HPV is not just one virus, but consists of over hundreds straina . Each virus is labeled with a number to distinguish it from the others, and different viruses can target different areas of the body, causing differentdiseases in humans.

HPV is most commonly associated with a risk for certain cancers, including cervical cancer, or oral cancers which involves, the base of the tongue or tonsils. 

5. Next in Cervical cancer

HPV causes more than 99% of cervical cancer cases and Approximately 400 new cervical cancer cases are diagnosed annually in Singapore.  

Cervical cancer ranks* as the 8th leading cause of female cancer in Singapore.

6. In Detection of HPV

A pap smear test is a cervical cancer screening tool that is commonly use to detect cervical cancer or pre-cancerous changes in the cervix.

A more sensitive test like the HPV DNA test can be used to detect certain high risk strains of HPV that can lead to cervical cancer

Rapid HPV Test is Available in out clinics (Next Day Result)

7. HPV in Men

Men can get HPV and pass it to their partners. HPV has been shown to increase the risk of anal cancer, penile cancer , oral and throat cancers in men.

8. There Is Also a Vaccine that Can Protect You

The HPV vaccine has been shown to be highly effective in protecting people against cervical cancer and warts..

Individuals already infected with HPV should still get vaccinated because the vaccine may protect against additional strains of hpv. However, for maximum benefit, vaccination should occur before an individual becomes exposed to the virus.

Thus it is recommended for preteens to get the vaccine at an early age.

Recently the US Food and Drug Administration expanded its approval of the HPV vaccine to include men and women up to 45 years old As an effort to protect more people from several types of cancer caused by HPV.

9. After HPV Vaccination…

Women should continue to get regular Pap screenings because the vaccine though reduces risk of cervical cancer, does not protect against all HPV types.

10. To Sum Up HPV

The best thing you can do is stay proactive and look after your well-being.

“HPV is something both women and men should be aware and well-informed about, protecting yourself and your loved ones,”

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Bagaimana jangkitan HPV dan masalah kesihatan yang disebabkan olehnya boleh dicegah?

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Apakah itu human papillomavirus (HPV)?

HPV adalah virus yang boleh menyebabkan penyakit kelamin (sexually transmitted disease, STD) dan adalah penyakit STD yang paling kerap berlaku di dunia. Jangkitan HPV dianggarkan berlaku di kalangan sekurang-kurangnya 80 peratus wanita dan lelaki yang telah bermula hubungan seks.  

Apakah gejala atau simptom jangkitan HPV?

Kebanyakan orang yang dijangkiti HPV tidak mempunyai apa-apa gejala kerana sistem ketahanan (imun) badan dapat menyingkirkan virus HPV sebelum apa-apa gejala berlaku.

Walaubagaimanapun, bagi individu yang mempunyai simptom, ketuat (genital warts) boleh dilihat di kawasan alat kelamin. Ketuat juga boleh dilihat di kulit (non genital warts) kerana HPV disebarkan antara kulit. Ketuat kebanyakkanya disebabkan oleh HPV jenis 6 dan 11. HPV jenis berisiko tinggi (high risk strains) boleh menyebabkan penyakit barah di cervix, dubur (anus), vulva dan faraj, zakar dan juga dalam mulut dan tekak (oropharyngeal).  

Bagi penyakit barah cervix peringkat awal, simptom-simptom adalah lelehan faraj berdarah di luar masa haid, selepas menopaus atau selepas hubungan seks. Lelehan faraj yang mungkin berbau juga adalah antara simptom barah cervix.

Bagaimana seseorang boleh dijangkiti HPV?

HPV adalah virus yang boleh dijangkiti melalui sentuhan kulit, melalui hubungan seks (sama ada melalui vagina, oral, zakar atau lubang dubur) atau melalui sentuhan kawasan genital (alat kelamin). Individu tidak boleh dijangkiti HPV melalui sentuhan objek contohnya tempat duduk tandas. 

Disebabkan virus ini boleh dijangkiti melalui hubungan seks, jika individu mempunyai beberapa pasangan seksual, risikonya ditingkatkan. Tambahan pula, kondom hanya memberi perlindungan yang tidak sepenuhnya. Pengisapan rokok juga boleh meningkatkan risiko jangkitan HPV sebanyak 4 kali ganda, bersama juga jika individu mengambil ubat yang melemahkan sistem imun atau mempunyai penyakit yang melemahkan sistem imun. 

Apakah komplikasi penyakit jangkitan HPV?

Seperti dijelaskan di atas, HPV boleh menyebabkan penyakit barah di cervix, vulva, faraj, zakar atau lubang dubur. Ia juga boleh menyebabkan barah tekak, lidah dan tonsil. 

Jenis HPV yang menyebabkan penyakit ketuat tidak sama dengan jenis HPV yang menyebabkan barah. Penyakit barah yang disebabkan oleh HPV selalunya mengambil jangka beberapa tahun untuk berlaku.

Bagaimana jangkitan HPV dan masalah kesihatan yang disebabkan olehnya boleh dicegah? Apakah rawatan penyakit jangkitan HPV?

Vaksin terhadap HPV adalah sangat digalakkan. Vaksin HPV adalah selamat dan berkesan. Keberkesanan vaksin ini adalah setinggi 97% di kalangan individu yang tidak pernah dijangkiti HPV. Vaksin juga bermanfaat jika penerima sudah dijangkiti HPV. 

