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Medical Forum / General / General / March 2005

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Abnormal Pap Smear - Mild Dysplasia - QUESTIONS

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lp1975 - 26 Feb 2005 17:33 GMT
Here's my situation: I've had yearly pap smears since I was 17 and have
never had one come back abnormal until now. This year's came back
reflecting 'mild dysplasia' per the nurse practitioner who called me.
I'm going in for a more indepth exam using a microscope of some sort.
The nurse said that this isn't a big deal, I shouldn't be worried
because it's very mild. I've had a few female friends and my mother
who've had one or more abnormal paps in the past but never ended up
having anything wrong - no cervical cancer, herpes or otherwise. After
reading on the net, I'm starting to get worried about the results
despite knowing this has happened to my friends.

I've been reading online about this topic and I'm really confused about
the association to cervical cancer and HPV. I've always thought of HPV
in the context of Herpes Simplex 2 (genital warts and other symptoms)
but then I see posts where HPV is described outside of this context,
perhaps not sexually transmitted and possibly cancer causing. Also, I
see posts about symptoms and risks about cervical cancer outside of the
HPV context. Lastly, I can't really get a firm grasp of what 'mild
dysplasia' actually means.

Outside of somewhat frequent yeast infections and UTIs, I haven't had
any gynocological issues. I have always had the yeast infections and
UTIs diagnosed via tests, so I don't think it's me mistaking the
symptoms for something else (like HS2). My family has lots of cancer in
our history, but not cervical. Anyway, I'm somewhat scared and my test
isn't for awhile, so I'm looking for some actual facts on the situation
to help me better understand the possibilities.

Please advise if you have input.

Thanks!
David Rind - 26 Feb 2005 17:54 GMT
> Here's my situation: I've had yearly pap smears since I was 17 and have
> never had one come back abnormal until now. This year's came back
[quoted text clipped - 27 lines]
>
> Thanks!

A few things:

1) Mild dysplasia on a Pap smear usually doesn't reflect anything very
serious going on, but additional testing is usually required to make sure.

2) Even if additional testing shows more significant cervical
abnormalities, nearly all are easily treatable.

3) You may be confusing HSV (herpes simplex virus) with HPV (human
papilloma virus). Certain strains of HPV are associated with cervical
dysplasia. HPV has nothing to do with HSV.

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David Rind
drind@caregroup.harvard.edu

lp1975 - 26 Feb 2005 18:10 GMT
Thank you.

Related to #3, I think you are right, I am confusing them. Based upon
your comment, I assume HSV is not linked with cervical dysplasia but
HPV definitely is, correct?
David Rind - 26 Feb 2005 20:41 GMT
> Thank you.
>
> Related to #3, I think you are right, I am confusing them. Based upon
> your comment, I assume HSV is not linked with cervical dysplasia but
> HPV definitely is, correct?

Although HSV has nothing to do with HPV, and certain strains of HPV are
definitely linked with cervical dysplasia, I intentionally didn't
address the question you are asking because the issue is somewhat complex.

There is some evidence that HSV may also have something to do with
cervical dysplasia. However, the evidence is weak and for the most part
people do not think there is an important link between HSV and cervical
dysplasia.

By the way, HPV infections are incredibly common. The vast majority of
people will be infected with HPV at some point. Most of these infections
do not cause any symptoms.

Signature

David Rind
drind@caregroup.harvard.edu

Emma Chase VanCott - 01 Mar 2005 00:18 GMT
: > Thank you.
: >
: > Related to #3, I think you are right, I am confusing them. Based upon
: > your comment, I assume HSV is not linked with cervical dysplasia but
: > HPV definitely is, correct?

: Although HSV has nothing to do with HPV, and certain strains of HPV are
: definitely linked with cervical dysplasia, I intentionally didn't

I understand that there are over 100 strains of HPV.

Some can cause Cervical Cancer -- not all.

In any case, always use condoms, or only have sex with one
monogamous partner.

And it's not just cervical cancer to be concerned about -- but receiving
fluids up a woman's reproductive tract is why she is at 17x the risk of
getting HIV, etc.

The Fallopian tubes empty into the abdominal cavity... it is NOT a closed
system.

Read up on PID ("pelvic inflammatory disease") and you will get the idea
of how bad internal infection via STDs can be deep inside a women's
bodily organs.

Emma
:)
lp1975 - 21 Mar 2005 16:24 GMT
Just a quick update... my biopsy turned out normal and I have to go
back in 4 months for another pap just to be sure. A side effect of the
biopsy was, however, that I bled for almost 2 weeks off and on. I think
the initial bleeding was from the biopsy which then subsequently lead
into my period, which came a bit early. Anyway, the biopsy wasn't
exactly pleasant but my peace of mind is back intact and I'm much more
educated on the whole topic now. :)
 
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