Cervical Cancer: Screening Is The Key To Prevention

Cervical Cancer Screening

Cervical cancer is cancer in the tissues of the cervix, the organ that connects the uterus with the vagina, and is a major cause of cancer mortality among women, with over a quarter of the burden borne by developing nations like India. Almost all cases of cervical cancer are caused by the human papillomavirus or HPV.

The good news is cervical cancer can very often be prevented through periodic screenings like Pap and HPV tests to detect the disease at a pre-cancerous stage and treat it effectively. If detected at an early stage, chances of a complete cure are a staggering 85%. The HPV vaccine can also help prevent cervical cancer. Nearly 93% of cervical cancers could be prevented through screening and vaccination.

Hence, the criticality of screening can hardly be overemphasized. Regular screening can help detect abnormal cervical cell changes and treat the condition before it develops into full-blown cervical cancer, thus potentially saving so many lives. In India, surprisingly, in spite of the high incidence, there isn’t any centrally mandated national screening programme. All the more reason to be on your guard and go for regular screening proactively…

There are two types of cervical cancers: one is Squamous cell cervical cancer or cancer on the outer surface of the ectocervix, which projects into the vagina, and the other one is adenocarcinoma of the cervix or cancer of the endocervix, the inner region of the cervix.

What are the cervical cancer screening procedures?

  • HPV test: Sample cells harvested from the cervix are tested for strains of HPV, the most common cause of cervical cancer. The test can also be performed on sample cells self-collected from the vagina. HPV tests are either done in isolation or in tandem with Pap tests.
  • Pap test: The Pap test or Pap smear is the most common screening tool used to detect early cell changes that could develop into cervical cancer. A Pap test is performed on sample cells collected from the cervix and is often part of a routine gynaecological workup or a pelvic examination.
  • Clinical examination with acetic acid: In this simple method, the doctor applies a dilution of white vinegar on the cervix to look for any red flags or unusual markers.

Are there any known risk factors for cervical cancer?

HPV, mostly sexually transmitted, is the main cause of cervical cancer, with HPV-16 and HPV-18 accounting for almost 70% of cases worldwide. Some other known factors include:

  • Family history of cervical cancer
  • Compromised immune system
  • History of smoking
  • Uncontrolled and prolonged stress
  • Contraceptive pills might also raise the risk
  • HIV infection
  • Obesity
  • Multiple full-term pregnancies

What are the early warning signs of cervical cancer?

Most often, there are no symptoms at all. Still, watch out for and see a doctorif you experience any of the following:

  • Abnormal vaginal bleeding
  • Unusual, continuous vaginal discharge
  • Pain during sexual intercourse or in the pelvic region

The problem is that the cervical cancer disease is often asymptomatic till it becomes full-blown and invasive, when one experiences symptoms like unusual bleeding after sexual intercourse, post-menopause or in between periods. Many women are prone to miss or dismiss the early warning signs, which can prove really costly, even fatal. Hence, it’s absolutely vital to go for periodic screenings so that the disease can be detected at a pre-cancerous stage and treated to achieve total cure. In this light, efforts to increase awareness about the different screening tools for cervical cancer including Pap smear and HPV test must be increased. In resource-poor countries like India, at least visual screening should be promoted and integrated into the primary healthcare programme.

Impact of Thyroid Disorder on Fertility

hypothyroidism and infertility

Our thyroid gland produces hormones that control our metabolism which is responsible for vital functions. Thyroid disorders are a clutch of conditions when this very important gland malfunctions, resulting in either too much (hyperthyroidism) or too little (hypothyroidism) production of thyroid hormones.

Can thyroid disorders interfere with fertility?

Hypothyroidism is sometimes associated with infertility among women, since low levels of these hormones could impair fertility by impeding the release of an egg from the ovary.

Hypothyroidism is often precipitated by an autoimmune disorder or pituitary disorder, which in itself might cause a roadblock to fertility. There’s also a risk of early miscarriage because of lack of implantation. Having said that, hyperthyroidism can also impact fertility. While thyroid disorders and fertility issues are more often than not linked to women, sometimes the male partner is also affected since these conditions could damage sperm quality and hinder motility, besides reducing semen volume.

What are some common symptoms of hypothyroidism?

  • Heavy or frequent periods
  • Feeling tired and sore all the time
  • Dryness of skin and hair, thinning hair
  • Tendency to forget things
  • Hypersensitive to cold
  • Tendency to put on weight
  • Constipation

How can hypothyroidism impact fertility?

  • It can disrupt the menstrual cycle, rendering conception difficult
  • It can impede ovulation or release of an egg from the ovary
  • It raises the risk of miscarriage
  • It can result in pre-term birth

Can hyperthyroidism impact fertility too?

Yes, hyperthyroidism, which is often caused by an autoimmune disorder called Graves’ disease, can also impact fertility, in pretty much the same ways as hypothyroidism, like disturbing the periods, raising the risk of miscarriage and premature birth, etc.

How important is it to have thyroid disorders treated?

It is extremely critical to have your thyroid disorder medically evaluated and treated before you plan to have kids. It can reduce the risks related to pregnancy. For women, correcting infertility is hugely dependent on addressing hypothyroidism.

The treatment protocols for a dysfunctional thyroid would vary from patient to patient, depending on the severity of the condition and symptoms. More often than not, these disorders are treated with medication and regular monitoring. Close surveillance and follow-up will be the key. Very rarely does a thyroid disorder require surgery.

Women trying for pregnancy with hypothyroidism should work in tandem with a fertility expert for proper monitoring and cutting risks. Sometimes when hypothyroidism is corrected and yet the fertility problem remains, some other intervention could be required, which your fertility expert can then suggest.

So please remember that the thyroid gland could be tiny in size, but mammoth in its significance. So ignore symptoms of thyroid dysfunction at your own peril. Very often, the early warning signs of a dysfunctional thyroid are not heeded, which can result in fertility issues later.

So if you are experiencing irregular periods or any of the symptoms mentioned above, please see your doctor without procrastinating. The more you delay diagnosis, the more the chances of complication with your pregnancy, while an early detection of a thyroid condition will enable your doctor to prescribe medication in time, boosting your chances of hassle-free conception.

A few critical points to remember:

  • Let your doctor know if you are planning to conceive
  • Thyroid disorders are highly treatable and pregnancy shouldn’t be a problem once the condition is corrected
  • If you have received treatment for Graves’ disease, there’s a slim chance that your baby might suffer from a temporary phase of hyperthyroidism. This can, however, be treated
  • Do not alter your medication dosage without consulting your doctor if you are being treated for hyperthyroidism
  • You can have a passing disorder called postpartum thyroiditis, which often dissipates without any treatment
  • If there’s a family history of thyroid disorders, do consult your doctor before planning a pregnancy

In situations where a couple fails to conceive even after normalizing the thyroid levels post lifestyle modifications and medications, assisted reproduction provides an effective solution. In-vitro fertilization (IVF), Intra uterine insemination (IUI) and Intracytoplasmic sperm injection (ICSI) are recommended procedures that can help in inducing pregnancy and reducing chances of miscarriage.