Introduction

Regardless to say that the uterus is a precious organ not only for women, but also for human beings.

Uterine development relies on female hormones that are secreted by the ovaries. Hormonal homeostasis is so impressive that uterine condition must feedback to the hypothalamus situated in the deep area of the brain by whatever the whole bunch of information it is in the blood and whatever impulses they are through autonomic nervous system from the periphery. Moreover, the hypothalamus is the center of hormonal control influenced from the outside the world through five senses so that it controls the lower hormonal gland, such as the ventral gland of the pituitary, which secrets ovarian stimulating hormones targeting the ovary.

The uterus is said to reflect one’s reproductive age because it atrophies rapidly after menopause. Hormone replacement therapy, which has recently attracted attention for its anti-aging attributes, is helpful to maintain feminine features and alleviate menopausal syndromes.

Men have the remnant of a uterus, but its development is suppressed by male hormones. It has been said that women think with their uterus and in ancient times. Greeks created the word “hysteria”, which means uterus. Looking back on human history, it would be reasonable to say that the uterus symbolizes the female gender as much as the breasts. However, I’m afraid that this statement may be construed as sexual discrimination in contemporary Japan.

Uterine cancer is divided into two kinds, uterine cervical cancer and endometrial cancer. Among developed nations, as well as in Japan, rates of morbidity and mortality from uterine cervical cancer are decreasing. On the other hand, those of endometrial cancer are gradually on the rise. The reasons for this escalation are clear and I will explain them in detail later in terms of hypothalamus by subcultural influence from the outside.

The assumption is, initially, that cervical cancer is related to viral infections and is dependant on genital hygiene and sexual education. However, endometrial cancer depends on female hormones. Those hormones are strongly influenced by diets high in beef, pork, dairy, and sweets with creamy or whip flavor in addition to sexual influence. Women are exposed to excessive female hormones in this contemporary lifestyle. Female internal environment is unconsciously getting with excessive female hormones. I will talk about this issue in detail in the next essay.

Uterine cervical cancer

In this essay, I would like to talk about uterine cervical cancer. When the uterus is healthy and not in the state of pregnancy, it is in the shape and size of an eggplant, with a small empty space in it. It is as if the eggplant was placed upside-down, with its stem-side down. The position of the “stem” is equivalent to where the uterine cervix is situated. It is connected to the vagina, with the external part being the pudendum. Where the bulbous, round part of the eggplant would be is where the uterine tubes are connected, one on each side, at the top, which is bolstered underneath by the bladder. The slit-like empty space in the uterus is covered with the endometrium, which is where the fetus is nourishedduring pregnancy.

When a woman is not pregnant, the endometrium (uterine lining) is shed about once every month, which is called menstruation. In this hormonal cycle, the endometrium goes through the proliferative phase by estrogen and eventually becomes fertile by progesterone.

The endometrium is connected to the uterine cervix where the “stem” of the eggplant would be located, which protrudes into the vagina. Those organs are closely connected, and the hygienic environment of the “vulva-vagina-uterine cervix”, which is related to sexual intercourse, has a great influence on uterine cervical cancer development. In order to protect the important uterus, the inside of the vagina is kept acidic by lactic acid fermentation created by resident bacterium, including Doederlein bacillus. This particular bacterium is believed to be a good one. The acidic environment it creates may prevent various attacks from outside pathogens. But the invasion of viruses and infection cannot be prevented completely. In order to keep this sensitive environment clean, proper genital and sexual hygiene is indispensable.

Human papillomavirus (HPV)

Many Japanese women have human papillomavirus coexisting in the pelvic area. About one third of the adult females in Japan is estimated. The AIDS virus, avian flu and other types of viruses may exist, but you don’t need to be fearful of every virus. Since the beginning of time, there have been many different kinds of viruses that peacefully coexist with human beings. HPV is one of those types of viruses. Virus (parasite) and host relationship was elaborately mentioned in the previous chapter (Liver cancer).

Women’s bodies can tolerate the coexistence of this virus under normal immune conditions when HPV parasitizes epithelial cells of the vagina and uterine cervix. Epithelial cells infected with HPV are typically not damaged under ordinary circumstances.

Maintaining the immune balance is very important for the immune system, but balance can be lostfor instance lowered in a part of immune systems, then virus can grow rapidly followed by damage of cells infected by virus leading arachidonic acid derived from the cell membrane, which cause inflammation in the cervical area as a mechanical result of sexual intercourse. If the inflammation is chronic or occurs repeatedly, leukocytes are attracted to the area, causing various symptoms. Leukorrhea may increase and the patient may feel pain or heaviness in the pelvic area. If inflammation becomes chronic, the inflammatory cells (leucorrhea) attack not only pathogens, but also the patients own body, because leukorrhea is a natural phenomenon like a chemical reaction. One should give up the presumption that “your own cells are always on your side”.

Leukorrhea attacks pathogens with a very strong weapon called “active oxygen” or free radicals. But at the same time, they also destroy epithelial cells which HPV parasitize. Those epithelial cells then regenerate themselves.

In chronic inflammation, this process occurs repeatedly and when epithelial cells proliferate, those cells are undergoing DNA replication and are at their most vulnerable. In this process, the DNA of epithelial cells in the uterine cervix is parasitized by HPV and the cells are gradually damaged and may become malignant.

It is obvious that when HPV infection and inflammation are prevalent, it will progress to malignant changes in epithelial cells. It may depend on the individual as to how long this process will take, but usually it can be from 10 to 15 years, as was found in a clinical study conducted in New Zealand. This process can be traced with a light microscope, referred to as cytodiagnosis in pathology and this examination is also used in uterine cancer. Cells that have been scraped off as well as inflammatory cells can be examined with a microscope and a pathologist determines if they are benign or malignant. Even if a malignant diagnosis is given, it doesn’t mean the patient should undergo surgery immediately. Observation is of utmost importance on this stage especially for women in their mid-20s to mid- 30s. I have heard that vaccinations for uterine cervical cancer will be put into practical use. HPV have more than 10 subtypes and pathogenicity of them are researched. Vaccines have been produced in accordance with their pathogenicity. Now in Japan vaccination of some of them has been proactical. However, its protective efficacy will be anticipated only around 50% so that cancer formation is closely related not only to its viral infection but also to chronic inflammation.

Epithelial cells parasitized by HPV can spread from the vagina to the uterine cervix, but cancerous changes are limited only to the uterine cervix. This phenomenon is very suggestive, in that HPV parasitism may be an initiator, but chronic inflammation related to sexual intercourse is the promoter of cancerous changes. Screening exam for vaginal smear called Pap smear exam is quite effective for checking cytodiagnosis of atypical cells desquamated from the cervical mucosa. Credibility of this exam is dependent upon expert technologists and pathologists. Epithelial cells infected by HPV with inflammation appear to be atypical. This condition is supposed to be in the premalignant consequence. In the course of its following-up, targeted cervical biopsy is recommended and diagnosed by board certified pathologist.In conclusion, avoidance of viral infection and of chronic inflammation should absolutely be recommended. Even if in case of HPV infection, chronic inflammation should be treated.

I think that a functional food such as BioBran should be recommended to alleviate inflammation to regulate immune balance in women who are experiencing persistent inflammation, because it inhibits cancer promotion. An anti-inflammatory drug like aspirin is not recommended because it has adverse effects.