Green Tea for HPV Treatment
Green tea extracts and their catechin EGCG are not recommended for treatment or prevention of HPV infection based on the highest quality randomized controlled trial evidence, which showed no benefit over placebo. 1
Evidence Against Routine Use
The most definitive evidence comes from a phase II randomized, double-blind, placebo-controlled trial that directly contradicts earlier promising reports:
In 98 women with persistent high-risk HPV and CIN1, Polyphenon E (containing 800 mg EGCG daily for 4 months) showed no difference in HPV clearance compared to placebo (17.1% vs 14.6% complete response rate). 1
Concerningly, progression of disease was actually more common in the green tea extract group than placebo (14.6% vs 7.7%), though this difference was not statistically significant. 1
The study concluded that 4 months of Polyphenon E intervention did not promote clearance of persistent high-risk HPV or related CIN1. 1
Why Earlier Studies Were Misleading
Earlier uncontrolled studies suggested benefit, but these had critical methodological flaws:
A 2003 study reported 69% response rates with green tea extracts versus 10% in untreated controls, but this was not a randomized trial and did not account for the high spontaneous regression rates of cervical lesions. 2
Single case reports of successful treatment exist but represent anecdotal evidence that cannot overcome the negative randomized trial. 3
In vitro studies show green tea catechins inhibit HPV-related cellular pathways, but laboratory findings do not translate to clinical efficacy. 4, 5
Standard of Care Recommendations
Current evidence-based guidelines make no mention of green tea or catechins for HPV treatment. Instead, established management includes:
For external genital warts: Cryotherapy, podophyllin, podofilox, trichloroacetic acid, electrodesiccation, or imiquimod are recommended treatments. 6, 7
For subclinical HPV infection without dysplasia: No treatment is recommended, as no therapy has been demonstrated to eradicate infection. 6
For cervical dysplasia: Treatment decisions should be based on the grade of dysplasia using established ablative or excisional procedures. 6, 7
Critical Pitfall to Avoid
Do not delay or substitute proven treatments with green tea products. The randomized trial evidence demonstrates lack of efficacy, and relying on unproven therapies could allow progression of precancerous lesions. 1 HPV vaccination remains the most effective prevention strategy, with the nonavalent vaccine preventing approximately 90% of HPV-related cancers. 7
If Patients Inquire About Green Tea
While green tea catechins showed acceptable safety and tolerability in clinical trials 1, there is no evidence-based dosage recommendation because the intervention does not work. The studied dose of 800 mg EGCG daily failed to show benefit. 1
Focus counseling on proven interventions: HPV vaccination for eligible patients, appropriate screening with Pap testing, and evidence-based treatment of detected lesions when indicated. 7