Monday, April 7, 2014

Integrative Medicine Approaches to HPV Infection

Jean Wisgirda, MD
Commonwealth Ob/Gyn Specialists  
For many women, the following is a familiar scenario: you saw your doctor for a routine gynecologic exam, and were notified that your Pap smear showed the presence of high-risk HPV (Human Papillomavirus).  Otherwise, your Pap smear did not show any abnormal cells, and you were advised to come back in a year for another Pap smear.  Or maybe there were abnormal cells, and a procedure called colposcopy was recommended, done, and the cellular changes seen were minor.  No treatment was recommended, but careful follow-up with another Pap smear was planned.  You and your doctor are waiting for this viral infection to run its course and, hopefully, to disappear.

So, what can you do to help your body heal from the infection?

HPV is not new. Papillomavirus causes our cells to make warts, and warts have been around for as long as we can imagine. There are over 100 different HPV strains, with about 40 infecting the genital tract.  Some are external and look like warts, others are flat and are not visible unless the slight skin thickening they cause is brought out by application of acetic acid and/or inspection with magnification. Some cause benign changes and are called “low risk,” and others are “high risk,” meaning that their presence has been found in cervical cancers.

The connection between HPV and cervical cancer was not recognized until the mid-1980’s. Today, we know that HPV is actually the inciting factor that underlies essentially all cervical cancers, and up to 80% of American women will have been infected with HPV by the age of 50. The majority of high risk HPV infections never lead to cancer and 80% to 90% of new HPV infections will clear on testing over 2 years because our immune system works to immobilize the virus and heal the cellular changes that HPV creates.

The time course from HPV infection to cervical cancer typically is 10-20 years, and is most likely to happen in women whose bodies do not clear the virus, rather, chronically carrying it.  This means that when changes are very early and mild, there is time to introduce steps to assist the immune system in doing its job to clear the infection.  These steps all revolve around maintaining a healthy lifestyle.

Quit smoking now. The biggest lifestyle risk associated with progression of HPV infection to cervical cancer is cigarette smoking. It is estimated that cigarette smokers have 3 ½ times the cervical cancer risk of nonsmokers.  HPV infection is the inciting factor for cervical cancer, but the toxins in cigarettes are promoters of cervical cancer.  Quitting smoking is the healthiest step you can take to help heal yourself from HPV.

Eat plenty of colorful vegetables and fruits. Several studies have shown that women who have good levels of beta carotenes and folate in their blood also have less chance of developing precancerous changes. However, these women did not use supplements. They got these healthy levels of antioxidants by eating plenty of foods that are naturally high in them.  Studies using beta carotene and folic acid SUPPLEMENTS did NOT show any advantage. It seems that other substances exist in the foods themselves that are beneficial, alone or in concert with the antioxidants, for fighting off the HPV virus and reversing early abnormal cellular changes. Other studies have shown some preliminary evidence that the antioxidants EGCG (epigallocatechin-3-gallate), glucosinolates, and indole-3-carbinol show activity against HPV infected cells, though more clinical studies need to confirm a definite beneficial link. Foods containing other antioxidants (Vitamins C and E, flavonoids, and polyphenols, for example) may also help boost immunity and have been found to help decrease risk of some other cancers. Lastly, a very recent study looking at the effect of a shiitake mushroom extract on HPV infected mouse cells showed antiviral effect, both on the cells in the lab and in infected mice. Studies are presently being done to see if the benefits translate clinically to women as well.  

Adopt lifestyle behaviors that strengthen your immune system. Chronic stress and negative emotions have been shown to decrease the ability of the immune system to fight off disease.  In contrast, positive emotions will strengthen immunity. Learning to manage stress through exercise, meditation, hobbies, and nurturing supportive and caring relationships with friends and family will also contribute to improved immune function.  This includes getting regular and adequate sleep.  It is also advisable to avoid excessive amounts of sugar (pervasive in highly processed foods) and alcohol, which can both adversely affect immune function.

One final thing to consider is that post-diagnosis is not a good time to become involved in a new sexual relationship, since this opens up the possibility of a new infection with a different HPV strain. If you are 26 years old or younger, you may be eligible for the Gardasil immunization. While not conferring benefit for the HPV infection you already have, it would help protect you from any of the four most virulent strains to which you have not been exposed. It should especially be noted that more significant, precancerous changes in the cells do need to be treated directly by your doctor, but you can use the same lifestyle and diet strategies to assist your body in healing from the underlying condition.


The approach to healing HPV infection with either normal cells or mild cellular changes on Pap test is essentially watchful waiting and careful follow-up over months to several years with your practitioner.  This can be done safely, and healing can be optimized by adopting healthy habits and eating a nutritious, plant-abundant diet.  

For further inquiries about Integrative Medicine, HPV Infection, or general gynecological concerns, contact Jean Wisgirda, MD, of Commonwealth Ob/Gyn Specialists, at 804.285.8806.