Protecting Pelvic Health: A Nutritional Guide for HPV & Dysplasia

Human papillomavirus (HPV) is the most common sexually transmitted virus in the world.  80% of women will get at least one type of HPV at some point in their lifetime. Often, the immune system successfully resolves or clears the infection. However, if the infection persists, it can potentially trigger precancerous changes to the cells of the cervix, which can lead to a condition called cervical dysplasia. 

There are over 100 strains of HPV, and the low-risk strains can cause warts on the hands, feet and genitals. The high-risk strains, HPV 16 and 18,  have a higher likelihood of developing into cancer, with nearly all cervical cancer cases testing positive for HPV. Male reproductive systems are just as susceptible to HPV. High-risk strains can also develop into oropharynx (throat, tongue, and tonsils), penile, or oral cancers.

The strain of HPV and the overall health of an individual’s immune system are factors that can affect the level of symptoms and the degree of epithelial cervical cell abnormalities that could progress to a variety of cancers.

Considering the potential complications, discovering that one has HPV or abnormal cervical cell changes can obviously be unsettling and scary. It is often associated with emotional and physical stress, including holding tension, specifically in the pelvic region. Unfortunately, because it is an STI, it is also common for individuals to internalize a feeling of shame or guilt (1), further compounding their stress level or guarding-type patterns in their pelvis.

Conventional medical approaches to HPV and addressing the varying levels of cervical dysplasia (called CIN 1, 2 and 3) range from a “watch and wait” approach for mild cervical dysplasia to a variety of surgical interventions for more severe cases. These surgical procedures don’t treat HPV directly and can cause complications. The HPV vaccine,  Gardasil-9, may prevent infection from 9 strains of HPV and has had a high level of efficacy since it was introduced.

Key Strategies for a Proactive Approach 

Awareness of evidence-based nutritional and lifestyle strategies that strengthen the immune system, support the body’s response to HPV and promote cervical health can be a valuable component of a proactive and empowered approach, especially during “watch and wait” periods between check-ups.

Risk factors for HPV to consider:

• Smoking
• Long-term use of the birth control pill
• The health of the vaginal microbiome
• Nutritional deficiencies
• Emotional stress (including the stigma associated with an STI)
• Inadequate sleep
• Lack of exercise

Nutritional Strategies

Specific nutritional deficiencies can be a risk factor for the recurrence of HPV infection, and key nutrients have been found to be missing and low in people with reduced immunity. Replacing or augmenting these nutrients through diet and supplementation can optimize the immune system.

The following 10 clinically-researched nutrients support the immune response to HPV and promote cervical health:

1. Folate: Studies have found that individuals with folate deficiency have an increased risk of positive HPV status, as well as an increased risk of progression (2).  Folate-rich foods include dark green leafy vegetables (such as spinach, asparagus and Brussels sprouts), nuts and beans and liver

2. Vitamin A (Carotenoids) and Lycopene: Studies have shown that those with deficient levels of carotenoids and lycopene need additional immune support (3). Foods rich in carotenoids and lycopene include peppers, tomatoes, carrots, mangos, sweet potatoes, spinach and kale

3. Vitamin C: Research studies conclude that individuals with higher Vitamin C and Zinc levels support the immune system and the body’s response to HPV (4). Foods highest in Vitamin C include yellow bell peppers, guava, dark green vegetables (especially kale and turnip greens), kiwi and broccoli

4. Selenium: Individuals with cervical dysplasia have been reported to have deficient levels of the mineral selenium. In recent studies, selenium has also been shown to support cervical and cellular health (5). Foods generally higher in selenium include Brazil nuts, oysters, tuna and sunflower seeds

5. Vitamin E: Has been shown through clinical studies to promote cervical cell health and support the immune system through its powerful antioxidant properties (6). Foods high in Vitamin E include cooked spinach, almonds, roasted sunflower seeds, avocados and fish

6. Zinc Sulfate: Has been associated with supporting the body’s response to HPV (7).

7. Broccoli sprout: Indole-3-carbinol, DIM, and sulforaphane are powerful metabolites found in broccoli family vegetables that support DNA health and have been shown to promote overall health and cervical wellness (8). These important ingredients are found in cabbage, broccoli, broccoli sprouts, Brussels sprouts, cauliflower and kale

8. Green tea: Has long been known as a powerful plant that stimulates the immune system (9). Orally, green tea intake has been associated with a positive impact on cervical and reproductive health through its antioxidant properties

9. Reishi mushroom: Has been celebrated for its properties for more than 2,000 years. Clinical studies have shown that the use of these mushrooms dramatically supports the immune system (10).

10. Astragalus root: Recent studies have shown this herb’s impact on the health of cervical epithelial cells and regulating cell growth (11).

These 10 nutrients could each be taken as individual supplements. Dr. Elizabeth Goldspink, ND, a well-respected Canadian naturopathic doctor, has also thoughtfully researched high-quality sources and optimal serving amounts of these ten nutrients in one convenient supplement formula called Papillex®.

Another noteworthy supplement to help further optimize the immune system is AHCC®, a mushroom extract derived from the shiitake mushroom species, extensively studied in over 30 human clinical trials. A landmark study in 2020 by Dr. Judith A. Smith highlighted a new understanding of the relationship between AHCC® and HPV (12). Preliminary analysis of her Phase II clinical trial involving 50 participants shows a 63.4% clearance rate of HPV infection after six months of supplementing with AHCC®.

