Nearly half of adults in US infected with HPV

“An interesting read about adults in the U.S. with HPV”

— Dr. Dale

From Nearly half of adults in US infected with HPV

If you currently are sexually active, have been sexually active in the past or have sex in the future, there's an extremely high chance that at some point before your sex life is over you will have been infected with the human papillomavirus (HPV), a sexually transmitted infection that is linked to several cancers. Just this month, the National Center for Health Statistics announced that it found that 45.2 percent of men and 39.9 percent of women 18 to 59 years in age were infected with genital HPV during 2013 to 2014.

Even more alarming, the center found that during the same time period 25.1 percent of men and 20.4 percent of women were exposed to high-risk genital HPV, which result in about 31,000 cases of cancereach year.

A viral infection, HPV is the most common sexually transmitted infection and can be spread between partners through anal, vaginal, or oral sex, and even through close skin-to-skin touching. The center's latest figures are a reminder that nearly everyone who is sexually active becomes infected with HPV during some point in their lives, according to the federal Centers for Disease Control and Prevention (which includes the NCHS).

"HPV is very common; up to 80 percent of sexually active people have been exposed at some point in their lives," says Summer Dewdney, MD, a gynecologic oncologist at Rush University Medical Center. "But the vast majority never develop any symptoms, and the body's immune system can usually clear HPV on its own within two years."

HPV causes nearly all cervical and oral cancers

But other times, the infection does not clear up. And since there is no cure for HPV, the virus puts people at risk for potentially serious problems—such as cancer and genital warts—down the road. Every year, more than 27,000 women and men are affected by the following cancers linked to HPV:

• Anal cancer

• Cervical cancer

• Oropharyngeal cancer, which includes oral cancer and throat cancer

• Penile cancer

• Vaginal cancer

• Vulvar cancer

Almost all of the more than 11,000 cases of cervical cancers diagnosed in the U.S. each year are caused by HPV. While oral cancers used to be attributed mainly to tobacco and alcohol, now 72 percent of oral cancers (particularly in young men) are caused by HPV.

"There has been significant change in the last decade. The HPV-associated oropharyngeal cancer has reached epidemic proportions," says Kerstin Stenson, MD, a head and neck cancer surgeon at Rush.

"By 2020, HPV is projected to cause more oropharyngeal cancers than cervical cancers in the U.S.," adds Karen Lui, MD, a pediatrician at Rush

Protect yourself with HPV vaccine ...

The doctors recommend taking precautions to prevent HPV infection and catch infections that do occur before they become major health problems. "We have a vaccine for cancer," Dewdney says. "Use it!"

Two vaccines, Cervarix and Gardasil, are available to protect against the types of HPV that cause the most cervical cancers, as well as anal cancers in men. A doctor can administer the vaccine in three shots over a six-month period.

• Gardasil is recommended for girls and women between ages 9 and 26

• Cervarix is recommended for girls who are 9 years of age, plus women of any age who have not previously been vaccinated and have not previously been diagnosed with cervical cancer.

• The HPV vaccine is also recommended for boys, starting at age 11. 

"If you aren't eligible but your children are the right ages, consider taking them to be vaccinated," Dewdney says. "But the important thing to know is that even if you were not vaccinated as a child, you can still get the vaccine up to age 26."

... get regular pap tests and dental exams ...

Additionally, Lui recommends annual PAP tests for women starting at 21 years of age—whether they've been vaccinated or not. Pap tests enable doctors to detect abnormalities—changes on the cells on a woman's cervix—and take action before cervical cancer develops. "Screening is the best way to catch HPV-related cancers early," Liu says.

"Once you turn 30, we recommend pap smears every five years as long as you have HPV testing with your Pap and the results are negative," Dewdney says. "In addition, any bleeding with intercourse should be evaluated by a gynecologist."

According to the American Cancer Society, between 60 and 80 percent of women in the United States with newly diagnosed invasive cervical cancer have not had a Pap test in the past five years. And, even more alarming, many of these women have never had the exam.

Stenson stresses the importance of regular visits to the dentist. "Dentists play a key role in detecting oral cancer," she says. "You might not see a primary care physician even once a year, but most people see their dentist twice a year. Having regular dental visits can help catch cancers early to help ensure the best outcome."

... also, practice safe sex

Studies have shown that women who have many sexual partners increase their risk of developing HPV and their risk of cervical cancer. 

"If you are sexually active, use a condom every time you have sex," Dewdney says. "Unprotected sex leaves you at risk for contracting sexually transmitted diseases that can increase your risk of getting HPV and greatly increase your chances of developing precancerous changes of the cervix."

While condoms help to lower the risk of developing HPV-related diseases, including cervical cancer, be aware that HPV can infect areas that are not covered by a condom, so condoms may not fully protect against HPV. That's why it's essential get the HPV vaccine in addition to using condoms.

