The Vitruvian Protocol

System XI of XI

Reproductive

Reproductive organs

Why it matters

Reproductive health affects fertility, hormones and some of the most preventable cancers. Cervical cancer, and a growing share of throat and anal cancers, are caused by human papillomavirus (HPV), which is common, usually silent, and vaccine-preventable.

The protocol

Protocol 1

Get HPV-vaccinated, and keep to your screening schedule

Grade A · Strong evidence
How to do it
  • HPV vaccination is routinely recommended at ages 11–12, with catch-up through age 26. From 27 to 45, discuss it with a clinician.
  • Cervical screening, if you have a cervix: from 21 to 29, cytology every 3 years. From 30 to 65, an HPV test every 5 years, or cytology every 3 years, or both every 5 years2.
  • Get tested for sexually transmitted infections based on your risk. Use condoms with new or non-exclusive partners.
  • Practise testicular self-awareness, if applicable. Any new lump or swelling needs prompt evaluation.
Why it works
The vaccine triggers antibodies that block infection by the high-risk HPV types responsible for most cervical cancers and many cancers of the throat, anus and penis. Screening catches pre-cancerous changes years before they become cancer.
The evidence
In a Swedish national registry study of 1.7 million women, those vaccinated before age 17 had an 88% lower rate of invasive cervical cancer than unvaccinated women1. The US Preventive Services Task Force gives cervical screening from 21 to 65 its highest-grade recommendation2.

What to measure

  • HPV vaccinationComplete seriesTwo or three doses depending on age at first dose.
  • ScreeningOn scheduleKeep a record of your last cervical screen and STI tests, with results.
  • Menstrual cycle21–35 daysIf applicable: cycle regularity is a vital sign of ovarian and hormonal health. Persistent change is worth investigating.

Avoid

  • Smoking. It lowers fertility in all sexes, brings forward menopause and is a major cause of erectile dysfunction.
  • Anabolic steroids and unprescribed testosterone. They shut down the body's own sperm production, sometimes for a long time.
  • Heavy drinking, which disrupts reproductive hormones.

Sources

  1. Lei J, Ploner A, Elfström KM, et al. HPV vaccination and the risk of invasive cervical cancer. N Engl J Med. 2020;383(14):1340–1348. doi.org/10.1056/NEJMoa1917338
  2. US Preventive Services Task Force; Curry SJ, Krist AH, Owens DK, et al. Screening for cervical cancer: US Preventive Services Task Force recommendation statement. JAMA. 2018;320(7):674–686. doi.org/10.1001/jama.2018.10897

Educational content, not medical advice. These protocols summarize published evidence for healthy adults; they are not a substitute for care from a clinician who knows your history. Check with one before starting a new exercise program, changing medication, or if you are pregnant or managing a medical condition.