Jika individu menghidap barah yang disebabkan oleh HPV, rawatan yang diberikan termasuk pembedahan, kemoterapi dan radioterapi.

STDs: Apakah Simtom HIV Dan STD?

Anal Warts: What you have always wanted to know, but were too embarrassed to ask.

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Anal warts are definitely not a topic for polite conversation. As an affliction upon one of the more intimate parts of the human body, patients frequently have multiple concerns regarding cosmetic appearance, stigmatization, personal health and sexual relationships. It is also not commonly brought up to their spouses or doctors. We are here to find out more about this extremely common condition and dispel common misconceptions about it.

What are Anal Warts?

Anal warts are common skin growth around or inside the anal canal caused by a virus known as the Human Papillomavirus (HPV). They come in all shapes and sizes, ranging from a small pinhead-like growth to big cauliflower-like lesions. They usually do not cause patients much pain or discomfort and patients might not be aware that anal warts are present because of the nature of the location

What is HPV and how is it spread?

HPV is the most common sexually transmitted disease (STD) in the world. It is a family of viruses with more than 200 types. They are typically divided into low-risk and high-risk types based on associated risk for cancer in any body areas. The low-risk types HPV 6 and/or 11 are detected in around 90 percent of anal warts.

HPV is transmitted through contact with infected skin. Anal HPV infection is almost always acquired through sexual contact. Anal warts by themselves are not required for transmission but are highly infectious.

Common myths about anal warts

Myth #1 – My partner has anal warts, he/she is cheating on me!

This myth is responsible for a great deal of anxiety and anger. HPV infection can lie dormant in the body for months and years before causing anal warts. There is no way to find out when the infection was acquired. 

Myth #2 – Anal warts can lead to anal cancer.

Anal warts are almost always benign. They are caused by low-risk HPV types 6, 11, 42, 43 and 44 and do not develop into cancer. 

 

Myth #3 – HPV is incurable, and recurrence of anal warts are common.

It is indeed true that there is no known cure for HPV. However, warts and precancerous lesions can be easily treated when detected. Recurrence of anal warts is not a given, and some patients might find recurrence getting less frequent and eventually stopping with time. 

Myth #4 – Condoms use during sex will prevent HPV transmission

Unfortunately, that is not the case. Condom use will prevent transmission of pathogens such as HIV and syphilis that are spread through bodily fluids. They are not so effective against other pathogens such as herpes or HPV as they are spread through skin-to-skin contact. This is because condoms do not cover the entire external genitalia.

Nonetheless, condom use can still lower the risk of HPV transmission and other STDs. They still play an important role in sexual health and STDs prevention strategies. 

Diagnosis of anal warts

Diagnosis of anal warts is normally done at the doctor’s office clinically through a thorough history and physical examination. The majority of anal warts do not require a biopsy for diagnosis.

HPV screening for anal warts is not routinely recommended. This is because all commercial laboratories will only test for high-risk HPV types and not low-risk HPV types that causes anal warts.

Treatment

Anal warts treatment depends on the size, number, site as well as patient’s preference.

Home treatment with preparations such as Imiquimod cream or Podofilox solution are available. However, they are limited in utility due to the locations of the warts which might not be easily reached by the patient. 

Cryosurgery is the use of extremely low temperature through liquid nitrogen to destroy the abnormal anal wart cells. It can be done as an office procedure but will require multiple cycles for treatment depending on the size of the warts.

Radiofrequency ablation is a procedure in which heat, which is generated through an electric current, is used to destroy the abnormal anal wart cells. It can also be done as an office procedure. An injectable pain-killer is commonly given before the procedure to numb the area and commonly a single session will be sufficient for anal warts removal.

Finally, if the anal warts are too large or too extensive, surgical excision under general anasthesia might be considered by a surgeon. 

Prevention 

By observing safe sexual practices such as use of condoms during sex and limiting the number of sex partners, patients can reduce their chance of contracting HPV.

A vaccine (Gardasil 9) is available for males and females to prevent ano-genital warts but it will not treat existing HPV or ano-genital warts. This vaccine can prevent most cases of genital warts in persons who have not yet been exposed to wart-causing types of HPV.

Next read: WHY IS MY SEMEN GREEN OR YELLOW?

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Pap smear – Mengapakah anda perlu ketahui ujian ini?

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Apakah itu barah cervix, HPV dan apakah pemeriksaan yang disyorkan?

Apakah itu ujian Pap smear?

  • Pap smear (atau ujian Papanicolaou) adalah ujian yang dijalankan oleh doktor untuk mengesan tanda-tanda kanser (barah) cervix. Cervix adalah bahagian antara vagina dan rahim di dalam badan wanita (bahagian bawah rahim). 
  • Semasa ujian Pap smear, doktor tersebut akan memasuki sesuatu alat pemeriksaan bernama speculum yang digunakan untuk menolak tepi belah vagina. Setelah ditolak tepi, cervix dilihat dan sesuatu berus kecil digunakan untuk mengiris sel-sel di cervix secara perlahan-lahan. 
  • Individu yang menjalani ujian Pap smear mungkin akan merasa kurang selesa tetapi biasanya tidak merasa sakit. 
  • Setelah ujian lengkap, sampel akan dihantar ke makmal untuk diperiksa di bawah mikroskope. 

Siapakah sesuai untuk menjalani ujian Pap smear?

