Coping With Cervical Dysplasia

Hello to all. I would like to share my story with anyone who would like to listen because I think this site is very important and this is a bit of a hidden topic in medicine. So here goes…I am a doctor and I have absolutely no risk factors other than being sexually active (not even as a young woman!). On my most recent pap, I had ACUS (Abnormal Cells of Unknown Significance). Nowadays this reflexes back automatically to check for HPV which I had as a “high grade type”. Only because I am older (35 yo) did my Ob-gyn schedule a colposcopy.

In this situation with younger women, they would normally recheck in 6 months because cervical dysplasia is VERY slowly progressive. However, thank God we did it because even though there were only 2 small areas noted with the Acetic Acid (or vinegar) and there was no evidence of mosaicism or increased vascularity (ask your doctor about this as she/he can see this with the scope during the colpo) to indicate a moderate or severe dysplasia, that is what the pathology came back as. I was terrified that this was a very aggressive type and was feeling particularly unlucky as only 5% of paps with ACUS come back with moderate to severe dysplasia, however, really there was a bit of a catch-22 going on…as we age our transition zone pulls into the canal of the cervix and makes it less likely for the HPV virus to affect them, but apparently I have the cervix of a teenager. That made it more likely to be affected, but much more easily treated with the LEEP.

I had the LEEP which was not the worst thing in the world last week. It came back with mild to moderate dysplasia and clear margins. It is very unlikely for the LEEP to have worse results than the colpo, but often it is better as they have biopsied the worst areas on the colpo. The worst part of the LEEP itself was the needle going into the cervix and the Epinephrine which made me shaky, hot and tachycardic (high HR), but this lasted a very short time and it does minimize the bleeding. Since then, I do wear a pantyliner as there is a minimal amount of slightly bloody discharge daily.

I have a repeat Pap in 3 months. The 2 most important things to decrease the risk of recurrence are 1. clear margins and 2. resolution of the virus. Eliminated any other risk factors like smoking are important if you have them. I am taking a vitamin with increased vitamin B to aid my immune system in clearing this virus, but really a healthy diet an exercise will suffice. I was truly a wreck during this process and would be happy to help anyone through it. A couple of things that may have been different for me include the fact that I was moved quickly through this system (I think because I am a doctor and may actually have been even more freaked out than some of you…sometimes ignorance is bliss). No matter what, I have decided that even if I have to pay for it myself, I will never again go longer than 6 months without a pap and I did tell my sexual partner about this. We had recently broken up and I wasn’t sure of the utility of this as there is no test for men, but I felt he deserved to know that he is likely infected with HPV

Men are the vectors in HPV, but honestly they are not to blame. They rarely have symptoms (if they do, it is unlikely the type of HPV that causes the dysplasia as the type causing warts usually doesn’t, go figure, the one case where it might be better to have an ugly, old wart!), there is no test and no treatment! In addition, condoms do not prevent the spread. To some of you who have had a recurrence much later after a clear, keep in mind that there are several HPV “types” that cause dysplasia and even if you have cleared and therefore have immunity against one type, you do not against the others. I asked about the vaccine and it is still not approved for women my age, but if it is for you, I highly suggest you get it. Please let me know if you have questions or need someone to hold your virtual hand. Take care