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The human papillomavirus has more than 100 varieties, conditionally divided according to the degree of oncogenic danger. 16 and 18 strains belong to the number, that is, capable of provoking oncological diseases. Therefore, patients with these types are under special medical supervision and require surgical treatment.

HPV is a virus that can enter the body of a healthy person from the external environment. Depending on the routes of transmission, it infects the carrier with one or more strains of varying degrees of oncological danger. Usually the virus is in the body in a dormant state. Its activation is associated with moments of weakening of the immune system, which ceases to stop the development of viral particles.

Features of manifestation

The main feature of the infection is the formation of neoplasms located on the skin or mucous membranes. They can be single or multiple, have different shapes and sizes.

Such growths do not pose a danger in themselves, but their trauma against the background of constantly reduced immunity can lead to the degeneration of cells into a malignant form. As a result, a destructive process is launched that affects both the site of growth formation and the entire organism as a whole.

How does this manifest itself in gynecology?

It is the presence of 16 and 18 strains in the patient that in most cases leads to the development of cervical cancer. First, changes in the epithelium appear in the form of dysplasia, and after a while, cancerous growths also appear. This process can affect not only the cervix, but also affect the vulva, vagina and anus.

Usually, the time required for the transition from a benign neoplasm to a malignant one takes more than 10 years. However, there are factors under the influence of which oncological processes manifest themselves faster.

Symptoms of infection

Until the moment when the virus begins to actively spread, it is almost impossible to track its presence. Therefore, the symptoms of infection become visible only some time after infection. The main sign of the presence of HPV is the appearance of various growths that arise due to changes in the structure in tissue cells.

Possible innovations include:

• warts;
• papillomas;

For 16 and 18 strains, the development of genital warts is characteristic, appearing exclusively in the genital area. They are considered the most dangerous type of neoplasms, since it is these growths that subsequently change to cancerous tumors. Because of the elongated shape, ending in a rounded end, warts are called genital warts.

Subsequently, symptoms such as:

• burning;
• constant itching;
• pain;
• weight reduction.

All this manifests itself in the localization of condyloma and is caused by its presence. When neoplasms begin to grow and multiply, this indicates an exacerbation of the virus and a low level of immune defense.

Causes of the manifestation of HPV types 16 and 18

HPV is a type of virus that, when it enters the body, may not make itself felt for a long time. Because of this, a patient diagnosing a disease may not immediately understand what exactly contributed to his infection.

Among the factors that determine the manifestation of papillomavirus, the following can be distinguished:

• constant change of sexual partners;
• frequent relapses of chronic diseases;
• the presence of oncology;
• constant stress;
• avitaminosis.

All this contributes to the suppression of natural immunity, as a result of which the virus begins to actively spread.

Dangers during pregnancy

Types 16 and 18 of papillomavirus threaten the life and health of the mother to a greater extent, and not her fetus. The unborn child develops in the same way as other children, there are no obstacles to the formation of internal organs. Intrauterine development of the fetus proceeds in accordance with the norm.

However, the presence of genital warts on the genitals of a pregnant woman can affect the health of the child after birth. Passing through the natural birth canal, the baby comes into contact with a viral outgrowth, which causes it to become infected. And from birth, the child will become a carrier of a highly oncogenic type of virus that can contribute to the development of a cancerous tumor.

Therefore, it is imperative for a pregnant woman to be diagnosed for the presence of papillomavirus and take timely treatment in order to avoid risks. If the problem is detected at a later date, it is usually recommended to perform a caesarean section. This operation will help to avoid undesirable consequences for the child and reduce the risk of infection.

How is it transmitted?

The main route of transmission of the virus is sexual. A less common method of transmission is the contact-household and vertical (at birth) route of infection. Most often, people who only have sexual relations are exposed to infection. The first two years of sexual activity account for a greater percentage of papillomavirus infection.

Transmission of the virus from the carrier to a healthy person is carried out through damaged skin or mucous membranes. Virus particles penetrate deep into the epidermis due to damage to the natural barrier. For sexual intercourse, microtraumas are characteristic, through which the virus enters the body of a woman.

Diagnostics

Diagnostic measures are aimed not only at identifying papillomavirus strains, but also at tracking the consequences of its activities. Without this, it is impossible to prescribe further treatment.

The following methods are used to diagnose HPV:

Diagnostics helps to distinguish similar diseases, assess the degree of impact of the virus on the body and track the changes that are taking place.