  • Semua wanita yang berumur 25 tahun dan ke atas yang sudah aktif secara seksual sepatutnya menjalani ujian Pap smear. 
  • Bagi mereka yang tidak pernah mempunyai keputusan Pap smear yang tidak normal, Pap smear perlu dijalankan sekurang-kurangnya setiap 3 tahun. 

Apakah yang perlu disediakan sebelum wanita menjalani ujian Pap smear?

  • Tidak ada apa-apa yang spesifik yang perlu disediakan sebelum ujian Pap smear.
  • Wanita yang dalam haid juga boleh menjalani ujian ini. Jika haid terlalu berlebihan, individu tersebut boleh menghubungi klinik tersebeut untuk menukar tarikh temujanji.

Apakah itu barah atau kanser cervix?

  • Barah atau kanser cervix adalah barah ke-enam paling kerap antara wanita di Singapore. Barah cervix terjadi apabila sel-sel yang normal bertukar kepada sel yang tidak normal yang tumbuh diluar kawalan. Kebanyakan wanita yang mempunyai kanser cervix yang dikesan semasa peringkat awal boleh dirawat dengan sepenuhnya.
  • Faktor risiko barah cervix yang paling penting adalah jangkitan human papilloma virus (HPV).
  • Simptom-simptom barah cervix termasuk lelehan berdarah dari vagina yang berlaku di antara waktu haid (bukan semasa haid), selepas hubungan seks atau selepas menopaus.
  • Penyakit barah ini terbelah kepada beberapa peringkat (awal ke peringkat akhir). Barah ini boleh dirawat dalam beberapa cara termasuk pembedahan. Pembedahan termasuk “radical hysterectomy” atau pengeluaran cervix, rahim dan bahagian atas vagina atau pembedahan pengeluaran semua atau sebahagian daripada cervix – pembedahan ini boleh dilakukan dalam keadaan tertentu sahaja. 
  • Rawatan lain termasuk radiasi dan kemoterapi. 

 
Apakah itu human papillomavirus (HPV)?

  • HPV adalah virus yang boleh dijangkiti melalui sentuhan kulit, melalui hubungan seks (sama ada melalui vagina, oral atau lubang dubur) atau melalui sentuhan kawasan genital (alat kelamin). Individu tidak boleh dijangkiti HPV melalui sentuhan objek contohnya tempat duduk tandas. 
  • Disebabkan virus ini boleh dijangkiti melalui hubungan seks, jika individu mempunyai beberapa pasangan seksual, risikonya ditingkatkan. Tambahan pula, kondom hanya memberi perlindungan yang tidak sepenuhnya. Pengisapan rokok juga boleh meningkatkan risiko jangkitan HPV sebanyak 4 kali ganda, bersama juga jika individu mengambil ubat yang melemahkan sistem imun atau mempunyai penyakit yang melemahkan sistem imun. 

Adakah semua jenis atau strain HPV berbahaya?

  • Terdapat lebih daripada 100 strain atau jenis HPV tetapi kebanyakan jenis HPV tidak menyebabkan kanser. Lebih daripada 80% wanita akan terdedah kepada virus HPV dalam hidup mereka. Kebanyakannya, system imun badan akan menyingkirkan virus ini secara semula jadi sebelum virus ini menyebabkan penyakit teruk. Tetapi, peratusan kecil wanita akan menghidapi penyakit yang lebih serius seperti kanser. 
  • Terdapat jenis HPV yang berisiko rendah iaitu HPV jenis 6 dan 11 yang boleh menyebabkan penyakit ketuat kelamin (genital warts). Jenis berisiko rendah ini jarang sekali boleh menyebabkan kanser.
  • Antara jenis HPV yang berisiko tinggi adalah jenis 16 dan 18 yang boleh menyebabkan kanser cervix. Jenis 31, 33, 45, 52 dan 58 juga boleh menyebabkan kanser. 


Apakah ujian yang boleh dijalankan untuk mengesan HPV?

  • Ujian HPV boleh dilakukan pada masa yang sama dengan ujian Pap smear iaitu melalui pengunaan berus kecil yang digunakan untuk mengiris sel-sel di cervix secara perlahan-lahan. 
  • Di clinic Dr Tan & Partners, kita dilengkapi dengan mesin yang boleh mendapatkan keputusan HPV secara cepat iaitu melalui Rapid HPV test. Keputusannya boleh dihasilkan dalam masa 24 jam. 

Apakah cara yang boleh mengurangkan risiko seseorang dijangkiti HPV dan barah cervix yang disebabkan oleh HPV?

  • Vaksin adalah efektif untuk mengurangkan risiko ini dan boleh mengelakkan seseorang daripada dijangkiti 70-90% jenis HPV berisiko tinggi dan juga jenis HPV yang boleh menyebabkan penyakit genital warts. Vaksin tersebut dinamakan Gardasil 9.
  • Selepas individu menerima vaksin, individu tersebut masih lagi perlu menjalani ujian Pap smear sekurang-kurangnya setiap 3 tahun kerana vaksin tidak boleh mencegahkan seseorang daripada dijangkiti jenis HPV berisiko tinggi yang lain yang tidak dilindungi Gardasil 9. 

Siapakah sesuai untuk menerima Gardasil 9?

  • Vaksin Gardasil 9 diluluskan untuk diberi kepada perempuan yang berumur 9 tahun ke 26 tahun. Bagi mereka yang berumur lebih daripada 26 tahun, penerimaan Gardasil 9 boleh dibincangkan bersama doktor. 


Apakah beza Gardasil 9 dengan vaksin HPV yang lain? 

