Cervical Health

January is cervical cancer awareness month. Cervical cancer is almost always preventable so bringing awareness to it is extremely important. In the past few decades, cervical cancer rates have decreased significantly due to available screening tests in developed countries but in the developing world cervical cancer still remains the leading cause of female cancer related deaths. A pap smear is a screening test where cervical cells are collected and assessed for any abnormal cell changes. Abnormal cell changes on the surface of the cervix are referred to as cervical dysplasia or premalignant cells as they can precede cervical cancer. If abnormal cells are found they are categorized into low-grade squamous intraepithelial lesions (LSIL) aka mild dysplasia or high-grade squamous intraepithelial lesions (HSIL) aka moderate/severe dysplasia. Mild, moderate and severe dysplasia are all completely treatable and even if left without treatment usually take 10-15 years to develop into cervical cancer. All of this means that with proper screening, diagnosis and treatment most cases of cervical cancer are preventable.

Pap smears should begin once a sexually active woman (this includes transgender men who have retained their cervix) is 21 years old and repeated every 3 years if she has no abnormal results.  If a woman has an abnormal pap smear, depending on the severity she will either be told to repeat the pap smear in 6 months, be sent for HPV testing or go for another test called a colposcopy to get a better look at the cervix. If treatment is required, the most common treatment is the loop electrosurgical excision procedure (LEEP) which clears off the layer of abnormal cervical cells and can even revert a woman back to a negative HPV status within 1-2 years. It’s important to note that even without treatment, there can be spontaneous regression of cervical dysplasia within 6-24 months thanks to our immune systems^[1].

The cervix is a part of the female anatomy and is found at the bottom of the uterus, dividing the uterus and the vaginal canal. Because of its location it is susceptible to infection from the human papillomavirus (HPV), the most common sexually transmitted infection in sexually active adults. HPV is the cause of almost 100% of cervical dysplasia and is also the virus responsible for genital warts^[2]. In 2006, the HPV vaccine was introduced in Canada to protect against the two HPV strains that cause the majority of cervical cancer. Although most sexually active women will come in contact with HPV at some point in their life, most will not develop cervical dysplasia because their immune system is able to fight off the infection. Lifestyle factors that put women at risk of developing cervical dysplasia are smoking, early age of first intercourse, obesity and poor nutrition (a diet low in fruits and vegetables).

Naturopathic treatment and prevention of cervical dysplasia includes supplementation containing anti-oxidants, anti-inflammatories, immune boosting nutrients, antiviral herbs and compounds to assist in proper estrogen metabolism. Nutrition recommendations include diets that are high in colourful fruits and vegetables (especially yellow-orange ones for their carotenoid content), cruciferous vegetables (broccoli, cauliflower, cabbage etc) and phytoestrogens (organic soy, flax etc). The purpose of these specific treatments is to reduce inflammation, improve detox pathways and boost the body’s immune system. All of which help fight off an HPV infection to prevent cervical dysplasia in the first place and prevent LSIL from progressing into HSIL or cervical cancer if the treatment plan is to watch, wait and retest in 6 months. In Ontario, naturopathic doctors are able to perform pap smears. If you are have not had a pap smear in the recommended time frame or have any questions or concerns regarding cervical health, book in with one of our naturopathic doctors to find out more information and see how we can help.

References:

[1] Schlet NF, Platt RW, Duarte-Franco E. Human papillomavirus infection and time to progression and regression of cervical intraepithelial neoplasia. J natl Cancer Inst 2003 Sep 3; 95 (17): 1336-43.

[2] Burd E. Human Papillomavirus and Cervical Cancer. Clin Microbiol Rev. 2003 Jan; 16(1): 1–17.