Sex and the blame game

Sex and the blame game
Cervical cancer: The normal architecture of stratified squamous epithelium is replaced by irregular cells that extend throughout its full thickness. Normal columnar epithelium is also seen.

The famous American author and educational administrator, Henry B. Eyring once said: "We live in a world where finding fault in others seems to be the favourite blood sport. It has long been the basis of political campaign strategy. It is the theme of much television programming across the world. It sells newspaper. Wherever we meet anyone, our first, almost unconscious reaction may be to look for imperfections."

When it comes to sexually transmitted infections, fault-finding seems seem to the natural reaction.

In most cases, there is a victim - the innocent sufferer who usually (but not exclusively) is the loyal female partner, who obeyed the "rules of engagement".

On the other hand, there is a culprit - the mischievous offender (sadly, mostly men) who contracted the disease and thus breaking the "circle of trust".

An interesting quote from American religious leader, Ezra Taft Benson: "What does it mean to love someone with all your heart? It means to love with your emotional feelings and with all your devotion. Surely when you love your wife with all your heart, you cannot demean her, criticise her or find fault with her".

Will the same rule reciprocate, when it comes to women's attitude towards their men? We address this question.

Dear Dr G,

I know you are a urologist and a men's health advocate. I am not a man, but hope you are still able to answer my questions.

I am 46 and recently visited my gynecologist for my regular year Pap smear.

I was horrified when I went back for the results and was told that I have abnormal cells in the smear that can be the sign of early cervical cancer.

My doctor had sent the specimen for DNA analysis and found that it is HPV (Human Papilloma Virus) infection.

I was so shocked when my doctor told me that I have contracted the infection through sexual contacts.

He told me to get my husband to see a urologist for a check up.

I read online that HPV is a form of sexually transmitted infection. I feel sad that my husband had infected me with the virus.

Why do I have to pay the ultimate price of his infidelity? I understand this disease will eventually lead to cancer.

I really would like to ask for your advice on how to confront my husband.

Can I ascertain when I have contracted the HPV from my husband?

I would like my husband to test for the HPV and all the other sexually transmitted infections, so that I can be protected from other bacteria and viruses.

Is HPV curable? Is there anything we can do to stop the infection?

Do we have to have protections in all sexual contacts now?

I am really upset and confused. Please help!

Regards,

Joanne.

The link between HPV and cervical cancer was only unravelled less than two decades ago. There are more than 100 subtypes of HPV and only 30 of them are associated with genital warts and cancers.

Many sexually active women would have contracted HPV at some point in their lifetime, even with the first sexual contacts made many years ago, and are completely unaware of the infection.

HPV is spread primarily through skin-to-skin contacts during sexual activity including oral sex.

The risk of contracting HPV is present even during the first sexual contact without penetrative intercourse.

The chance of getting the infection increases with the number of lifetime sexual partners.

Interestingly, the age women are most likely and vulnerable to HPV infection is between 20 and 24 years old.

Of course, the likelihood of infection also increases with women who are sexually active with men who have multiple partners at the same time.

Certain HPV infections are classified as "high risk" as they can induce abnormal cell changes resulting in genital cancers.

In fact, researchers believe 99 per cent of cervical cancers are caused by HPV and subtypes 16 and 18 are responsible for nearly 70 per cent of the cases.

Women with "high risk" infections are usually advised to have regular Pap smear to monitor the progress.

If abnormal cervical tissues are detected, interventions such as surgery, laser treatment and freezing may be necessary.

Although the high risk HPV is associated with cancer, it may not necessary be the case.

The presence of HPV does not mean lifetime sexual contacts with condom.

In fact, the barrier technique is not often fool proof, as the condom is not able to prevent all the genital skin-to-skin contacts.

Of course, other sexually transmitted infections such as syphilis and HIV can be tested, however, there is no real link of HPV with other STI's.

Although the Pap smear and DNA analysis of the subtype of HPV is widely available in women, such routine investigation is not possible for men.

When carrying out research for men and HPV, the only method of obtaining tissues to study for the presence of HPV is vigorous extraction of the penile skin tissues with brushing.

I often wonder who would volunteer for such research work?

A recent diagnosis of HPV does not necessarily mean your partner has been unfaithful.

Women are most susceptible to the virus in their youth and the infection can be dormant in the body for decades.

Besides, the diagnosis of the HPV is impossible in a man; therefore, there is no way to find out when and from whom the infection first started.

When it comes to sex, we may not know when and how our past may come back to haunt us. Actress, Jessica Lange once said: "Acceptance, tolerance and forgiveness: those are life altering lessons."

Dr G really hopes that this challenging time can turn out to be a "life-altering" lesson, instead of a "blame game" in Joanne's relationship!

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