  • Terdapat vaksin yang lain yang dinamakan Gardasil dan Cervarix. Gardasil hanya boleh mencegah jangkitan HPV jenis 6, 11, 16 dan 18 sahaja (16 dan 18 adalah jenis HPV yang berisiko tinggi) dan Cervarix hanya mencegah jangkitan jenis 16 dan 18 sahaja. 
  • Gardasil 9 boleh mencegah jangkitan HPV jenis 6, 11, 16, 18 dan juga jenis 31, 33, 45, 52 dan 58 (31, 33, 45, 52 dan 58 juga boleh menyebabkan barah cervix).

____________________________________________________________________________
Jika anda mengalami simptom-simptom yang disebut di atas dan ingin berjumpa dengan doktor wanita, sila hubungi klinik kita di Dr. Tan & Partners cawangan:
Dr. Tan & Partners @ DUO Galleria
7 Fraser St,
#B3-18 DUO Galleria (Bugis MRT), 
Singapore 189356
Nombor telefon +65 6976 5023
Dr. Tan & Partners @ Robertson
11 Unity St
#02-06/07 Robertson Walk
Singapore 237995
Nombor telefon +65 6238 7810
Klinik juga bersedia menerima pesakit tanpa membuat temu janji. 

Is HPV Vaccine Necessary for Males?

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HPV is a virus that can infect both males and females of all ages. HPV infections may lead to diseases such as skin warts, genital warts, vaginal/vulvar cancers, cervical cancer, penile cancer and anal cancer. There are hundreds of subtypes of HPVs, with about 40 known to affect the genital area. Of these, there are high-risk types known to cause cancer and low-risk types which may cause genital warts. Vaccines against some of these high and low-risk types are available today.

 

Most HPV infections clear naturally, but there is no way to predict who can clear the virus on their own, or who will carry the virus and potentially spread it. The virus itself cannot be treated. However, some of the diseases it causes can be managed. For example, if a person infected with HPV presents with a wart, we can use medications to treat it or use various techniques to remove it, but the virus itself is not eradicated from the body. That is why vaccination is so important for everyone so that the virus will not take root in the body.

 

HPV vaccinations have been available since 2006, and the vaccination has seen high uptake in many countries as they have been introduced into their national immunization schedule. HPV vaccination, along with pap smears and HPV testing, has been the cornerstone in reducing the burden of cervical cancer in women. In fact, we are already starting to see the benefits of this vaccine in reduced precancerous lesions of the cervix among countries with high uptake of this vaccine.

Read: Counterfeit HPV Vaccines (Gardasil 9) In Hong Kong

The vaccination in its early introduction largely left out males. The U.S. Food and Drug Administration has recently approved the use of Gardasil 9 for both males and females ages 9 to 45. The HPV vaccination is also now recommended by the U.S Center for Disease Control for men through age 21, for men who have sex with men, transgendered people, or those who have a compromised immune system (including HIV) who are ages 26 and younger. In the UK, from September this year, boys aged 12 and 13 would be offered the shots as part of a government health programme.

Read: HPV Vaccination for Men-Who-Have-Sex-With-Men

HPV has been linked to more than 99 per cent of cervical cancers, as well as 90 per cent of anal cancers, about 70 per cent of vaginal and vulvar cancers and more than 60 per cent of penile cancers. The protection against female cancers has already been proven. It also appears that vaccinated boys will receive some protection against anal and penile cancers as well.

 READ: Perianal Warts (Peri-Anal Warts) & Anal Warts Removal

 

There are 3 different types of HPV vaccines available in Singapore. Cervarix, which protects against 2 high-risk HPV types – 16 and 18. Gardasil 4, which protects against the high risk 16 and 18 and 2 more low-risk types 6 and 11. And Gardasil 9, the only vaccine used in the United States now which protects against 9 subtypes (6, 11, 16, 18, 31, 33, 45, 52, and 58). The vaccination schedule is 3 doses; one on your first visit, one 2 months later and the last one 6 months after the first dose (0,2,6) Other dosing schedules may be suitable depending on your age.

So should you as a male get vaccinated? Speak to your doctor about it to discuss the pros and cons. As for myself as a male – I’m already vaccinated.

HPV Vaccination is available in all our clinics in Singapore & Malaysia

Other Reads:

  1. Do I Have HIV Rash? Or Are They Other STD-Related Rashes?
  2. Weak Erection? Erectile Dysfunction? How to Improve Erection with Pills
  3. 11 Causes of Penile Itching & Pubic Itch
  4. HPV Infection & HPV Vaccination for Men who have sex with Men
  5. STD Risk for Receptive Unprotected Anal Sex in Men
  6. Low HIV Risk Doesn’t Mean No HIV Risk
  7. HIV PrEP for Travel – How You Need to Know
  8. An Overview on STD from an STD Doctor
  9. Everything You Need to Know About Herpes Simplex Virus
  10. How Do I Treat Oral Herpes (Cold Sores)
  11. Syphilis Symptoms – Painless Sore & Ulcers
  12. HIV Symptoms – What You Need to Know
  13. Sex During Period (Sex & Menstruation) What To Know
  14. 10 Common HIV Related to Opportunistic Infections

 

HPV Infection & HPV Vaccination for Men who have sex with Men

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About 40 types of HPV are passed on through sexual contact. The virus can be spread through skin-to-skin contact that doesn’t involve penetrative sex. Condoms will not necessarily fully protect people from coming into contact with it. Also Read: Anal Pap smear for men

What you need to know about Gardasil 9 HPV Vaccine and HPV in Men who have sex with Men

 

What is Human papillomavirus (HPV)?

