Effect of the Menstrual Cycle and Hormonal Contraceptives on Human Papillomavirus Detection in Young, Unscreened Women

Schmeink, Channa E.; Massuger, Leon F.A.G.; Lenselink, Charlotte H.; Quint, Wim; Melchers, Willem J. G.; Bekkers, Ruud L.M.

doi:10.1097/aog.0b013e3181e238f0

Cited by 18 publications

(19 citation statements)

References 31 publications

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“…After controlling for plausible confounding factors, prolonged oral contraceptive consumption was found to be inversely associated with the risk of CIN in Australian women, consistent with a previous report of a decreased risk of CIN with use over 5 years [17]. The potentially protective mechanism may be attributable to the hormonal effect of oral contraceptive on HPV DNA expression and the viscosity of the cervical mucus [18,19]. Estrogen can protect the mucosal immune system against early HPV infection [17], while the viscosity of the mucus affects the penetration of foreign bodies including HPV [19].…”

Section: Discussionsupporting

confidence: 83%

“…The potentially protective mechanism may be attributable to the hormonal effect of oral contraceptive on HPV DNA expression and the viscosity of the cervical mucus [18,19]. Estrogen can protect the mucosal immune system against early HPV infection [17], while the viscosity of the mucus affects the penetration of foreign bodies including HPV [19]. The inverse association of the risk of CIN with long term oral contraceptive consumption could also be due to the relatively stable sexual relationships among middle-aged women, who tended to prefer oral contraception to the use of condoms [20].…”

Section: Discussionmentioning

confidence: 99%

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Condom and oral contraceptive use and risk of cervical intraepithelial neoplasia in Australian women

et al. 2014

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ObjectiveTo assess the association between condom use and oral contraceptive consumption and the risk of cervical intraepithelial neoplasia (CIN).MethodsA cross-sectional study was conducted in Perth clinics. A total of 348 women responded to the structured questionnaire. Information sought included demographic and lifestyle characteristics such as the use of condom for contraception, consumption of oral contraceptive, and duration of oral contraceptive usage. Crude and adjusted odds ratio (OR) and associated 95% confidence interval (CI) were calculated using unconditional logistic regression models and reported as estimates of the relative risk.ResultsThe prevalence of CIN was found to be 15.8%. The duration of oral contraceptive consumption among women with abnormal Papanicolaou (Pap) smear result indicating CIN was significantly shorter than those without abnormal Pap smear result (mean±SD, 5.6±5.2 years vs. 8.2±7.6 years; p=0.002). Comparing to ≤3 years usage, prolonged consumption of oral contraceptive for ≥10 years reduced the risk of CIN (p=0.012). However, use of condom for contraception might not be associated with a reduced risk of CIN after accounting for the effects of confounding factors (adjusted OR, 0.52; 95% CI, 0.05 to 5.11; p=0.577).ConclusionUse of oral contraceptives, but not condoms, for contraception appeared to be inversely associated with CIN. Prolonged use of oral contraceptive demonstrated its benefits of reducing the risk of CIN.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Condom and oral contraceptive use and risk of cervical intraepithelial neoplasia in Australian women

et al. 2014

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“…28,29 HPV detection with self-sampling showed a good concordance with physician-sampling, and is highly accepted by women. Self-sampling is therefore a suitable method to study HPV incidence and clearance among a large group of young women.…”

Section: Methodsmentioning

confidence: 99%

“…Due to small numbers of re-infection/reactivation, potential factors of influence could not be analyzed. The mean age of the women was 23.5 years [18][19][20][21][22][23][24][25][26][27][28][29]. At baseline almost all women (94.3%) were sexually active and the mean sexual age (i.e., years of being sexually active) was 6.8 years .…”

Section: Discussionmentioning

confidence: 99%

Prospective follow‐up of 2,065 young unscreened women to study human papillomavirus incidence and clearance