Stages of development of the disease

Gynecologists distinguish 4 main stages that the disease goes through during its development in the carrier's body:

1. incubation period. The virus enters the body and begins to gradually adapt to new conditions. At this time, the immune defense can stop the activity of the infection, after which the virus is in a "sleeping" state.
2. Manifestation of symptoms. After some time (from several months to several years), the first symptoms occur. The growth of genital warts begins, pathogenic activity affects different parts of the body.
3. The occurrence of dysplasia. Dysplastic changes. Mucosal dysplasia occurs due to the deep penetration of viruses into the DNA of healthy cells, which gradually atrophies the normal function of the epidermal layers. Against this background, pathological growths develop in the form of papillomas, condylomas, wart structures.
4. Oncology. The development of cancer occurs with irreversible consequences for the skin or mucous membranes. As a result, healthy tissues are suppressed, the cancerous tumor grows and deepens.

With timely diagnosis and treatment, prompt relief of the symptoms of papillomavirus is possible.

Analyzes

Any analysis for HPV involves the collection of biomaterial obtained from the cervical canal. As a result of the analysis, the presence of the virus is detected, its strain and the level of viral load are determined. An HPV test is recommended for every sexually active woman at least once a year for prevention. After diagnosing papillomavirus, tests for infection must be taken every six months.

The primary analysis that women take is a Pap smear. This cytological study allows you to diagnose the presence of atypical cells in the body in the cervical region and suspect a viral effect.

The most common analysis aimed at diagnosing HPV is the PCR test. This is the widest range of diagnostic measures that allows you to identify the viral pathogen, its concentration and, due to this, choose the best method of treatment.

The cost of such an examination will be from 700 to 2000 rubles, depending on the number of tested strains. The results are provided to the patient within 3 days after taking the biomaterial. For the reliability of the diagnosis, the study must be carried out approximately in the middle of the menstrual cycle.

In this case, a contraindication for analysis is:

• period of menstruation;
• recent sexual intercourse (less than 2 days ago);
• douching;
• recent colposcopy;
• the use of antibacterial drugs (only after 2 weeks).

Will be next:

LG<3,0 – инфекция отсутствует в организме;

Lg 3.0-5.0 - viral particles are present, the average level of concentration;

Lg>5.0 - the virus has a strong effect on the body, the concentration is high.

After receiving these data, it is possible not only to prescribe the correct treatment, but also to track the effectiveness of the therapy.

Methods of treatment and removal

All HPV treatment is reduced to conservative and radical methods. The first are designed to help strengthen the immune system, restore the normal state of immune defense. The latter relate directly to the removal of manifestations of the virus, that is, genital warts.

Potential treatments include:

• antivirals ( Allokin-alpha, Panovir etc.);
• immunomodulators ( Interferon, Viferon and etc.).

Both of these groups of drugs contribute not only to the rise of natural immunity, but also inhibit the virus, so that the growths stop multiplying.

Surgical methods for removing neoplasms are as follows:

• radio wave destruction;
• laser removal;
• cryotherapy;
• electrocoagulation.

Both methods must be used together to achieve the best therapeutic effect.

Whether it is possible to be cured up to the end?

The human papillomavirus, entering the body, remains there forever. Today there is no way by which he can be completely cured. The key to the health of patients with HPV is the timely administration of drugs, the correct surgical treatment.

Thanks to such measures, it is possible to ensure reliable prevention of the development of cancer, to secure one's life, and also to have healthy children in the future.

Consultation of an obstetrician-gynecologist about the dangers of oncogenic HPV:

HPV types 16 and 18 in women are a papilloma infection (Human Papillomavirus), which can provoke oncological diseases of the small pelvis. The fair sex may not be aware of their pathological condition.

It is often only discovered during a medical examination. The sooner the pathogen is identified, the greater the chance of a favorable outcome.

What is HPV types 16 and 18

Papillomavirus 16 and 18 increase the risk of malignant tumors in women. Such as dysplasia, cancer of the genital organs, vagina and cervix. Pathology is detected during gynecological screening.

Papillomavirus types 16 and 18 do not yet indicate a cancerous tumor, but increase the risk of its occurrence. The infectious process affects the mucous membranes and deep layers of the epithelium of the genital organs, the cervical canal. As a rule, the pathogen begins to develop in the body of women of reproductive age.