The Human Papilloma Virus (HPV) is not one virus, but a family of about 200 different strains that cause common warts, genital warts and some cancers.
Sexually active adults mostly acquire at least one variety of HPV and it’s a near-universal infection in people with HIV. Even people with a one-lifetime partner can get HPV if their partner has it.
About 40 types of HPV are passed on through sexual contact. The virus can be spread through skin-to-skin contact that doesn’t involve penetrative sex. Condoms will not necessarily fully protect people from coming into contact with it.
For most people, HPV will not cause any harm. Only some varieties of HPV can cause cancer and even if you do come in contact with these strains, the chances of developing cancer are very small.
However, some people do not clear the virus from their bodies, and this can cause:

  • Genital warts on the penis and anus. It is also possible to have these types of warts on the lips and in the mouth.
  • Cancer of the anus, penis and oropharynx (back of the throat, including the base of the tongue and tonsils).

Although some other strains of HPV are associated with cancers, two main strains of HPV – HPV 16 and HPV 18 – cause 70% of cervical cancers in women and over 80% of anal cancers worldwide.
It is estimated that HPV is responsible for about 5% of cancers worldwide. However, anal cancer is one of the most common cancers for people living with HIV.

Learn more about Rapid HPV Testing (Next Day Result)

HPV & Men Who Have Sex With Men (MSM)

Every year anal cancer is diagnosed in about two people per 100,000 in the general population.
Men who have sex with men are about 20 times more likely than heterosexual men to develop anal cancer, and men-who-have-sex-with-men who are living with HIV are even more likely (up to 100 times more than the general community).

What is the new Gardasil 9 (HPV Vaccine)?

GARDASIL 9 is a vaccine (injection/shot) given to individuals 9 through 26 years of age to help protect against diseases caused by some types of Human Papillomavirus (HPV).
In boys and men 9 through 26 years of age, GARDASIL 9 helps protect against:

  • Anal cancer
  • Precancerous anal lesions
  • Genital warts – Penile warts, Anal Warts and other areas

These diseases have many causes. Most of the time, these diseases are caused by nine types of HPV: HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58. GARDASIL 9 protects against diseases caused by these nine types of HPV.

What is the difference between Gardasil and new Gardasil 9?

Gardasil only covers 4 strains of HPV: 6, 11, 16, 18.
Gardasil 9 covers that and 5 more strains, 31,33,45,52.

HPV-4 types
(6, 11,16,18)		 HPV-9 types
(6,11,16,18,31,33,45,52,58)
Cervical cancer cases 70% 90%
High-grade cervical lesions 50% 75-85%
Low-grade cervical lesions 30-35% 50-60%
HPV-related vulvar cancer cases 70-75% 85-90%
HPV-related vaginal cancer cases 65% 80-85%
HPV-related anal cancers 85-90% 90-95%
Genital wart cases 90% 90%

As you can see, Gardasil 9 has a broader HPV coverage compared to Gardasil.

Frequent Asked Questions (FAQs)

1.) Can I get Gardasil 9 if I am above 26 years old?

Gardasil 9 in Singapore is indicated for boys and men from ages 9 to 26. That does NOT mean that men above the age of 26 years cannot get the vaccine.
If you are above 26 years old, the best thing to do is to have a discussion with our doctor about the pros and cons of the vaccine then make a decision on whether or not you will benefit from it.

 

2.) Can I get Gardasil 9 even if I have had genital warts?

There are 200 different strains of HPV. Even if you have been infected with 1 strain, the vaccine can help protect you against other strains.
Also, there is data to show that people who have received treatment for HPV related cancers and had the HPV vaccine were less likely to get recurrences of their cancers.
So even if you have had or currently have genital warts, you should still have a frank conversation with our doctor about how Gardasil 9 can benefit you.

3.) Can I get Gardasil 9 even though I have already had the older version of Gardasil?

Yes, you certainly can. Scientific data has proven that it is absolutely safe to receive the full dose of Gardasil 9 even though you have already completed the vaccination using the older version of Gardasil.
If you have any concern about HPV infection treatment or you are interested in getting HPV vaccination, please contact us for more information.

Gardasil 9 vaccination is avilable in all our clinics in Malaysia and Singapore.
You can call any of our clinics or email us at hello@dtapclinic.com.sg for an appointment.

Take Care!

Other Reads:

  1. Low HIV Risk Doesn’t Mean No HIV Risk
  2. Do I Have HIV Rash? Or Are They Other STD-Related Rashes?
  3. What are the Causes of Abnormal Penile Discharge?
  4. HIV PrEP for Travel – How You Need to Know
  5. An Overview on STD from an STD Doctor
  6. Everything You Need to Know about Herpes Simplex Virus
  7. How Do I Treat Oral Herpes (Cold Sores)
  8. Syphilis Symptoms – Painless Sore & Ulcers
  9. HIV Symptoms – What You Need to Know
  10. 10 Common HIV related Opportunistic Infections

Cervical Cancer, Pap Smear & HPV Vaccination – What You Need To Know

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What is Pap Smear?

Pap smear is a cervical cancer screening recommended every 3 years for all sexually active females starting from age 25 years old.