Significant updates are also taking place in a global initiative to end cervical cancer through more accurate and more accessible HPV testing. Countries worldwide are gradually introducing new HPV self-screening home kits as the primary and initial cervical cancer screening method instead of Pap smears. HPV testing has been shown to be 50% more accurate than Pap smears, which are also more invasive and require a visit to a healthcare provider.

The other positive news is that  HPV self-screening home tests are not only more sensitive but will be more accessible to remote areas and are practical for specific cultural groups and people who have suffered sexual trauma for whom speculum examination in the pelvic region is problematic. HPV testing will also only be required every 5 years if normal results are obtained.

While managing HPV and cervical dysplasia can impact an individual’s pelvic health in a range of challenging ways, it can be beneficial and empowering to become informed about valuable evidence-based nutritional and lifestyle strategies for a proactive approach to supporting the immune system and cervical health.  

Additional Resources:

“The Emotional Stress of HPV & Top 3 Immune Supportive Strategies that Can Help” with Dr. Vian Nguyen, MD and Dr. Christine Matheson, ND

Papillex supplements

Dr. Christine Matheson, ND has been practicing as a licensed naturopathic doctor since 2001 in Ontario, Canada. She’s also an Arvigo® Therapist and a certified Kundalini yoga instructor who helps women experience wellness from the inside out by taking the vital step of achieving better belly health through thriving gut health, improved pelvic health and fertility health if trying to conceive. Her signature Belly Be Well™ Programs are offered either through one-on-one naturopathic consultations or online group classes and combine teaching natural lifestyle approaches with the unique benefits of the Arvigo® Techniques of Maya Abdominal Therapy. Christine is honoured to have been one of the first naturopathic doctors in Canada who pioneered working as part of an integrative medical team in a hospital setting at the former Women’s Pelvic Centre at Women’s College Hospital. She enjoys being a health educator and speaking to the public and health professionals in various settings, including as Director of Education for Papillex. She aims to help as many women as possible unlock their ultimate vitality through better belly/pelvic health and by having a more positive relationship with this important region of the body. 

References

1 Waller J, Marlow LA, Wardle J. The association between knowledge of HPV and feelings of stigma, shame and anxiety. Sex Transm Infect. 2007 Apr;83(2):155-9. doi: 10.1136/sti.2006.023333. Epub 2006 Nov 10. PMID: 17098767; PMCID: PMC2598611.

2 Asemi Z, Vahedpoor Z, Jamilian M, et al. Effects of long-term folate supplementation on metabolic status and regression of cervical intraepithelial neoplasia: A randomized, double-blind, placebo-controlled trial. Nutrition 2016; 32 (6): 681-6

3 Peterson, Caryn E., et al. “Combined antioxidant carotenoids and the risk of persistent human papillomavirus infection”. Nutrition and cancer 62.6 (2010): 728-733. 

4 Chen, Alyce A., et al. “Genetic variation in the vitamin C transporter, SLC23A2, modifies the risk of HPV16-associated head and neck cancer.” Carcinogenesis 30.6 (2009): 977-981.

5 Karamali M, Nourgostar S, Zamani A, Vahedpoor Z, Asemi Z. “The favorable effects of long-term selenium supplementation on regression of cervical tissues and metabolic profiles of patients with cervical intraepithelial neoplasia: a randomised double-blind placebo controlled trial.” Br J Nutr. 2015 Dec 28;114(12):2039-45

6 Ono, A., Koshiyama, M., Nakagawa, M., Watanabe, Y., Ikuta, E., Seki, K., & Oowaki, M. (2020). “The Preventive Effect of Dietary Antioxidants on Cervical Cancer Development.” Medicina (Kaunas), 56(11), 604

7 Ayatollahi H, Rajabi E, Yekta Z, Jalali Z. “Efficacy of Oral Zinc Sulfate Supplementation on Clearance of Cervical Human Papillomavirus (HPV); A Randomized Controlled Clinical Trial”. Asian Pac J Cancer Prev. 2022 Apr 1;23(4).

8 Higdon, Jane V., et al. “Cruciferous vegetables and human cancer risk: epidemiologic evidence and mechanistic basis.” Pharmacological Research 55.3 (2007): 224-236.

9 Wang YQ, Lu JL, Liang YR, Li QS. “Suppressive effects of EGCG on cervical cancer.” Molecules. 2018 Sep;23(9):2334

10 Donatini, Bruno. “Control of Oral Human Papillomavirus (HPV) by Medicinal Mushrooms, Trametes versicolor and Ganoderma lucidum: A Preliminary Clinical Trial.” International journal of medicinal mushrooms 16.5 (2014).

11 Lyu, Ling, et al. “Effects of Astragalus injection on cervical immortalized epithelial cell growth and its cell cycle regulation mechanism.” Journal of Hainan Medical University 22.4 (2016): 17-20. 

12 Smith, Judith Ann, et al. “Phase II randomized, double-blind, placebo-controlled evaluation of ahcc for the eradication of HPV infections in women with HPV positive pap smears.” Gynecologic Oncology 154 (2019): 39