HPV Vaccine and Safe Sex in Menopause

HPV Vaccine and Safe Sex in Menopause

Are you too old for the HPV vaccine? Maybe not…

Human papillomavirus (HPV) is a very common, insidious, sexually transmitted infection that is typically benign. Men and women can be HPV carriers and pass the virus unknowingly to their sexual partners through vaginal, oral, or anal sex even if they have no symptoms. There is no test other than a pap exam to determine who is a carrier and who is not. There are over 40 types of HPV, but only a few strains are problematic. Two strains, 6 and 11, are benign but cause genital warts. Several HPV strains (16, 18, 31, 33, 45, 52, and 58) are considered high-risk because they are responsible for most cases of cervical, vulvar, and vaginal cancers in women, penile cancer in men, and anal, oropharyngeal, head and neck cancers in both men and women. 

Fortunately, there are effective vaccinations now to prevent HPV for all genders up to age 26. The U.S. Centers for Disease Control and Prevention (CDC) recommends shared decision-making about the HPV vaccination on a case-by-case basis for sexually active adults up to age 45 who may be at risk. But what about sexually active women older than age 45 with new partners? HPV vaccines are not licensed in the U.S. for women or men over age 45. However, in Canada, the National Advisory Committee on Immunizations (NACI) recommends HPV vaccination for ALL at-risk men and women regardless of age. 

Many women who are beginning or beyond the menopause transition are sexually active with one or more new partners. These women may experience vaginal dryness, putting them at risk for microtears during sexual activity, allowing pathways for viruses and other pathogens to enter the bloodstream. Good lubricants, condoms, and other means of protection certainly help, but for some women, the peace of mind from the added protection of a vaccine to prevent HPV-related cancer risks for themselves or their partner(s) may be worth considering. If so, consult with your provider about your concerns and individual risk factors to see if the HPV9 vaccine might be the right choice for you. The HPV9 vaccine targets all high-risk strains responsible for HPV-related cancers and the two strains responsible for genital warts. It has been proven to be highly effective in reducing HPV infections.

If you have been previously diagnosed with HPV, you may still benefit from the HPV9 vaccine to reduce your risk against any of the nine primary virus strains that you don’t have. Ask to have your HPV genotype assessed to determine which strain(s) you have. 

One caveat… Research on the vaccine’s effectiveness for women over age 45 is lacking. Therefore, insurance will not likely cover the cost of vaccination in adults over age 45 because it is considered off-brand or experimental. The HPV9 three-shot vaccine series averages $750 or more, depending on your area, so cost is another consideration. Your physician will likely want to see you for follow-up exams annually for a few years to determine whether you continue to test negative for HPV after vaccination. 

Protection from HPV is an important health consideration for all sexually active women in new relationships, even after menopause.