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Author Topic: Will my test results be valid?
Jill Valentine
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Been a while since I posted here. I hope you guys can help with this question since I do worry a lot. I had my first test for chlamydia and gonorrhea today and am expecting the results next week. The problem is my period came this morning, just hours before I turned up for the test. I was given the thing that looks like a Q tip to do the vaginal swab on myself (not sure how testing is done over there in the US but that's how we do it in the UK) and hand the specimen back. The nurse that saw me said it's totally fine to get tested on my period. I made sure to poke the cotton swab around thoroughly inside me though it did come out with a fair amount of blood, not too much but the cotton tip was all red.

I've checked with my local sexual health helpline and they also said it's fine to do that swab on my period, saying, and I quote, "it happens quite regularly to other women". Sadly I'm not 100% convinced after reading this:

quote:
In order to obtain high validity of test results, avoiding sample contamination is essential. For instance, vaginal swabs should be collected before cervical swabs as cervical discharge can contaminate the vaginal canal ... Furthermore, two or three specimens should be collected for further detection, and samples from women should not be taken during menstruation.
http://www.ukessays.co.uk/essays/biology/chlamydia-infection-essay.php#ixzz2f3VrfmjD

The last sentence seems to refer to contamination with samples collected during menstruation.

So I'm very confused. To the best of your knowledge, was it okay to have had my chlamydia/gonorrhea swab during my period? Any reported cases or experiences you have had as to yes or no? I'm just not sure if my results will be accurate due to this very bad timing of my period. Any advice is appreciated.

[ 09-16-2013, 06:55 AM: Message edited by: Jill Valentine ]

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Robin Lee
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Hi Jill,

Can you maybe clue me in on why you don't trust the nurse who conducted the test? it seems to me that you asked the most reliable source, the healthcare provider *doing* the test. It is not in a provider's best interest to give a patient false information or to conduct a test that would not yield a reliable result.

So, what is making you feel like you can't trust the primary source on this and has sent you looking for other information? What do you think about calling the office or clinic where you had the test done and asking for reassurance from them?

--------------------
Robin

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Jill Valentine
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When I asked her and we discussed this, it was on the understanding that my period is still quite light. It started getting heavy all of a sudden as I went to the bathroom to swab myself and by the time I got out, she'd already had another patient in her room and the receptionist said I couldn't go back to ask her more questions. I did want to ask her if it would still be okay now that my flow is heavier and there's a lot of blood on the swab, but couldn't, and that's why I've looked to other sources. I'm unsure as to whether her answer would change if she'd known I was bleeding more.

So now I have conflicting information in front of me and would love to hear directly from people who work in these fields. If you have heard of women being on their period, with not just a light flow, and gotten valid test results, I'd be happy with that.

[ 09-16-2013, 11:00 AM: Message edited by: Jill Valentine ]

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Heather
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The two clinics I have worked with directly who do STI testing via swabbing have never, to my knowledge, had any protocols around whether women are menstruating or not.

And that's sound, IMO, since what a test is looking for is a bacteria, one which would be present in ANY vaginal secretions (and other body fluids, like urine), including menses (most of which is not blood, for the record).

--------------------
Heather Corinna, Executive Director & Founder, Scarleteen
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Robin Lee
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You still have the option to call the clinic and ask to speak with one of the healthcare providers.

I don't actually know if menstrual blood affects test results. I'll check with other staff and volunteers, but in the meantime, I do think that the clinic where you got the test performed is your best option for information here.

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Robin

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Heather
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For the record, when you're looking at a piece like the one you linked, I'd say you should basically just toss it out per considering it credible since it doesn't even give you a byline, let alone any information about the background or education of the writer.

Again, like Robin said, your clinician isn't going to do tests they aren't sure will net sound results: that'd not only be a waste or your time and money and theirs, it'd also be ethically questionable, since giving patients tests that aren't needed or won't be valid is a medical ethics no-no.

--------------------
Heather Corinna, Executive Director & Founder, Scarleteen
About Me • Get our book!
Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has. - Margaret Mead

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Jill Valentine
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Thank you both. I will ring them tomorrow about this. I rang the national sexual health helpline for chlamydia screening and the lady on the phone told me I'd need to have the test done again and she said, if I remember correctly, it's "not normal" to do the test while on a period. Now I'm even more confused. Maybe different clinics have different testing standards but people seem to have different opinions for sure. I'll have to see if my clinic has a health advisor I can speak to tomorrow over the phone.

My main concern is that there's been a misunderstanding, and the nurse thought my period was very light when it was already a medium flow. She didn't see the swab after I'd done it either - I just left it with reception.

