This is the 14th edition of The 2 Susans, a monthly newsletter with Dr. Susan Baumgaertel and Dr. Susan Vogler.
This month we focus on two important vaccines. The first is to prevent human papillomavirus (HPV) which can lead to cervical cancer. The second is to reduce the chances of varicella-zoster virus (VZV) causing shingles.
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Susan V:
HPV vaccination: The key to preventing cervical cancer
Cervical cancer can be prevented by getting vaccinated against HPV, having regular cervical cancer screenings, and ensuring timely follow-up treatment. The success of cervical cancer treatment largely depends on prevention and early detection.
When is the optimal time for women to begin screening, and how does the approach to screening change as we age?
Although women need to consult with their medical professionals to determine the most appropriate screening based upon their personal health history and risk factors, here are the guidelines as recommended by the American College of Obstetricians and Gynecologists (ACOG):
- Age 21-29 years, Pap smear every three years
- Age 30-65 years, Pap smear every three years, HPV testing every five years, or Pap smear and HPV testing every five years
- After 65 years, screening is discontinued if there is no history of high-grade lesions or cancer and there have been adequate negative screenings.
Should I get the HPV vaccination?
Across the world, cervical cancer is the fourth most common cancer in women, with approximately 660,000 new cases and 350,000 deaths in 2022. The highest incidence of cervical cancer is among low- and middle-income countries, at least in part due to the lack of access to health care resources, vaccinations, screening, and treatment. In most cases, cervical cancer is caused by the persistent infection of the human papillomavirus, commonly referred to as HPV.
Cervical cancer is largely preventable with proper screening for early detection and the HPV vaccine to protect against the types of HPV that most often cause cervical cancer. The HPV vaccine is recommended for preteens but can also be given up to age 45 years.
The HPV vaccine significantly reduces the incidence of genital cancers including cervical, vaginal, vulvar, and anal disease caused by these HPV types. HPV vaccines are among the most effective vaccinations available worldwide, and data demonstrate that they are greater than 99% effective when administered to women who have not been previously exposed.
According to the Centers for Disease Control and Prevention, infections with HPV types that cause most HPV-related cancers and genital warts have dropped 88% among teen girls and 81% among adult women. Additionally, among vaccinated women, the percentage of cervical precancers caused by HPV types most often linked to cervical cancer has dropped by 40%.
Taking proactive steps such as getting the HPV vaccination and adhering to recommended screening guidelines can significantly reduce the risk of developing cervical cancer. Consult with your medical professional to determine the best approach for your health needs and ensure you are protected.
Stay informed, stay healthy, and take charge of your well-being!
Sources:
American College of Obstetricians and Gynecologists (ACOG) Practice Advisory, April 2021, ‘Updates Cervical Cancer Screening Guidelines’
American College of Obstetricians and Gynecologists (ACOG) Committee Opinion, Number 809, August 2020
National Cancer Institute
Centers for Disease Control and Prevention (CDC)
American Cancer Society
World Health Organization (WHO)
Art in Bloom exhibit at Museum of Fine Arts, Boston. Photo credit: Dr. Susan Vogler on May 2, 2025.
Susan B:
Shingles
What is shingles?
Shingles is reactivation of dormant chickenpox virus. As a kid in the 1960s, I recall that some parents had chickenpox parties—no joke! Their hopes were that their child would get chickenpox from another child who had an active case. This way they would “get it over with.” Less was known in that era about the dangers of contracting chickenpox which include pneumonia, encephalitis and even death. Thanks to scientific advances—vaccines!—these pox parties are now considered dangerous and are discouraged.
The virus that causes chickenpox (varicella) lives dormant in the body forever. It can reactivate years or decades later, often as one ages, experiences stress or develops illness. This reactivation produces shingles. Shingles is typically a painful rash on the skin, staying in a region that follows a specific nerve pathway such as on the face, the chest, and the back.
Is shingles contagious?
In most cases, the answer is no. However, people who have never had chickenpox, have never had the vaccine, have lost immunity to varicella over time, or are immunosuppressed can be vulnerable to this virus if they come into contact with the blistering skin rash.
Is there a way to prevent shingles?
Yes! The first shingles vaccine was Zostavax. This live vaccine is no longer used in the U.S. and has been replaced by Shingrix, which is an inactivated (non-live) vaccine. This shot is given in two doses, 2-6 months apart. This is unrelated to the chickenpox vaccine which is typically given to kids, adolescents and adults who haven’t yet been vaccinated, and also to certain high-risk adults.
Who should get the shingles vaccine?
Anyone 50 and older should get the shingles vaccine. Younger people who have weakened immune systems also benefit. The risks of developing shingles increases with age.
How is shingles treated?
Antiviral medications can help reduce the length and severity of a shingles outbreak if started early in the course, soon after a rash appears. Delaying a diagnosis may prolong the outbreak. Pain management is important as shingles can be quite painful. Postherpetic neuralgia can sometimes develop, causing prolonged or even permanent pain in the region of the affected nerve.
Vaccines work! Please consult your physician if you think you’d benefit from Shingrix.
Near Egilsstaõir, Iceland. Photo credit: J. Osako on June 13, 2025.
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To read our June edition, Women’s Health: Representation & Research, just click here.
📆 Our August edition will focus on Osteoporosis & bone health. 🦴
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📝💬 The 2 Susans would love to hear from you!
Let us know the women’s health & aging topics YOU are curious about. Please also share this newsletter in your network and tag us—we are so grateful.
Susan B: susan@mymdadvocate.com
myMDadvocate | MenopauseMenu | The Menopause Menu book | LinkedIn
Susan V: susan@voglermedical.com
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The 2 Susans newsletter is for informational purposes only. It does not represent medical advice and is not intended as a substitute for professional advice, diagnosis, or treatment. Always consult with your private physician.