Schmeink

Massuger

Lenselink

et al. 2013

Intl Journal of Cancer

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Human papillomavirus (HPV) is a necessary factor in the development of cervical intraepithelial neoplasia and cervical cancer. However, HPV is also a very common sexually transmitted virus and many women clear their infection. To study HPV incidence and clearance, 2,065 women, aged 18-29 years, were followed for 12 months and were asked to provide a self-collected cervicovaginal sample and fill-out a questionnaire every 3 months. For HPV DNA detection, the SPF 10 -DEIA LiPA 25 system was used. Incidence rates of any-type high-risk HPV and low-risk HPV were 17.0 per 1,000-person months, and 14.3 per 1,000-person months, respectively. HPV types 16, 52, 51 and 31 had the highest type-specific incidence rates. HPV incidence was increased in singles, and women having a new relationship. A higher number of lifetime sex partners, and a higher frequency of sexual contacts in the past 3 months was associated with an increased HPV incidence. The overall clearance of the newly detected typespecific high-risk HPV infections and low-risk HPV infections was 61.2% and 69.0%, respectively. Having a sexual relationship compared to being single, and a higher sexual age both positively influenced the clearance of any-type high-risk HPV. Among the women infected with HPV 16, the women who had a co-infection had a lower proportion of clearance of HPV 16. In conclusion, in this young Dutch study population, HPV incidence rates are not related to age and comparable to other western countries. Clearance was only independently related to factors associated with sexual behavior, either past or current.It is generally accepted that a persistent human papillomavirus (HPV) infection is the necessary cause of cervical cancer. Acquisition of an HPV infection is therefore the main precursor of the series of events that eventually lead to cervical cancer.1-4 Fortunately, most of the acquired HPV infections are transient and clear spontaneously within 12 months after first detection, and about 90% of the women will have cleared their HPV infection within 24 months. [5][6][7][8][9][10][11][12][13] HPV is a very common sexually transmitted virus, mainly acquired early in sexual life.14,15 Rates of acquiring an HPV infection are high following first sexual intercourse, and with each new sexual partner. 7,16,17 The risk factors associated with acquiring an HPV infection are therefore mainly related to the individuals sexual behavior. 18HPV prevalence, however, is not only influenced by sexual activity but also varies by age and geography, as shown by the International Agency for Research on Cancer (IARC) and others. [19][20][21] Young women have high rates of HPV acquisition, and incidence tends to decline with age. 10,17,22,23 Whether age is also related to the duration of the infection remains controversial. Some studies report that there is no influence of age on the clearance rate of the HPV infection. 10,24,25 Whereas other studies report a lower clearance rate with increasing age, 26,27 or in contrary a faster clearance rate in older women (>4...

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“…[1][2][3][4][5][6] A recent study exploring the effect of oral contraceptive (OC) use on HPV detection revealed a higher detection rate during the follicular phase among non-users, whereas OC users experienced a higher detection rate during the luteal phase. 7 Using data collected in the Ludwig-McGill cohort study conducted in Brazil, we evaluated the effect of menstrual phase on HPV detection, and attempted to validate previous findings concerning OC use.…”

Section: Introductionmentioning

confidence: 99%

Cervical human papillomavirus detection is not affected by menstrual phase

et al. 2012

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Objectives In many settings, human papillomavirus (HPV) DNA testing already plays an important role in cervical cancer screening. It is unclear whether hormonal fluctuations associated with menstrual phase or oral contraceptive (OC) use have any effect on HPV detection. We evaluated the effects of OC use and timing of cervical sampling in relation to women’s last menstrual period (LMP) on HPV detection, and viral load in the Brazilian Ludwig-McGill cohort study. Methods Women in the cohort were followed every 4–6 months, and at each clinic visit they were asked to complete a questionnaire and to provide a cervical sample for HPV testing. Specimens from 6093 patient visits (n = 2209 women) were categorised according to date of LMP into four distinct phases: follicular (days 5–9), midcycle (days 10–15), luteal (days 16–22), or late luteal (days 23–31). Results Compared with follicular phase (referent group), HPV detection did not differ according to reported LMP for midcycle (OR = 1.14, 95% CI 0.95 to 1.37), luteal (OR = 1.03, 95% CI 0.85 to 1.25), or late luteal menstrual phase (OR=1.01, 95% CI 0.83 to 1.24), and was also not influenced by OC use. Analyses restricted to high-risk HPV types (grouped) and HPVs 16 and 18 (separately), produced similar non-significant associations. For HPV-positive samples, we found that the menstrual phase did not influence the total viral load. Conclusions These results indicate HPV detection is not associated with menstrual phase. Our findings suggest that standardising the timing of specimen collection for HPV testing is not necessary.

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Effect of the Menstrual Cycle and Hormonal Contraceptives on Human Papillomavirus Detection in Young, Unscreened Women

Cited by 18 publications

References 31 publications

Condom and oral contraceptive use and risk of cervical intraepithelial neoplasia in Australian women

Condom and oral contraceptive use and risk of cervical intraepithelial neoplasia in Australian women

Prospective follow‐up of 2,065 young unscreened women to study human papillomavirus incidence and clearance

Cervical human papillomavirus detection is not affected by menstrual phase

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