A new patient came to see me this week, concerned about the fact that her period was a little over a month late.
After ruling out the obvious (no babies), we ran some labs. A few days later, she returns to review her test results (yay normal!) and she presents me with this, the real reason she’s worried: she had her first dose of the HPV vaccine two months ago. And she’s been hearing some stuff about Big Bad Things happening to young people everywhere because of it. In fact, she’d read something somewhere about a girl who went into MENOPAUSE after she received it. Could Gardasil be the reason her period is overdue? Will she ever have a period again???
Let’s see. In the past two months she’s also moved to a new country, started a graduate program, been ROBBED (ugh – thanks for nothing, Big City), and engaged in several other unspecified interpersonal conflicts. In other words, she’s been going through a rough stretch. I’m thinking that maybe, just maybe, there might be a few other things going on in her life right now that could be affecting the regularity of her menstrual cycle besides the HPV vaccine.
But here’s the thing. Even though I’m absolutely confident in saying that it’s highly (HIGHLY) unlikely that the vaccine had anything to do with her menstrual issue, can I say that there’s 0% chance? That it’s completely, unequivocally impossible? Well, no. But only because I’m almost never willing to commit to 0% or 100% certainty on anything. (See how even there, I said almost?) Because SCIENCE DOESN’T WORK THAT WAY.
This can prove to be a problem. Because it means that when you’re talking to someone who’s unfamiliar with how the research process DOES work, saying things like “it’s highly unlikely that” or “there’s no evidence to suggest that” or “no more frequently than placebo” may be accurate, but they can also sound suspiciously like “I’m not sure. Maybe?”
And if you’re, say, a cynical manipulative media type desperate to remind people that you have a daytime talk show no one seems to know exists (*cough* katie couric *cough*) then all you have to do is book a few sad stories for an episode that exploits this disconnect between perception and reality - because apparently a couple of anecdotes without any confirmed link to the vaccine in question are equivalent in relevance to an enormous and growing scientific evidence base - and before you know it, hey, people are talking about you again! Win!
Back to my patient. What I said was this: there is zero evidence or theoretical support, at this time, for a link existing between the HPV vaccine and anything scary whatsoever, including a late period. And, what we DO know is that the vaccine is highly effective at preventing HPV. Which is associated with the development of the vast majority of cervical (and vaginal, and vulvar, and anal, and oropharyngeal, and penile) cancer. And which you’re practically guaranteed to be exposed to if you plan on being sexually active with another human being at any time in your life, ever.
So, yes. You should most definitely plan on coming back for dose #2.