HPV infections can occur in various ways, such as through sexual contact, mother-to-child transmission, or indirect transmission through skin, mucous membrane contact with items contaminated by HPV. Many women may think that HPV infections mainly exist in young women with active sex lives and don’t need to be screened as they get older. In fact, that’s not the case…
Source of the GIF: soogif
Ms. Wan has been feeling very distressed lately. After menopause for 6 years, she found out during a check-up this year that she tested positive for high-risk HPV18 in the cervix, with cervical cytology suggesting high-grade squamous intraepithelial lesions. Subsequent cervical cone biopsy pathology directly indicated cervical cancer, fortunately at an early stage, as in situ carcinoma. However, Ms. Wan couldn’t understand: she has not been sexually active since menopause, maintains good personal hygiene, so how could she be infected with this virus?
Perimenopausal/postmenopausal women are more susceptible to continuous HPV infection
Research indicates that there are two critical factors determining HPV infection:
Vaginal environment, immune system
Women have two high-risk periods of HPV infection during their lifetime: one is during the childbearing age, due to active sexual activity making them more prone to contact with the virus, and the vaginal environment being more susceptible to imbalances. But don’t panic, with a normal immune system, around 70% of women can naturally clear the HPV virus within 2 years.
The other period is perimenopause. Even with reduced sexual activity during this time, as ovarian function declines, estrogen levels decrease, the local “defense” of the vagina weakens, making them more vulnerable. With decreased vaginal lactobacilli, microbial imbalances, and a shift towards neutral/alkaline pH, inflammation is more likely. Several studies have found that women with HPV infection have a high incidence of bacterial vaginosis, vulvovaginal candidiasis, commonly known as yeast infections. Additionally, with aging, the prevalence of metabolic diseases increases, reduced physical activity, lowered immune response, leading to increased susceptibility. Furthermore, with decreased “resistance,” postmenopausal women take longer to clear HPV and are more likely to develop persistent infections.
Cervical cancer is more common in women over 50
Data shows that the average age of onset of cervical cancer worldwide is 53 years old, indicating that cervical cancer is more prevalent in menopausal or postmenopausal women. Why is this so?
This may be related to several “weak points” in perimenopausal and postmenopausal women:
1. More susceptible to continuous HPV infection
As mentioned above, women in the perimenopausal period aged 40-45 are more prone to continuous HPV infection. Continuous infection with high-risk HPV is a major pathogenic factor for cervical cancer, with HPV16, 18, 52, and 28 being the most common carcinogenic subtypes in China.
2. Belief that no sexual activity means no need for screening
From HPV infection to the development of cervical cancer takes several years or even decades, during which there may be no clinical symptoms. Many perimenopausal and postmenopausal women may mistakenly assume that without sexual activity, they won’t have “gynecological diseases,” hence neglecting their annual gynecological check-ups. By the time they are diagnosed, HPV infection may have been present for a long time, leading to lesions or even cervical cancer.
3. Harder to detect early lesions
Vaginal atrophy in perimenopausal and postmenopausal women causes the squamocolumnar junction to retract into the cervical canal, making sampling for cervical screening more challenging, and early cervical lesions harder to detect.
How can perimenopausal and postmenopausal women prevent cervical lesions?
Regular check-ups
Get checked annually and never skip cervical screening.
Boost immunity
Have a balanced diet, exercise regularly, maintain a regular sleep schedule, stay happy to improve immunity.
Proper hygiene
Wash the external genital area daily, change undergarments regularly and cleaning supplies, avoid excessive cleaning, unnecessary vaginal rinsing, or using cleansers under normal circumstances.
Seek medical attention promptly
Treat inflammations promptly; if you experience dryness, pain, consult a doctor for the use of topical medications.
Key Takeaway: Perimenopausal and postmenopausal women have weakened local vaginal immunity, making them more prone to continuous HPV infection. Don’t overlook gynecological exams just because sexual activity has reduced.
Review Expert: Li Bin
Deputy Dean, Party Committee Member, Professor, Chief Physician, Doctoral Supervisor. Specializes in premature ovarian failure, menopausal syndrome, infertility, gynecological tumors, precancerous lesions, common gynecological diseases, skilled in laparoscopic surgical treatment of gynecological diseases.
Authors: Chen Xi, Li Miaoran
Editor: Li Miaoran