This is a quick, simple and painless procedure that can be done in the clinic and it only takes a few minutes.  A brush will be used to collect some cells from the neck of the womb (cervix) and it will be sent to the lab to identify any precancerous and cancerous cells.

Cervical Cancer

In Singapore, cervical cancer is the 3rd leading cause of cancer deaths in women age 15-44 years old.
Cervical cancer risk is increased with :

  1. Multiple sexual partners
  2. Human papillomavirus (HPV) infection
  3. Smoking
  4. Unprotected sex

What is Human papillomavirus (HPV)?

Human papillomavirus (HPV) is one of the commonest sexually transmitted infection. It can affect both men and women.
There are 2 types of HPV – the low risk and high-risk types.

  1. Low-risk HPV can cause genital warts in both female and males. These are flesh coloured growths on the genitals, and they are infectious.
  2. High-risk HPV plays a significant role in the increased risk of cancer, such as cancer of the cervix, vulva, and vagina in women as well as anal cancer in men who have sex with men (MSM)..

The American College Obstetrician and Gynaecologist (ACOG) strongly recommends co-testing using Pap smear and HPV DNA testing (high-risk HPV types) especially for women ages 30-65 years old.
Patients are advised to repeat these tests in 5 years if pap smear and HPV results are negative.
This allows patients to extend their screening interval.

However, for women who test positive for high-risk HPV types, this means their risk is increased and hence, may need to have Pap smear screening at a closer interval, i.e once a year and depending on the results of the pap smear, some may need a referral to a gynaecologist for early intervention.

Remember, women can have no symptoms with an abnormal pap smear and HPV infection. Hence, early detection and screening are crucial as early intervention can be life-saving. Symptoms such as bleeding and pain during sex (postcoital bleeding), bleeding in between periods, heavy vaginal bleeding, and bleeding after menopause are usually late signs of cervical cancer.

The good news is cervical cancer can be prevented through vaccination.

GARDASIL 9 is a vaccine that helps protect against Human Papillomavirus (HPV). Most people infected with HPV show no signs or symptoms, this means they can transmit the HPV virus to others without knowing it in any kind of sexual activity or skin to skin contact.

Gardasil 9 provides protection against 9 major strains of HPV, which includes HPV types 6,11,16,18,31,33,45, 52 and 58 which are responsible up to 90% of genital warts and cervical cancers or precancer changes.

The vaccine, however, does not treat the infection.

It can be given to both females and males from the age of 9 up to 45 years old.
From the age of 9-14 years, 2 doses 6 months apart is recommended while those age 15 onwards, 3 doses will be recommended according to the schedule of 0, 2 and 6 months.
The side effects post vaccination is usually mild and temporary including pain, swelling, bruising over injections site and very rarely may cause fever and nausea.
HPV vaccine reduces your risk significantly but it does not mean your risk becomes zero.

After the completion of HPV vaccination, all women who are sexually active and above the age of 25 should still undergo routine screening via pap smear.

If you are due for your routine PAP smear or if you have questions about cervical cancer screening & HPV vaccination and wish to find out more, please call or visit any of our clinics or drop us an email at hello@dtapclinic.com.sg
We have Female doctors at our Robertson Walk, & The DUO Galleria Branches Location. Call our clinic @ +65 6976 5023 

Take Care! 

Other Interesting Reads:

    1. What You Need To Know about HPV, Cervical Cancer, Pap Smear & HPV Vaccination
    2. 11 Causes of Dyspareunia (Pain During Intercourse)
    3. What is HPV Vaccination (Gardasil 9)
    4. 10 Causes of abnormal Vaginal Lumps and Bumps
    5. An Overview of Gonorrhoea
    6. Herpes – What You Need to Know
    7. The Good Wrinkles, Bad Wrinkles & the Ugly Wrinkles

9合1 加卫苗(Gardasil 9)疫苗

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9合1 加卫苗(Gardasil 9)疫苗可预防9种病毒株的人类乳头瘤病毒（HPV）所引起的癌症与疾病。
HPV是一种可分为两大类型的病毒，一组可致癌而另一组可致疣或乳头状瘤。
现今有超过一百种HPV病毒株并且每一株都有自己指定的数字，例如HPV16或HPV52。迄今为止，能致疣的HPV病毒株不会致癌而能致癌的病毒株并不会致疣！
HPV受诱惑于并仅活于体内的鳞状上皮细胞。这类细胞可存在于皮肤表面和潮湿的粘膜表面，例如：

  1. 阴道、肛门、子宫颈、外阴部（围绕阴道外）
  2. 阴茎的内包皮和尿道
  3. 内鼻、口、喉气管（主要呼吸管）和支气管（较小的呼吸管，分支于气管）
  4. 内眼睑

因此，这些表面的感染导致疣和癌细胞的形成。
9合1加卫苗有助于防止9种HPV病毒株的感染，因而适当的命名为9合1加卫苗。疫苗里的9种HPV病毒株当中，有2种用于预防疣（HPV16和18），而其余的7种用于预防癌症（HPV16、18、31、33、45、52与58）。
关于癌症，HPV是大多数宫颈癌、阴道癌、外阴癌、肛门癌、阴茎癌和口咽癌（咽喉癌和舌癌）病例的主要致癌病毒。