Though studies have shown that using a condom properly and consistently—meaning every single time you have sex—can reduce HPV transmission, any area of the penis not covered by the condom can be infected by the virus.

"While the infection is most commonly passed by vaginal or anal sex, you can also transmit it during oral sex and skin-to-skin contact, and in those cases a condom isn't going to protect you at all," Lui says. "That's where the vaccine can help safeguard you."

Protect your children 'for the rest of their lives'

Due to controversy about vaccinating young people against a sexually transmitted infection and parental concerns about possible long-term effects of these relatively new vaccines, many children, teens and young adults aren't getting vaccinated, leaving them vulnerable to future HPV infection.

Lui encourages kids and parents to have an ongoing, open conversation about their wishes when it comes to being vaccinated.

"It's hard for some kids to admit to their parents that they're sexually active or are considering it," says Lui. "But it's important to be honest with your parents and tell them that you want to protect yourself."

Also, research has shown that getting the HPV vaccine does not encourage kids to become sexually active or start having sex at a younger age—a common concern cited by parents.

"Parents need to understand that just because their kids want the HPV vaccine, it doesn't mean they're promiscuous, or even that they plan to start having sex right away," Liu says. "They're talking about doing something now that can help keep them safe for the rest of their lives—and as parents, that's all we really want for our children."

Secrets To A Less Stressful Life

“An enjoyable read about living a less stressful life.”

— Dr. Dale

From Secrets To A Less Stressful Life 

You’re at your desk, about to log off for your lunch break, when you hear the ding of an incoming text. You read the message from your partner saying, “Meeting got moved. Can’t get kids from school today.” By the time you glance back up at your screen, an email has come in from your boss, asking about the progress of a lagging project. As you craft your reply, your phone beeps again, and you eagerly check for the life-saving words of your best friend saying she can pick up your kids, but instead, you’re greeted by a news alert about some unspeakable thing happening in what seems to be an increasingly insane world.

Fill in the blanks of your own latest text, email, and news alert, and most of you can probably relate to this scenario. In fact, the American Psychological Association (APA) recently reported that the constant checking of devices is contributing to high levels of stress for the majority of Americans. This year, results from an APA survey also showed a “statistically significant increase” in stress for the first time since the survey was first conducted in 2007. Stress is on the rise for myriad reasons that are worth examining. But here, I want to explore how to best handle the new waves of stress that have entered our lives. No matter what it is that’s making each of us anxious, we can all arm ourselves with the tools to help us stay calm, centered, and feeling strong in the face of challenges. Here are some techniques we can adopt to better handle moments of stress.

1. Get a hold of your inner critic: One thing we should realize about stress is that so much of what we worry about is based not just on what’s happening in our lives but the messages we tell ourselves about what’s happening. Facing a deadline is stressful, but it’s those nagging thoughts telling us, “You’re never going to finish” or “This is all gonna blow up in your face” that really get us worked up. Getting our kid to finish their homework is tiring, but it’s made all the worse by attacks like “You’re a terrible parent” or “You can’t even get your own kid to listen to you. What a failure!” Take the time to ask yourself, “what are the thoughts around my stress that perpetuate it?”

There are a lot of things in our lives that don’t go our way or that we can’t control, but what makes matters much worse is a “critical inner voice” we all possess that punishes us unnecessarily and escalates our stress. “How can you sleep? You have so much to do.” “What makes you think you can just relax?” “This is just too much. You can’t handle it.” This voice is a friend to our stress, paving a tunnel for it to pour in and consume our state of mind. Identifying our “inner critic” by noticing when it starts yammering away will help us peel away its negative messaging from whatever our actual circumstances may be.

2. Practice pressing the pause button: The saying that “whatever you practice gets stronger” is a useful one to remember when it comes to stress. If you practice stress, it will become the norm. If you practice calming yourself, it can also become the norm. When you feel your emotions start to spiral out or overpower you, remind yourself to take just one moment to pause and tune in to yourself. Take a few deep breaths, and slow down your thoughts. You might even put one hand on your belly and another on your heart, while you breathe in and out. This will help you feel more centered.

3. Embrace mindfulness (without judgment):  William James said, “The greatest weapon against stress is our ability to choose one thought over another.” Mindfulness is a practice of, not necessarily choosing our thoughts, but choosing how we react to our thoughts and not letting them take over. Mindfulness meditation, for example, teaches us to focus on our breath and tune in with our bodies. As we do this, we can notice individual thoughts as if they are train cars passing on a track. We can acknowledge each one without choosing to board the train and disappear into a land of worry.

Mindfulness teaches us to remain in the moment. The philosopher Lao Tzu said “If you are depressed you are living in the past. If you are anxious you are living in the future. If you are at peace you are living in the present.” So much of our stress has to do with feeling bad about the past or worrying about the future, but what many of us find is that in the present moment, we are often okay.

