EU Reccomendations on HPV Vaccines

   Cervical cancer is most commonly, if not entirely, caused by the human papillomavirus (HPV). Forty of the 100 strains are transmitted through sexual contact, including oral, vaginal and anal intercourse.  Of those strains, some cause genital warts (unsightly and uncomfortable but minor) and others are associated with cervical cancer.  Having the human papillomavirus may increase the risk of penile cancer for men.  There are other causes of penile cancer which itself is very rare.  Conversely, cervical cancer is the second most common cancer for women.  Breast breast cancer being the most common.  There were just over 12,000 cases of cervical cancer in the US in 2008.  Cervical cancer deaths are not common as the PAP smear is able to detect abnormalities and prevent the cancer.
   It is estimated that at least 50 percent of all adults have been exposed to HPV at one time or another.  The virus is usually cleared by the body's immune system, but can be a chronic condition in rarer cases.  One can transmit the virus to others through sexual contact in the acute state and if they do not clear the virus they will continue to risk transmission through sexual activity.  The lingering virus is a serious matter and transmission rates are very high.  For this reason, the two vaccines that are available have an important role (only for those not previously exposed).  Because so many sexually active people have been in contact with a person carrying the virus, the target of the vaccine is girls (maybe boys too) who have not yet begun sexual activity.
   The two vaccines, Gardasil and Cervarix, only target the most important strains of the 100.  Gardasil covers two that cause warts and two that cause HPV.  Cerarix only covers the HPV strains, however, Cervarix has also been shown to have an impact on oral cancer and this is important.  Most people think of smokeless tobacco as the main cause of oral cancer - actually it is smoking BUT the rise in new oral cancer cases is associated with HPV NOT tobacco at all.
   Earlier this month, European health officials with information from the European Centers for Disease Control, made a recommendation that ALL girls in Europe (ages?) be vaccinated.  Some countries in Europe have coverage rates as low as 17% while Portugal and Brazil had coverage rates as high as 80%.  The recommendations include more promotion of the vaccines and steps to make vaccination easier (logistics).  The article that I read did not indicate if the coverage rates 17-80% were for the full series (3 shots) or for any vaccination level.
    In the USA, the issue of HPV vaccines became a political firestorm when a presidential candidate made some erroneous statements regarding side effects. 
    According to the US CDC, all girls AND boys ages 11-12 should be started on the series of shots.  The coverage is low and more info about this can be found here.

Let's Talk About Sex

The research that I am referring to today can be found in the online version of BMJ and this particular article is available for free. Lindau and Gavrilova 340 (92): c810. (2010)
http://www.bmj.com/cgi/reprint/340/mar09_2/c810

The researchers are from Department of Obstetrics and Gynaecology, University of Chicago, 5841 S Maryland Avenue, MC2050, Chicago, IL 60637, USA, and Chicago Core on Biomeasures in Population-Based Aging Research, University of Chicago Centre on Demography and Economics of Aging.

The scientists reviewed data from two different sources, surveys and interviews of two large groups of men and women in the USA. The purpose of the study was to investigate sexual activity and satisfaction as we age.

I am thrilled with a new concept that they present. You are familiar with the term active aging and active or healthy life expectancy etc etc. The purpose of my blog is to support and encourage healthy active aging. These researchers have determined markers of "sexually active life expectancy." How cool is that? And what exactly determines your sexually active life expectancy? According to the researchers any amount of sexual activity with a partner (snicker snicker) counts. So if you stop having any sex at all, your sexually active life years are over.

The researchers determined that on average, at age 55 - (life expectancy at that age is about 24 more years for men and 27 more years for women) men have about 15 more years of sexually activity and women have only ten. But there are MANY reasons why that might be. Let me also say that the study discusses any sexual activity, satisfying sexual activity, interest in sexual activity and frequency of sexual activity. Also, I did not read every word of this study, but in what I did read, I could not find any statement on whether or not this was only a heterosexual study, but it appears to be.

So, men who are healthy in middle age tend to live longer than men who are not. These men are usually married in later life and engage in sex with that partner on a pretty regular and satisfying basis. Men in this group have more interest in sex than women tend to at the same age, and also have options for enhancing their sexual ability through the use of pharmaceutical therapies.

On the other hand, many women who are in old old age, 80 and up - tend to be widowed and thus do not report sexual activity as it seems that in the group of people studied, having a partner (or being in a relationship) was one of the biggest predictors of sexual activity.

Men who are in poor health do not share the same sexually active life expectancy. Women, even unhealthy women, tend to live longer than men. Women's sexual health has not gotten the same attention as men's, but perhaps this study will provide some impetus for that. OF note, women have hormonal shifts in late middle age that lesson sexual desire and enjoyment - this is something that may be addressed in the future.

In this study they did find that men's attitudes now are very different than they were ten years ago and that this could be related to ED drugs.