It is rather difficult to say how HPV 16 and 18 differ from other types in women. Outwardly, they are very similar to other papillomas. A difference exists in the genetic information of HPV type 16 and type 18 DNA.

Perhaps 2 outcomes of the disease. The fair sex is either cured or dying. It all depends on the body's defenses, the stage of the disease at which effective therapy was started. Thus, if we say what HPV (papilloma) types 16 and 18 are, it is a pathogen that increases the risk of developing malignant tumors, which, as a rule, lead to death.

Probability of infection

According to statistics, papillomavirus 16 more often causes oncological pathologies than type 18. The risk of developing cervical cancer when infected with the first type is 50%, the second - 10%.

Moreover, in men, the infection rarely provokes cancer. 90-95% of them are only carriers of pathogenic DNA HPV 16 and 18.

HPV types 16 and 18 of the route of infection in women may have the following:

• sexually;
• vertical route of infection (in pregnant women, from mother to child during childbirth);
• through household items (especially through personal hygiene products).

Causes that can cause infection:

• frequent change of sexual partner;
• intimacy without means of protection;
• from 5 or more sexual partners;
• entering into intimate relationships at an early age (before 16 years).

Factors that increase the risk of infection:

• abortion;
• inflammation in the vagina and uterus;
• STD;
• vaginal dysbacteriosis;
• pathology in gynecology of a chronic nature.

Experts have noticed that women with this pathology usually have concomitant diseases.. Such as chlamydia, ureaplasmosis and others.

Stages of the disease

Papillomavirus in women 16 and 18 has four stages of its development:

• Initial (incubation). Runs asymptomatic. The exact duration of this stage cannot be determined. It all depends on the type of infection, the individual characteristics of the patient's body, the nature of the pathology. The pathogenic microorganism is latent, since it does not change the structure of cells, but is already amenable to diagnostic examinations.
• Second phase. There are characteristic formations on the skin. During this period, there is an active development of pathogenic microorganisms.
• Dysplasia. There is a combination of microorganisms that cause pathology, and the DNA of human cells. This is a precancerous condition.
• The fourth stage (malignant). This is the final stage of development. During this period, cancerous neoplasms are already diagnosed.

The sooner the disease is detected, the easier it will be to cure it. Therefore, it is recommended to periodically take tests for the presence of pathogen varieties. Especially those who are predisposed to it.

Symptoms

Manifestations of a pathological condition in a person can be different. It all depends on the strain. As a rule, in humans, when the papilloma virus begins its development in the body, warts appear in the external and internal genital organs. During intimacy, bleeding is observed. All this is accompanied by the following signs:

• burning and itching in intimate places;
• impaired urine output;
• pain during intimacy.

However, these symptoms may indicate the presence of many diseases (cystitis, urethritis, etc.). Without special tests, the disease cannot be distinguished from other pathologies of the genitourinary system. T Only after a complete diagnosis can the doctor make an accurate diagnosis and prescribe the necessary treatment.

Diagnostics

If you suspect papillomavirus type 16 and 18, you should contact a gynecologist for diagnostic tests. First of all, the doctor collects an anamnesis of the disease (how long ago the symptoms appeared, what pathologies close relatives suffer from, etc.). After that, an examination is carried out on a gynecological chair (external manifestations are examined). With the help of special mirrors, the cervix and vagina are studied. In addition, biomaterial is taken for analysis.

Screening is done to detect infected cells. This analysis of HPV 16 and 18 allows you to identify pathological changes even without external signs. After that, PCR is prescribed - this is an analysis for detecting the DNA of an oncological virus. The task of the polymerase chain reaction is not only to identify the pathogen, but to type the infection. It is important to know how the analysis is taken. It is collected with a smear from the cervix. 2 hours after the last trip to the toilet. A negative value means that no pathogens were found. Positive that you may be infected.

Quantitative reference values ​​may be displayed erroneously. Additionally, the following diagnostic tests may be prescribed:

• colposcopy (examination of the cervix);
• special tests with ethanoic acid, Lugol's solution;
• digene test (test rate below 100 thousand copies of the pathogen / 1 ml of material).

If the presence of a pathogen is detected, the woman is assigned an additional examination to identify concomitant diseases that are sexually transmitted.

Treatment

Treatment of papillomaviruses (HPV types 16 and 18) must be carried out. Even if there are no clear symptoms of a pathological condition. If you do not start the necessary therapy, then the risk of cancerous tumors increases significantly. Therapeutic measures are aimed not only at eliminating external signs, but also at suppressing the activity of the pathogen.