4. Give yourself permission to stop worrying: A lot of our stress is about what we can’t control, yet we all indulge in some degree of magical thinking that tells us that somehow worrying or considering every potential negative outcome will solve the problem or at least protect us. Rather than repeatedly setting off warnings in our heads that tell us to panic, why not give ourselves permission to stay in the moment and deal with what is rather than what might be? We could give ourselves permission to let go of the bad thoughts and feelings as much as possible. We can do this each time we’re faced with a challenge. It’s possible to confront the reality of a situation without adding the extra weight of torturing ourselves about the possible scenarios of this reality or its potential consequences.

5. Be around people who make you feel good: In a recent article in The Atlanticaddressing post-election stress, Jack Saul, the director of the International Trauma Studies Program, said, “Strengthening connections with families, communities, and organizations is the most important preventive approach.” Studies show that friendship itself is a natural and effective antidote to stress. It’s important to surround ourselves with the right kind of friend, one who keeps us on the right side of ourselves.This means a friend who doesn’t perpetuate our stress by encouraging us to ruminate or wallow in our worries or who doesn’t add to it by joining in and stressing along with us. Find positive people, who have an easier time staying calm or who are more resilient and less hyper-reactive to problems.

6. Try out a different perspective: On a survival level, our brains are wired to notice danger and focus on potential problems in an attempt to protect us. Unfortunately, this can make it much too easy to become overwhelmed by things we can’t control. Dr. Salvatore Maddi, who’s studied “hardiness” or emotional resilience for more than 30 years, has found that people with more hardiness see challenges as part of the human condition and regard them as opportunities to change and gain strength. Imagine that moment when life hands us something we could so easily stress about. If we feel overpowered by our circumstances, we may give up, get upset, or engage in a lot of thoughts and behaviors that amplify our stress. If we take a moment to pause to see this instead as a challenge, a natural bump in the road of life, we can change the way we feel inside when facing the very same external circumstances.

7. Make self-compassion a permanent goal: Dr. Kristin Neff is a lead researcher on self-compassion. She has discovered incredible benefits to practicing self-compassion, as it helps people avoid self-evaluation, while allowing them to be kind to themselves. Self-compassion is sometimes mistaken for feeling sorry for oneself, but it is actually the opposite. It allows us to feel for ourselves and our circumstances and accept our suffering as part of the human condition. It allows us to see our flaws or limitations without hating ourselves, and therefore, we can take steps to make changes. Self-compassion can be a powerful tool when we feel stressed, because it reminds us to be kind and sensitive to ourselves and treat ourselves the way we would a friend facing these same circumstances.

8. Develop strategies to calm yourself down: There are many good exercises for reducing our immediate feelings of stress. Breathing exercises such as taking a few long, slow breaths or simply paying attention to our breath, even yawning or inflating a balloon, can help us lower our heart rate and calm down. In terms of our thinking, there are practices to help us better process what’s occurring. When something painful or distressing happens, for example, psychologists Jack Kornfield and Tara Brach recommend the RAIN Approach, which involves Recognizing the trauma or loss, Acknowledging/ Accepting/ Allowing that this trauma occurred and may not be resolved, Investigating the experience as it relates to your past and present life, and Non-identification with the experience, which means we don’t over-identify with what happened or allow it to define us.

Learn more tools and techniques for coping with anxiety.

9. Notice the triggers that set you off: We all have real stressors in our lives (bills to pay, work to do, schedules to manage), but why are we able to handle some things with calm and competence, while others seem to push us over the edge? We all have specific buttons that set off our stress more than others. The more we learn what triggers our strongest emotions, like fear and frustration, the more we can understand ourselves and control our reactions to these triggers. For example, does a tone of condescension set off critical inner voices of being incapable? Is the nightly news making you feel like hiding under a desk? Does a certain way your child cries leave you feeling unbelievably overwhelmed?

When we identify these triggers, we can go deeper into exploring why these particular things stir us up so much. Maybe they remind us of feeling helpless as a child or having a parent who flew off the handle. Maybe they trigger real or existential fears about ourselves and our family. Knowing our triggers can help us face more core emotions that are pumping life into our stress, and they can also teach us what may not be best for us in our daily lives. We should ask ourselves, “Can I avoid, limit, or better handle certain things that make me feel stressed?” Can I put away my phone after 9PM? Can I turn off the news when my heart starts to race? Can I take a couple smaller projects off my calendar? Can my partner handle this tantrum when I’m not feeling myself?  This approach isn’t about eliminating or avoiding real responsibilities or circumstances, but about actively seeking better strategies to deal with them.