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Heather
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She wouldn't have to see it: when it went to the lab, if it wasn't a useable sample, you'd hear back with them asking you to come back and do it over.

--------------------
Heather Corinna, Executive Director & Founder, Scarleteen
About Me • Get our book!
Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has. - Margaret Mead

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Jill Valentine
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Apparently there is nothing mentioned in official testing guidelines that it would be a problem to collect a swab during menstruation. One woman I spoke to proposed something interesting: whatever the result is, I can ask for another test if I have my doubts. I think it's just a waiting game to be played for now. I'll post an update here in the coming week.
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Heather
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Honestly, it would make no sense to me given what is being tested for, and how it infects the body (when it does) for this to be an issue. This idea that menses somehow changes so many situations for people is usually not based in fact, but in myth. (See the user's post about menses and camping today: this is the same deal as that, IMO.)

But I think your friend has it right here: in the event you don't feel satisfied when the results come in, you certainly can always retest.

--------------------
Heather Corinna, Executive Director & Founder, Scarleteen
About Me • Get our book!
Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has. - Margaret Mead

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Jill Valentine
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Based on the new information I've uncovered, I'll speak to my health advisor next week and see if a retest is viable. I think this might be useful to anyone in the future with a concern similar to mine so I'll share it here.

My specimen tube was labelled with the name of the testing platform, so I looked up their protocol out of curiosity. The test is called the BD ProbeTec Chlamydia trachomatis/Neisseria gonorrhoea (CT/GC) Qx Amplified DNA Assays ...what a mouthful. But that is the test that is used so I would have 100% confidence in what they say. My nurse told me beforehand the test checks for DNA so she was spot on.

The only thing is it talks about endocervical swabs in women and not vaginal swabs (I wonder why, I was asked to just do a vaginal swab without needing to touch the cervix), but assuming the same applies to both kinds of swabs, this information should be very reliable.

According to the manufacturer's protocol and clinical trials:
quote:
Assay performance with moderately to grossly bloody swabs was not statistically different than assay performance with non-bloody or lightly bloody swabs.
But also:
quote:
In laboratory studies, blood > 5% (v/v) was shown to cause indeterminate (inhibitory) results in both urine and swab specimens (with AC) and false negative results in urine specimens (with and without AC). Blood > 5% (v/v) may cause false negative results in swab specimens (with and without AC). Specimens with moderate to gross blood may interfere with BD ProbeTec ET CT/GC Assay results.
There was no mention whatsoever of menstruation, but I take it that "bloody swabs" can cover period blood, breakthrough bleeding, spotting, etc.

So it seems to me to be saying that there is a chance that blood in the specimen can cause indeterminate or false negative results, but it would depend on how much blood and even then it may or may not make a difference, which, given everything you guys and others have told me, makes a lot of sense.

Source: http://www.bd.com/ds/technicalCenter/clsi/clsi-viper-ctgc.pdf

Heather/Robin, if you have further insight or anything else to add, please do. Otherwise I'm happy with what I've found - it just helps a lot to know what I should expect. Coming from the manufacturer, it should be a credible source, right?

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Heather
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I've got nothing else to add, save that this backs up what we've been saying here and you've already been thinking. In a word, if it DID cause an issue, then your test results won't come out clearly, which your provider will tell you.

--------------------
Heather Corinna, Executive Director & Founder, Scarleteen
About Me • Get our book!
Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has. - Margaret Mead

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Heather
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Also, if you can say Chlamydia trachomatis/Neisseria gonorrhoea ten times fast, you get a cookie. [Razz]

(In labs and clinics, they usually just call this a CT/GC test, and you can see why!)

--------------------
Heather Corinna, Executive Director & Founder, Scarleteen
About Me • Get our book!
Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has. - Margaret Mead

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Jill Valentine
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I actually wondered what CT/GC stood for. Wow, way slow.

I intend to post my results next week but this discussion in the meantime has gotten me through a LOT of worrying. Thank you! [Smile]

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Heather
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Sure thing. [Smile] Take good care of yourself.

--------------------
Heather Corinna, Executive Director & Founder, Scarleteen
About Me • Get our book!
Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has. - Margaret Mead

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Jill Valentine
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So I got my test results today a few days earlier than expected. I'm negative for both chlamydia and gonorrhea. The nurse said women get tested on their period, and I quote, "all the time" so there wouldn't be any false results. She told me to not worry. I don't plan on asking for another test, at least not in a long time, so I guess that wraps it all up for now. Thank you for your support on this thread. [Smile]

[ 09-20-2013, 04:56 AM: Message edited by: Jill Valentine ]

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Robin Lee
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You're welcome. [Smile]

--------------------
Robin

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