了解更多: 水货九价hpv疫苗-到底能够采取什么措施来避免接受

这个疫苗与旧款疫苗希瑞适（卉妍康 Cervarix）和4合1加卫苗（Gardasil 4）有什么区别？

与4合1加卫苗相比，9合1加卫苗对于HPV可提供更广泛的保护，它不仅能预防4合1加卫苗所预防的4种病毒株，它还能预防另外5种高危型的病毒株：HPV31、33、45、52合58。这几种病毒株加起来就已经覆盖了能导致百分之九十的宫颈癌病例的病毒株。
两种加卫苗都可预防致癌的HPV16、18，以及致疣的HPV6与11。
另一方面，希瑞适只针最常致癌的HPV16与18，而且并不能预防疣。

男女性都能接种9合1加卫苗吗？

是的，男女行都能接种9合1加卫苗，反观，希瑞适只适用于女性。

适合接种9合1加卫苗的最小年龄是？

9合1加卫苗可接种的最小年龄是9岁。在发生任何HPV接触之前接种疫苗是最有效的。

对女性而言，9合1加卫苗有多重要？

宫颈癌是新加坡15-44岁女性因癌症死亡的第三大主要原因，每月有6名妇女因宫劲癌而死。
通过疫苗接种可轻易预防宫颈癌，因此在女性当中受到了极大的推荐。
请记住，接种疫苗预防宫颈癌、阴道癌、外阴癌、肛门癌或口咽癌并不是百分之一百的有效的，但至少它现今提供了最好的预防机会，更何况，这些癌症还有其他致癌的HPV病毒株和其他致病因素。

对男性而言，9合1加卫苗又是如何重要？

首先，我们将根据不同的性行为进行两大分类：进行穿插性肛门性交的男性和不进行该行为的男性。
进行穿插性肛门性交并是接受一方的男性一般患上HPV相关肛门癌的风险较高，因HPV将贮藏于肛门粘膜表面。
无论往后的性取向如何，男孩或年轻男性进行早期接种疫苗都有助于预防肛门癌。与女性不同的是，进行肛门性交的男性目前尚无类似宫颈抹片实验（PAP Smear）这类受批准的筛查检测方案可实行。
不接受肛门性交的男性依然可从接种疫苗中受益。该疫苗可降低其口腔癌和阴茎癌的风险，因为在进行阴道性交或口交期间HPV可贮存于阴茎上，同样地，HPV也可在口交时贮存于口腔内。
许多异性恋男人可能会问：“HPV一般常导致宫颈癌，似乎更是个女性的问题而非是男性的。”仔细想想，HPV相关癌症对于女性是致命的，只要接种疫苗的男性人数越多，免疫人群就越大，从而降低把HPV传播给女性的风险。这被称为”“群体免疫力”。
相反，随着更多的女性接种疫苗，更多的男性就被赋予“群体免疫力”的保护，HPV流行率下降从而降低了感染HPV相关疾病的风险。
因此，我们也应该鼓励男性接种9合1加卫苗以降低HPV相关癌症和疣的总体风险和发生率。以澳洲为例，HPV疫苗接种已被纳入其国家免疫计划赞助的以学校为基础的举措，广泛接种12至13岁的男孩。

疫苗的使用方式和计量方案是什么？

医师将在您的胳膊、大腿或臀部肌肉上进行9合1加卫苗注射。
计量方案一共是3剂，在理想情况下，这3剂应在6个月内分散注射，例如：如果您今天已注射了第一剂，那么您的第二剂量将在2个月后注射，而第三剂将在第一剂的6个月后。
即使您忘记或延迟您的后续剂量，只要您在12个月以内完成所有3次剂量注射仍然可以实现有效的免疫力。

注射了9合1加卫苗后女性还需要进行宫颈抹片检查（PAP Smear）吗？

是的。虽然9合1加卫苗比旧款疫苗更覆盖了更多的HPV病毒株，但它仍然不能覆盖所有致癌的病毒株，而这其中就有7种。请记住，已知晓能导致癌症的HPV病毒株有15种，或许还有更多是我们还不知道的呢！
宫颈抹片检查应至少每三年进行一次，若您的检验异常，您的医师可能会建议您每6-12个月复查一次以便进行更密切的监测。
若您有意注射HPV疫苗或想了解更多相关信息，请联系我们在新加坡与马来西亚的诊所。
新加坡诊所
马来西亚诊所

Genital Warts: The Cauliflower-Like Lumps on the Genitals

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Genital warts are white or flesh-coloured, smooth, small bumps that can appear anywhere in the general area of the genitals. They can also grow larger and appear as fleshy, cauliflower-like lumps on the genitals. Neither of which are more dangerous than the other, it is merely a characteristic and the stage that the illness was noticed.
Genital warts is an STD symptom caused by the Human Papilloma Virus (HPV).

HPV can cause multiple illnesses in the body as there are multiple strains of the virus attributing to different diseases in humans. Out of the hundreds of known strains of HPV, about 30 strains of the virus cause diseases of the genital area. These include warts, or in more sinister cases, cancer of the anus, cervix, vagina, and penis. Read: Causes of Vaginal Lumps & Bumps & Perianal Warts (Peri-Anal Warts)

Most of the other strains have no known effect on humans.

How do I get infected by the Human Papilloma Virus (HPV)?

Human Papilloma Virus (HPV) is a contagious disease that is transmitted through genital skin contact or through direct contact with genital fluids of a person already infected with HPV.
For transmissible illness such as these, using barrier methods of protection for sexual intercourse such as condoms should be emphasised. However, condoms are not very effective against transmitting HPV just because the HPV virus does not require penetrative sex to transmit the virus.