10. Take positive actions: At times, stress can make us feel overwhelmed or hopeless and can actually impair our ability to take action. If we feel stressed, it can be beneficial to sit down and come up with some actions that will help alleviate our stress rather than contribute to it. This isn’t about making a long to do list that will overwhelm or agitate us; it’s about taking pause and really pinpointing a positive step we can take to feel better or move forward on a task. This could be something as small as going for a walk outside, taking 15 minutes to meditate, setting aside an hour to make progress on a project, calling a good friend, or listening to uplifting music.

These actions can also be a direct response to whatever is causing our stress. For example, if we feel frustrated by the state of the world, we can set up time to volunteer or donate to a cause that matters to us. If work is chaotic, we can seek out strategies to keep calm. One friend of mine found it helpful to just check in with herself every hour to ask “how are you hanging in there?” and taking a few moments to breathe. If we’re overwhelmed at home, we can engage in a healthy conversation with family or friends about how we can all help one another. My sisters often pick up each other’s kids once or twice a week to allow the other to have an extra hour at the end of the day. Another friend makes a game out of late-night grocery shopping with his whole family when he or his wife has trouble making time to get to the market. Whatever it is that helps, give that action the time and importance it deserves. Anything we can do to help squeeze more joy, peace, and meaning out of our day is a worthy pursuit that everyone deserves.

Do You Have IBS Or Are You Just Stressed?

“Determine the difference between stress symptoms or IBS symptoms.”

— Dr. Dale

From Do You Have IBS Or Are You Just Stressed?

Your body does really weird things when you're feeling stressed out, and most of the time, it's out of your control. You sweat, your heart races, and sometimes you have to poop — badly, like really badly. But, if stress makes you poop, and that happens to you a lot, does that mean that you have irritable bowel syndrome? Maybe.

IBS is a chronic bowel syndrome that affects your large intestines, and usually causes a whole cast of bowel problems: constipation, diarrhea, bloating, cramping, or a mix of alternating diarrhea and constipation. And all these symptoms come out to play when you're stressed.

"Stress can make symptoms of IBS worse," says Melissa Rosen, MD, gastroenterologist and clinical assistant professor of Medicine at NYU Langone Medical Center. The link between stress and IBS is a little mysterious, but Dr. Rosen says that doctors know that stressful events can exacerbate IBS symptoms. And "stressful events" can include running for a train, meeting an ex for the first time post-breakup, or just living your life.

Most people will experience these types of GI issues at some point in their life (perhaps after eating a particularly rich meal or going too long without water or fiber), but a person who has IBS gets them over and over again, regardless of what they're eating. According to Dr. Rosen, people usually see a doctor for IBS when they feel like they can't get their bowels under control. "We have a criteria for diagnosing IBS, because there's a range for how people experience it," she says.

So how do you know if you have IBS? There's not a definitive test that doctors use to diagnose it; it's a "diagnosis of exclusion," Dr. Rosen says. This means that gastroenterologists typically look to rule out other common GI issues that would cause your bowels to get out of whack, such as celiac disease, ulcerative colitis, and Crohn's disease, she says. A person with IBS usually has a healthy appearing colon, without evidence of any inflammation, even though their bowels can be really erratic and irregular. Your doctor might also run a few blood tests to check for anemia or thyroid issues that could be contributing to your GI symptoms, but for people with IBS, these tests usually come back normal.

Even though IBS is hard to pinpoint, it's still a very common syndrome. Between 10 and 15% of the population has IBS, and two in three IBS sufferers are female. "It is more common in women, and one theory is that hormonal fluctuations cause symptoms, because women have changes around their menses — but that's just one explanation," Dr. Rosen says. (And many people just poop a lot during their period.) There's definitely a link between mindset and IBS, and it's also possible that someone with IBS is just more sensitive to these varying symptoms, so they recognize them more, she says.

If this sounds like you, it's a good idea to talk to your doctor about your bowels, so they can make sure you don't have a serious GI condition. Dietitians typically help IBS patients figure out what foods trigger their symptoms, and work to modify their diet so their bowels can flow a little better. "By incorporating dietary changes and figuring out their food triggers, patients often feel better," Dr. Rosen says.

But that's not all it takes, and Dr. Rosen says anxiety and stress management is a huge part of IBS treatment. "Whether it's needing management of anxiety with a therapist or exercise, it helps a lot," she says. "Exercise helps with your overall mood and energy, which, in turn, can alleviate IBS symptoms." Some IBS patients get stressed about having IBS, which causes a vicious cycle of symptoms. "Patients can spend all day wondering where the next bathroom is, or patients have trouble using the bathroom outside of their home, which can be anxiety-provoking, so it can feed on itself," she says. Anxiety and depression can worsen symptoms to a degree, so gastroenterologists will sometimes work with psychiatrists to prescribe an antidepressant, Dr. Rosen says.

And most importantly: "If you have symptoms, you shouldn't discount them," Dr. Rosen says. Whether or not you have IBS, your poop and your stress really matter and deserve to be taken seriously. They're the shit, just like you.