Complex therapy is used to treat the human papillomavirus. If a pathogen is detected, the following techniques are applied:

• Medical. Local and general purpose drugs are prescribed. What to treat, the specialist determines, based on the degree, progressivity of development and the individual characteristics of the woman. The list of drugs for HPV is extensive.
• Invasive. The method is based on the removal of growths surgically.
• Folk. These methods can be used only after the recommendation of a doctor. He will tell you what you can do and what not, based on individual characteristics.

Patients often worry about whether human papillomavirus types 18 and 16 can be cured. It is completely impossible to get rid of the disease. But if therapy is started on time and the treatment regimen is correctly selected by a specialist, then the pathology will not provoke the development of oncology.

Consequences of removal

Surgical intervention, as a rule, is prescribed for dysplasia of 2 and 3 degrees. At the 1st stage, conservative methods are applied. In women at HPV stage 2, treatment is also carried out with medications. If therapy does not bring any results, surgical treatment is prescribed. The following methods of mechanical removal of growths can be performed:

• cryodestruction;
• radio wave therapy;
• diathermocoagulation.

Patients are very worried and ask the doctor what danger is behind the surgery. At stage 2 of the development of dysplasia, 2/3 of the epithelium is affected. The operation will not cause the loss of reproductive function. At the 3rd stage of the development of pathology, most of the cells are affected. In this case, the reproductive organ may be completely removed. As a result, the woman will not be able to get pregnant.

How to live with this virus

Many patients who have a pathogen found do not know how to live with it further, because it is not completely treated. Do not despair and give up. Despite the fact that papilloma 16 and 18 is a terrible disease that can lead to dire consequences, it is still possible to avoid cancer with adequate treatment.

Once treatment has been performed and pathogens have been suppressed, the following recommendations should be followed to prevent the risk of recurrence:

• Eat rationally. Eat foods that contain beneficial elements. To strengthen the immune system, take vitamin complexes.
• To increase the protective functions of the body, do morning exercises, perform hardening procedures.
• Treat all diseases promptly. Do not let them become chronic.
• Regularly visit a antenatal clinic.
• Lead a measured intimate life. Choose your sexual partners carefully. Use contraception.

Although there is no way to cure the pathology completely, however, malignant neoplasms form only under certain circumstances. If you follow all of the above recommendations, you will be able to reduce the risk of cancer to a minimum.

If you have not been infected, but fear that you will, it is recommended that you routinely vaccinate against the pathogen. Follow all the recommendations that are described earlier. All diseases in the human body develop due to the weakened defenses of the body. Strengthen your immune system, follow your lifestyle and then you will not be afraid of any infection.

Video

HPV 16 in a woman - how to live after infection.

Despite the fact that there are more than 100 types of papillomaviruses in total, most often, when talking about this disease, doctors pay attention to dangerous forms of infection. The World Health Organization says that HPV type 16 in women causes cervical cancer - in 70% of patients with this diagnosis, the virus was detected in the blood. How to get rid of the disease and what to do if the tests show a positive result for the presence of an infection?

HPV symptoms

What is HPV and how does the disease manifest itself? The presence of the human papillomavirus, according to medical research, was found in almost 80% of the population. At the same time, not every carrier suffers from papillomas - a manifestation of the disease. For example, HPV 16 in men appears only in 5-7% of cases. This is due to the fact that a healthy immune system is able to suppress the activity of the virus, and it simply cannot cause growths. Risk factors for the growth of papillomas are:

• General weakness of the body.
• Improper nutrition with a lack of vitamins.
• Frequent SARS.
• Diabetes.
• HIV and other types of immunodeficiencies.
• Hormonal failures, diseases of the endocrine system.
• Autoimmune diseases.

If we talk about the manifestations of HPV type 16 in women, then additional risk factors are:

• Early onset of sexual activity.
• Infection with venereal diseases.
• abortion.
• Gynecological diseases.

Human papillomavirus type 16 can appear on any part of the skin and mucous membranes, but in most cases it affects the genitals. This type is characterized by the formation of flat papillomas, often resembling extensive rashes with a series of hardened plaques. Doctors call this disease "bovenoid papulosis." It manifests itself on the skin of the thighs, external genitalia, in the anus. Such rashes are easy to notice, and therefore patients go to the doctor in time.

