HPV vaccine really affects menstruation! Should ordinary people get it?
2024-07-27
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Many female friends have observed changes in menstruation after receiving the HPV vaccine. Some people have irregular menstruation, but some people have always had regular menstruation, but they also experience changes in menstruation after receiving the HPV vaccine. This cannot be completely explained by accidental influences such as psychological factors and environmental factors.
As more and more people report menstrual problems, those who originally planned to get the HPV vaccine may have doubts: Does the HPV vaccine really affect menstruation? Is it still possible to get the vaccine?
Let me start with the conclusion: HPV vaccine may indeed affect menstruation, but don’t worry too much. You still have to get it.
How the HPV vaccine works
There is a capsid protein in the HPV virus called L1 protein, which not only mediates the initial binding of the HPV virus to the cell, but is also highly conserved.High conservation means that L1 protein is very stable during the replication and proliferation of HPV, so it can be used as a characteristic protein to identify HPV. Based on this theory, existing HPV vaccines use yeast, E. coli, etc. as carriers to produce proteins with similar structures to L1 proteins, thereby inducing the immune system to form memory of HPV L1 protein and achieving the purpose of preventing HPV infection.Copyright images in the gallery. Reprinting and using them may lead to copyright disputes.
The L1 protein structures of different HPV viruses are different, so the HPV vaccine can prevent different HPVs, and it contains the L1 protein analogs of those HPVs respectively.These proteins used to make vaccines are called virus-like particles.（virus-like particle, VLP）They are not pathogenic and have no replication function. They are just fakes that trick the immune system into remembering the real ones.Therefore, from the perspective of mechanism of action, HPV vaccine is essentially no different from many other common vaccines. They all use specific ingredients to induce the immune system to form memory, thereby achieving immune response.PathogensEffect.In this case, it stands to reason that the immune system should be busy after receiving the HPV vaccine, and menstruation is the result of regulation of the reproductive endocrine system, so how could it be affected?Vaccines may really affect menstruation
But don't worry too much
Many people experience changes in menstruation after receiving the HPV vaccine. Some surveys and studies have observed an increase in abnormal menstruation events after receiving the HPV vaccine. The instructions for a certain nine-valent HPV vaccine also note the possible adverse reactions of "dysmenorrhea" and "irregular uterine bleeding." In addition to the HPV vaccine, other vaccines have also been reported to cause changes in menstruation after vaccination.Therefore, although the act of active immunization such as vaccination does not seem to affect menstruation in theory, we cannot easily deny the possibility that it affects menstruation.Copyright images in the gallery. Reprinting and using them may lead to copyright disputes.
Some researchers speculate that some immune cells and immune factors are involved in the formation and shedding of the endometrium. Some people experience changes in menstruation after vaccination. This may be because when the immune system responds to the vaccine, the activated immune cells and immune factors also affect the endometrium of that menstrual cycle.Fortunately, most of the menstrual changes caused by vaccination are within the range that the body can tolerate and can quickly return to normal. HPV vaccines have not been found to cause any damage to the reproductive system or fertility.A meta-analysis involving more than 1.25 million patients showed that the risk of ovarian insufficiency (commonly known as premature ovarian failure) did not increase after HPV vaccination. Instead, due to the HPV vaccine's preventive effect on HPV infection, it is beneficial for protecting fertility.However, some studies have found that although the chance of seeking medical attention due to menstrual problems increases after vaccination, after comparison and statistical analysis, menstrual problems have not become more significant after vaccination. The researchers analyzed that it may be that HPV vaccine recipients are worried that the vaccine will affect menstruation, which increases their attention to menstruation and thus increases their tendency to seek medical attention.In general, based on current medical research results, menstrual abnormalities do occur after vaccination, but it is not certain whether this is due to the influence of the vaccine or attention bias.However, even if the menstrual abnormalities are indeed caused by the vaccine, there is no need to worry, as the effect will generally recover quickly.If you are really worried, or if you have not returned to normal in more than 3 months, go to the hospital, because you may have been affected by the vaccine, or the disease may have occurred at this time. It is always a good idea to care more about your health.Should I get the HPV vaccine?
The WHO Global Advisory Committee on Vaccine Safety has repeatedly confirmed the safety of HPV vaccines after comprehensively evaluating a large number of studies, stating that the benefits of HPV vaccination outweigh the risks. The committee collected data from multiple countries based on a large population level, and not only ruled out the risk of premature ovarian failure that many people are concerned about, but also ruled out complex regional pain syndrome. (CRPS)Postural tachycardia syndrome (POTS), venous thromboembolism, Guillain-Barré syndrome and other risks, and also confirmed that the HPV vaccine will not cause worrying autoimmune safety issues.Although HPV vaccination is still recommended to be postponed during pregnancy for safety reasons, after evaluating hundreds of thousands of cases of accidental HPV vaccination during pregnancy, the committee concluded that accidental HPV vaccination during pregnancy has no known adverse consequences for the mother or baby.Copyright images in the gallery. Reprinting and using them may lead to copyright disputes.
In general, the safety of HPV vaccines is highly guaranteed, and in areas where HPV vaccination programs are effectively implemented, the benefits are also very obvious.Several countries that have introduced HPV vaccines into their immunization programs have reported a 50% decline in the incidence of cervical precancer in young women. In contrast, in Japan, where HPV vaccination is not actively recommended, cervical cancer mortality increased by 3.4% from 1995 to 2005. This acceleration in disease burden was particularly evident among women aged 15 to 44 years.So, although the HPV vaccine may indeed affect menstruation in the short term, considering its reliable safety and extremely high health benefits, I still recommend that all eligible people try to get the HPV vaccine.[1] Nesterova AP, Klimov EA, Zharkova M et al. Chapter 2 - Infectious diseases. 2020:35-94. doi:10.1016/B978-0-12-817086-1.00002-6.
[4] Gardasil 9 [prescribing information]. Whitehouse Station, NJ: Merck & Co., Inc.; 2022.
[6] Male V. Menstrual changes after covid-19 vaccination. BMJ. 2021;374:n2211. Published 2021 Sep 15. doi:10.1136/bmj.n2211
[7] Wise LD, Wolf JJ, Kaplanski CV, Pauley CJ, Ledwith BJ. Lack of effects on fertility and developmental toxicity of a quadrivalent HPV vaccine in Sprague-Dawley rats. Birth Defects Res B Dev Reprod Toxicol. 2008;83(6):561-572. doi:10.1002/bdrb.20174
[8] McInerney KA, Hatch EE, Wesselink AK, et al. The Effect of Vaccination Against Human Papillomavirus on Fecundability. Paediatr Perinat Epidemiol. 2017;31(6):531-536. doi:10.1111/ppe.12408
[9] Torella M, Marrapodi MM, Ronsini C, et al. Risk of Premature Ovarian Insufficiency after Human Papilloma Virus Vaccination: A PRISMA Systematic Review and Meta-Analysis of Current Evidence. Vaccines (Basel). 2023;11(1):140. Published 2023 Jan 9. doi:10.3390/vaccines11010140
[10] Suzuki S, Hosono A. No association between HPV vaccine and reported post-vaccination symptoms in Japanese young women: Results of the Nagoya study. Papillomavirus Res. 2018;5:96-103. doi:10.1016/j.pvr.2018.02.002
Author: Doctor Feidao Duanyu
Reviewer: Lan Yibing, deputy chief physician, Department of Obstetrics and Gynecology, Zhejiang University School of Medicine
Planning丨Fu Sijia
Editor: Fu Sijia
Proofread by Xu Lai and Lin Lin
The cover image and the images in this article are from the copyright library
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