Cervical cancer is caused by certain types of human papilloma virus (HPV). A new vaccine, developed in Australia, is the only vaccine that may help guard against diseases caused by HPV Types 16 and 18, which cause 70 percent of cervical cancer cases and HPV Types 6 and 11, which cause 90 percent of genital warts cases. The vaccine comprises a series of 3 injections over 6 months. It is recommended to initiate vaccination prior to the commencement of any sexual activity, and is therefore indicated for women aged 9 to 26 years of age. It may be given after commencement of sexual activity because it would be unlikely that you are infected with all 4 types of HPV and it may be able to prevent the more serious (cancer-producing) types of HPV.

HPV is extremely common in our community and is easily spread. For most people the virus goes away on its own. When the virus does not go away, then it may lead to the development of cervical cancer. It often takes 10 years to develop cervical cancer.

A Cervical Screening Test should be done every 5 years. It may detect the presence of human papilloma virus and if required further testing may identify pre-cancerous cells. These cells may be successfully removed and therefore prevent the development of cervical cancer.

Cervical Screening Test

Vaginal discharge occurs in most women at some time in life and is usually due to bacterial vaginosis or vaginal thrush or both.

There are lots of different causes but one of the most common causes is called bacterial vaginosis (BV), or Gardnerella. Vaginal discharge from this condition occurs in 10 to 30 percent of women. It is not serious and usually only requires treatment if symptoms are present. Those women who do seek treatment may notice a fishy or musty smell from the vagina that may get stronger after sexual intercourse. A few women may have soreness of the vulva (the skin at the opening of the vagina). There may also be a vaginal discharge that can vary from a little to a lot, and may be white but also thin, watery and frothy.

Bacterial vaginosis is not sexually transmissible and therefore your sexual partner needs no treatment, however it sometimes develops soon after intercourse with a new partner. The condition is not an infection but due to excessive presence of vaginal bacteria. Fungal infection (thrush), STIs (such as chlamydia or gonorrhoea), HPV (human papilloma virus) may occur simultaneously and make symptoms of bacterial vaginosis worse. The symptoms of BV are modified by intercourse trauma, cyclic hormonal changes, the Pill, antibiotics, tampons and douching.

An antibiotic known as metronidazole is often used to treat the infection, either as a single dose or for five days. A prescription from the doctor is necessary. Remember, if symptoms persist, it may be due to other causes and you should see your doctor for further tests.

Vaginal thrush or candidiasis is also very common and is caused by an overgrowth of yeast known as candida albicans. It may cause vaginal discomfort – itching or burning, a thick, white discharge with a “cottage cheese” appearance, redness or swelling of the vagina or vulva, and stinging and burning when passing urine. It is also not sexually transmissible. The overgrowth may be due to antibiotic use, the Pill, diabetes, pregnancy, general illness and immune disorders.

Treatment usually involves antifungal creams or pessaries that are placed in the vagina at night. These may be purchased without prescription from the pharmacy. To help prevent thrush, wipe from front to back after using the toilet (this will prevent the spread of candida from anus to vagina), use only mild soaps to wash the genital area, avoid using antiseptics, douches and perfumed sprays in the genital area, and avoid wearing tight pants and synthetic underwear.

If you have repeated thrush, you should see your doctor as bouts of suspected thrush may be a result of other underlying conditions and you may need further investigations and treatment.

In Australia, the average age of menopause is 50 to 51 years of age, but in some women it could happen earlier or later. If it happens before the age of 40, it is called “premature menopause”. Menopause is a natural process that results from normal ageing of the ovaries.

This refers to the transition time that leads to menopause. During this time, the normal function of the ovaries slows down, producing less hormones (oestrogen and progesterone) until ovulation no longer occurs and periods stop altogether. This phase may last for 6 months to 10 years. A woman is considered postmenopausal when she has not had a period for 12 months.

Symptoms vary from woman to woman. Some have no symptoms at all, others may experience symptoms and not be bothered by them, whilst some women find them irritating and troubling. These symptoms include hot flushes (often accompanied by sweats, day or night), disturbed sleep, aches and pains, a dry vagina (making sex uncomfortable), reduced sex drive, urinary frequency, headaches and or migraines, forgetfulness and or irritability, mood swings, and dry skin or a crawling or itching sensation.

The long-term risks associated with menopause are a thinning of the bones known as osteoporosis together with an increased risk of cardiovascular (heart) disease. A healthy lifestyle with a good diet and regular exercise is an important part of managing menopause.

Regular Cervical Screening Tests to the age of 70-74 and breast checks including mammography are recommended for menopausal and post menopausal women. It is also recommended that you discuss with a doctor the need for bone density testing to check for any signs of osteoporosis together with the need for any calcium supplementation. Your cholesterol, blood glucose and blood pressure should also be monitored.

The aim of this therapy is to replace the hormone or hormones that were made by the ovaries prior to menopause. It can reduce many of the unpleasant effects of the symptoms of menopause and may be appropriate for short-term use in women with moderate to severe menopausal symptoms. HRT must be prescribed by a doctor and is not available over the counter. HRT comes in various forms and combinations of hormones (oestrogen and progesterone). Anyone considering this treatment should discuss the benefits, risks and side effects with a doctor and have their treatment well monitored.

If you have ever had sexual intercourse you should have regular Cervical Screening Tests even if you are not currently sexually active. It is recommended that women should have Cervical Screening Tests every 5 years until the age of 70-74. The first Cervical Screening Test should be performed at the age of 25 unless there are symptoms prior. You should continue to have your Cervical Screening Tests after menopause has occurred and in some cases after hysterectomy if your doctor advises.

When a Cervical Screening Test is performed, an instrument called a speculum is gently inserted into the vagina. It is used to hold the walls of the vagina apart to allow the cervix (neck of the womb) to be clearly seen. A small brush is then inserted to collect cells from the cervix. These cells are then transferred to a special solution and sent to a laboratory for testing. Your results should be available within 2 weeks.

Cervical screening test information

Risk factors for developing cervical cancer include the presence of some types of the human papilloma virus (HPV) on the cervix and smoking. HPV is quite a common viral infection that can cause skin warts and can affect the genital tract in both men and women. There are many types of HPV and most of them are not cancer producing.

The Cervical Screening Test results may reveal low risk for cervical cancer and screening is advised again in another 5 years. It may be suggested that the test be done in another 12 months as sometimes low grade strains of HPV may be cleared from the body naturally. In other situations, where the high grade strains of HPV are detected, then referral to a specialist is necessary for colposcopy (further sampling of the cervix) and possibly removal of abnormal cells by various means.

A series of three vaccines over six months is available which has the potential to reduce the chance of cervical cancer by 70 percent. It is recommended for women aged 9 to 26 and preferably before a woman or girl becomes sexually active. It is designed to prevent infection from HPV, which is the main cause of cervical cancer. Cervical Screening Tests are still required every 5 years as the vaccine does NOT protect 100 percent against cervical cancer. It can be purchased with prescription from the pharmacy and injected by your general practitioner. However, there is a school-based program which targets 12 and 13 year old girls, generally delivered in the first year of high school.