The greatest danger in gynecology is the defeat of HPV type 16 of the internal genital organs, in particular the cervical canal. In this case, a woman may not know about the presence of the disease and its development for many years. Those who do not undergo scheduled examinations by a gynecologist are at the highest risk of advanced disease.

The symptoms of HPV type 16 appear not only on the genitals. Characteristic flat papillomas grow on the palms, elbows, affect the mucous membrane of the mouth and throat. Along with flat rashes, a person may develop other types of papillomavirus - genital warts.

Methods of infection

How can you get infected with papillomavirus? The transmission of all types of papillomaviruses occurs from person to person, less often through household items. A characteristic feature of HPV 16 is that it is transmitted in 80-95% of cases through sexual contact - the sexual partner becomes the main source of the virus. Therefore, rashes in the genital area are characteristic of the disease. Papillomavirus 16 is a highly contagious infection that can be transmitted from an infected person in 60% of cases. Risk factors that increase the likelihood of infection:

• Unprotected intercourse.
• 5 or more sexual partners.
• Early onset of sexual activity.
• Concomitant diseases of the genital organs. It is especially critical in gynecology, since even minor diseases change the microflora of the vagina and make the mucous membranes less protected.

It is extremely rare to get HPV type 16 through household items, personal hygiene products. Infection of a newborn can occur during childbirth, when the child passes through the birth canal, which has papillomas. It should be noted that the female body during pregnancy is significantly weakened, and this can also provoke the growth of papillomas. Treatment of the virus in this case should be started in the 1st trimester, then its activity can be suppressed, and it will not pose a danger to the unborn child. Since the infection is transmitted through contact with papilloma, it is advisable to remove the neoplasm before pregnancy.

Why is papillomavirus diagnostics needed?

As already mentioned, the manifestations of papillomavirus are not always noticeable. This is especially critical for women, in whom the virus can develop in the vagina and on the cervix. The male body, as a rule, is more resistant to diseases, so the infection is rarely manifested by papillomas. As a result, people may not be aware that they have a dangerous disease. When it begins to manifest severe symptoms, a malignant neoplasm is already diagnosed.

Type 16 papilloma is dangerous primarily for women, as it provokes the development of cervical cancer. Therefore, the World Health Organization recommends screening once every 2 years. In gynecology, such diagnostics include:

• Medical examination.
• Colposcopy (examination of the condition of the cervix).
• Pap test (Papanicolaou test) - an analysis that the doctor takes from the cervical canal.
• Blood test (PCR diagnostics).
• DNA of the virus (scraping from the mucous membrane of the cervix).

If the presence of the virus is confirmed, the sexual partner must also undergo all the necessary examinations.

Diagnosis of HPV type 16 in men includes an external examination by a urologist and a blood test that helps determine the genotype of the virus. Such examinations are not included in the number of mandatory diagnostics, but doctors still recommend that they be done at least once every 5 years.

Over the past 6 years, the number of infected people has increased 10 times, because HPV type 16 is transmitted quite easily. Therefore, the importance of screening examinations can hardly be overestimated - it is regular diagnostics that makes it possible to detect an infection at an early stage and prevent the development of cancer.

Ways to treat HPV-16

A sick person who has papillomas and a type of virus with a high oncogenic risk is confirmed must undergo treatment. First of all, neoplasms should be examined - the patient is given a biopsy. A histological examination will reveal the type of papillomavirus cells, show whether the oncological process has begun. In the event that the neoplasm is benign, treatment consists of the following steps:

• In gynecology with damage to the internal genital organs - the elimination of inflammatory processes, the restoration of microflora, the treatment of STDs.

• Surgical removal of papillomas (neoplasms caused by HPV type 16 must be disposed of).
• Drug treatment aimed at strengthening the immune system.

HPV type 16 in women and men in the presence of papillomas is treated with the help of such operations: cryodestruction, laser removal, wave surgery, excision with a scalpel. The method is selected depending on the stage, prevalence and location of papillomas. Type 16 papillomas are usually flat, so when they are removed, the nearest healthy tissues are captured, and healing takes longer than after resection of genital warts.

Medications to strengthen immunity, which are prescribed for type 16 papillomavirus, must be taken in full. This stage is no less important than the removal of neoplasms. Medicines help to avoid recurrence of the disease. Most often, doctors prescribe drugs such as Interferon, Groprinosin, Cycloferon.