It can also be transmitted from a mother to an unborn child if the mother has an active HPV infection during the course of the pregnancy.

How do I know I am infected with HPV? How can it be detected?

A majority of people infected with HPV do not realise they even have the virus as it does not present with any symptoms.

Some people will notice bumps or warts around the genital area, otherwise known as genital warts. These usually occur one to three months after initial infection with HPV.


The most sinister manifestation of the HPV disease is cervical cancer affecting women in their 30s or 40s. The simplest way to detect cervical cancer is by identifying if an individual is an active risk of getting the disease and doing regular PAP smears. MOH guidelines are also apparent on the timing and interval for PAP smears for women in the reproductive age group. Sometimes a biopsy of unhealthy cervical looking tissue may be needed.

For men-who-have-sex-with-men (MSM), it is recommended that they do an anal PAP smear to investigate for HPV.

We also provide Rapid HPV Testing (next day result) in all our clinics in Singapore.

How can HPV & Genital Warts be treated?

In most cases, the HPV infection is self-limiting therefore no treatment is deemed necessary.

Unless an individual has issues with antibodies or a weak immune system in general, the body should be able to contain and eradicate the virus from the body in due time.
If an individual has an impaired immune system or a weak immune response, a lingering infection or a co-infection with another sexually transmitted illness can occur.

In cases of genital warts, the treatment options are largely dependent on the severity of the infection. The most common treatment options include creams and paint-on ointments. These induce a state of cell death so warts around the genital will eventually wither and fall off the skin.

Some patients may be offered cryotherapy where the wart is frozen then removed. The wart is frozen prior to that so that there will be no transmission of the wart after.
Apart from the above surgical options for wart removal also exist. This is where a surgeon uses electrocautery or a scalpel and surgically excise warts. See: Genital Warts Removal

Unfortunately, the majority of genital warts or other warts can recur very frequently and is rather common to have warts recur post removal. Sometimes, repeated treatments are required for complete remission, but patients should be aware of the recurrence rates in such an infection.

HPV and Cervical cancer

Some HPV viruses are known as high-risk viruses. This is particularly true in virus strains 16 and 18. This is because it induces changes in the cells in the cervix of a woman and causes cervical if not detected early.

It is in this light that it is recommended that all sexually active women are advised to go for regular PAP smear tests, screen for HPV infections and visit your doctor for HPV vaccination in Singapore.

HPV and PAP Smear

Pap smear is a relatively painless test that can be quickly done. It involves inserting a speculum into the vagina of the patient to allow for inspection then a tool is inserted to obtain scraping. The patient should go back to resume activities of daily living with no hindrance once after the procedure completed by our female doctor.
These scrapings and obtained cells are then examined under a microscope to look for abnormal cells.

We also provide Rapid HPV Testing & Pap Smear in all our clinics in Singapore.

HPV and HPV Vaccination

Human Papilloma Virus (HPV) is a group of virus that can cause:

  • Vaginal Cancers
  • Vulvar Cancers
  • Anal Cancers
  • Penile Cancers
  • Oropharyngeal Cancers (cancers of the throat and tongue)
  • Genital warts or Papillomas

HPV vaccination is used to protect against HPV-related diseases and cancers.
To complete the HPV vaccination, 3 doses of injections will be given. The recommended HPV vaccine schedules are:
First dose: During your doctor visit.
Second dose: 1 – 2 months after the first dose
Third dose: 4-5 months after the second dose

Get More protection with New 9-valent HPV vaccine (Gardasil 9)

There are over a hundred strains of HPV and they are each given a designated number e.g. HPV 6 or HPV 16 or HPV52.
HPV strains that cause warts will NOT cause cancers and HPV strains that cause Cancer will NOT cause warts.

Compared to the older Gardasil, the new GARDASIL 9 offers a wider range of protection against HPV strains.
Both Gardasil and Gardasil 9 give you protection against the cancer-causing HPV 16 and 18 and the wart-causing HPV 6 and 11.
Gardasil 9 protects additional 5 other high-risk types: 31, 33, 45, 52 and 58.
Together these types cause about 90% of cervical cancers.

Another HPV vaccine Cervarix, on the other hand, protects only against the commonest cancer-causing HPV 16 and 18. There is no wart protection with Cervarix.
If you are interested in getting the HPV testing & PAP smear, genital warts treatment or HPV vaccine, please visit our STD clinics and speak to our male and female doctors.
If you or your partner are experiencing any possible signs or symptoms of infection, or have had any potential risk exposures, please see our STD doctors today.
Take Care. Be Safe!

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Other Interesting Reads:

  1. An Overview of STD – From an STD Doctor
  2. Anal Pap Smear for Anal Cancer Screening
  3. HIV Rash: What You Need To Know
  4. Genital Blister, Genital Ulcers & Genital Warts – What You Need to Know
  5. What You Need To Know about HPV, Cervical Cancer, Pap Smear & HPV Vaccination
  6. 11 Causes of Dyspareunia (Pain During Intercourse)
  7. 10 Common HIV related to Opportunistic Infections
  8. What is HPV Vaccination (Gardasil 9)
  9. 10 Causes of abnormal Vaginal Lumps and Bumps
  10. An Overview of Gonorrhoea
  11. What is the Treatment for Cold Sores? What causes Cold Sores?
  12. Herpes: Everything You Need to Know!
  13. Genital Warts: The Cauliflower-Like Lumps on the Genitals
  14. Syphilis Symptoms (Painless STD Sores & STD Rashes)