What to do if cancer is detected

HPV type 16 DNA interacts with the DNA of human cells and is able to change the genetic code - at this stage we are talking about the beginning of the oncological process. Women are diagnosed with cervical dysplasia. In this condition, the patient is treated by a gynecologist, but to prevent the development of the disease, a woman can be registered with an oncologist.

If dysplasia is not treated, the neoplasm degenerates into a malignant one. This stage involves full-fledged therapy in the oncology department. The person will need to:

• Chemotherapy.
• Operation (including removal of metastases in other organs).
• Radiation therapy.

With the 1st stage of cervical cancer, recovery is possible in 78.1%, and with the 4th stage - only 7.8%. Therefore, if papillomavirus type 16 has led to cell mutation, treatment should be started as soon as possible.

Prevention of papillomas

Preventive measures against HPV can be divided into two large blocks - the prevention of infection with the virus and the prevention of the formation of papillomas in carriers of the infection. Given that papillomavirus type 16 is among the sexually transmitted diseases, the following measures will help prevent infection:

• Protected sex.
• Permanent partner.
• The beginning of sexual activity after 16 years (doctors call early sexual relations one of the main risk factors).

The World Health Organization also recommends that girls be vaccinated against viruses types 6, 11, 16 and 18. There are two vaccines available today, Gardasil and Cervarix. Vaccinations are also recommended for those women who have HPV of the listed types. However, it must be remembered that vaccination does not replace screening for cervical cancer. Appropriate examinations by a urologist should also be carried out by the sexual partner.

It is impossible to completely get rid of the virus. But this does not mean that having an infection will necessarily lead to cancer. A carrier of HPV must follow the rules of prevention that will protect him from the development of complications:

• Strengthen immunity. Proper nutrition, the rejection of bad habits and a rational daily routine will largely help to avoid the activation of the virus.
• Annually undergo preventive examinations at the gynecologist, urologist, if necessary, at the oncologist.
• Monitor the health of the reproductive system - prevent inflammation, chronic diseases. When it comes to STDs, the partner must also undergo full treatment.

HPV type 16 in women is one of the hundred most dangerous strains of the human papillomavirus, which, according to statistics, affects more than seventy percent of the female population. There are several main ways of infection with the human papillomavirus. Mostly, infection is carried out sexually, as a result of unprotected sexual contact with a person who is a carrier of papillomavirus. Another common way of infection with the human papillomavirus is called placental. It is an infection of the fetus during passage through the birth canal. In addition, it is possible to become infected by household means, when using the same items with a sick person, as well as when removing hair from the skin, shaving, etc. The presented disease can, to a large extent, increase the likelihood of developing oncological processes, as well as cause cervical neoplasia of the squamous epithelium.

What is a disease?

Papillomavirus belongs to a group of pathogenic viruses that are transmitted mainly through sexual contact and are characterized by an increased oncogenic factor, increasing the likelihood of developing malignant neoplasms by approximately 60%. This pathology has recently become extremely widespread. Doctors state a disappointing fact: in six years, the number of infected patients has increased by almost 10 times.

This virus has a large number of varieties. In particular, HPV 16, along with HPV type 18, is considered to be the most dangerous not only for health, but also for the life of a woman. The fact is that the presence of this pathology, to a large extent, contributes to the development of cancer of the cervix, provoking malignant mutation processes of the mucous membranes and skin of the organ. As the results of scientific studies have shown, oncological lesions of the uterus are observed in a few percent of women who are carriers of this virus. It is for this reason that pathology needs competent, adequate, timely treatment.

Methods of infection

Experts identify certain risk factors that contribute to infection and the development of the disease. They include the following reasons:

1. Early onset of sexual activity.
2. General weakness of the body.
3. Disturbances in the functioning of the immune system.
4. Existing sexually transmitted diseases.
5. The presence of HIV infection.
6. Disorders in the work of the endocrine system.
7. Chaotic sex life.
8. Diabetes.
9. Previous abortions.
10. Abuse of alcoholic beverages.
11. Prolonged and uncontrolled use of hormonal contraceptives.
12. Prolonged smoking.
13. Diseases of the gastrointestinal tract of a chronic nature.
14. Frequent stressful situations.
15. Age factor (it is believed that young women under the age of twenty-five are at a special risk group).
16. Oncological diseases.
17. Long courses of chemotherapy and radiation therapy.
18. autoimmune processes.