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» Scarleteen Boards: 2000 - 2014 (Archive) » SCARLETEEN CENTRAL » Sex Basics and Sexual Health » Abnormal Pap : Implications

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Author Topic: Abnormal Pap : Implications
breath
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I went to the doc and had an abnormal pap smear. I know that they will take care of the medical side of things. I had the following questions. I understand it is a matter of personal preference but want to hear "recommended practices" based on others experiences:

1) How long is it recommended that should I abstain from sex after this?
2) Is it good ethics to tell the last partner about this before I went in for a pap?
3) Similarly, is it good ethics to any future partners about this, since the virus will stay inside forever? Clearly, many people may refrain from engaging with me.

I feel sad that perhaps I wouldn't be able to have sexual intimacy anymore [Frown]

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skiesofgreen
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Just to be clear you mean you got a pap smear done and your doctor informed you that your results were abnormal? This was not an STI test and the doctor informed you you were positive for an STI?

If so you're not worrying about a virus. Pap smears are used to screen for cervical cancer. When a doctor says you've had an abnormal pap smear it means that some of the cells in the sample they took from you appear abnormal. It does not mean you have cancer, but that they'll want to take another sample to varify the results. When this happened for me they had me come back within six months rather than a year.

So, if it is an abnormal pap smear you're talking about, there's no real ethical issue in telling your partners, as far as the spread of diseases goes.

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breath
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Yes, I got a pap smear that was abnormal. This is caused by HPV so this means that indirectly, I have HPV?
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Karybu
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Just to be clear, most abnormal pap results are caused by HPV, but not all of them are. So, it's very likely that you do have HPV, but it isn't guaranteed, and your doctor will recommend further tests for HPV specifically if they think that's necessary. (It's possible to test for the specific type of HPV you may have, although whether that's needed is something best decided by your doctor.) There's a really detailed rundown of abnormal pap smear results, what they mean and how they relate to HPV here: http://www.cancerscreening.gov.au/internet/screening/publishing.nsf/Content/EFAA19DECAA2111ACA2574EB007F73AF/$File/pap-smear.pdf (A bit long, but well worth a read.)

Assuming you do have HPV, you may not always have it, either. Many people clear the virus from their systems within a couple of years. It also doesn't mean - at all - that you won't ever be able to have sex again. People with HPV (and other sexually transmitted viruses like herpes) can and do have very enjoyable sex lives. Honesty is always a good thing when it comes to talking about possible STIs, and that might mean that your pool of sexual partners is a bit more limited than it would be otherwise, but I can pretty much guarantee that you can still and will still have sex. [Smile]

I'm not actually sure what you mean by your first question - are you asking how long you need to abstain from sex after having a pap smear?

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breath
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Well, Clearly, if a lot of people have HPV, then no one really talks about it and it goes without saying? That's why its recommended to take care of your health/check up.

I don't have usual sex or often /frequent sex. But I wonder if I have to tell any sexual partners that I have or have been exposed to HPV (under a general rule of ethics/right thing to do)? Since it's so common, they may already have it and not know it.


So pretty much I have to wait 1-2 years until it's clear before I don't have to tell anyone? However, since the virus is always there, even if 1 year from now I have a normal pap, doesn't that mean that I'm always at risk for it reoccuring and have to always tell every partner?

By first question, I mean- is it recommended to stop having intercourse or oral sex when you have a abnormal pap until it comes back normal again??

I don't think most people wouldn't be interested in having sex with someone who says they might have HPV.

I go to planned parenthood and I doubt that they will do a check to see what kind of HPV is there. They have a very steamlined process of care for such things: abnormal pap --> coloscopy --> whatever next.

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breath
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Also this feel a bit unfair but hopefully with a good life style etc, the time of clearance of HPV in both genders can be comparable?
[Frown]


"The same study discussed above found that most men who were infected with HPV cleared the virus within six months of becoming infected — in other words, HPV was no longer detectable in their bodies. In fact, three quarters of men showed no trace of the virus after one year, and this was true whether the men were infected with cancer-causing (oncogenic) strains or nononcogenic strains. This is in contrast to previous studies, which found that women tend to stay infected with cancer-causing strains of HPV for longer periods of time. Women have also been shown to be more susceptible to oncogenic HPV than nononcogenic HPV, something that, again, does not appear to be the case for men."

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Heather
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Actually, the usual protocol anywhere with abnormal paps is to do a second pap, first. Particularly since even changes in the menstrual cycles can result in an abnormal smear, or recently having had sex.

I don't think it's sound to assume you have HPV right now. Even if you do, it certainly isn't world ending, or sex life ending, or anything close, but I think going there at all with one abnormal pap just isn't sound, just like someone who founds something amiss in a breast self-exam assuming cancer wouldn't be.

When did they schedule you for that second pap? Did THEY suggest you needed a colposcopy?

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breath
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Yes, they asked me to come in colposcopy . I went yesterday, and and they took biopsy. When they called me to tell me the results of my first (Ever!) pap smear, they said it was LSIL ( low grade squamous intraepithelial lesion) . During the colposcopy/biospy (they take the tissue /cells at the same time), the nurse said that her impressions were that it was "mild".

I got the idea from talking to the nurses/health staff, that the nurses don't really make executive decisions, and they just follow protocol. They do colposcopy after an abnormal pap and during the colposcopy, they almost always do biopsy unless everything looks normal (which is usually not the case, anyways, since the pap was abnormal ).

I am totally fine/calm and understand the risks etc. I am just not sure what is the sound thing to do or how it can affect my sex life or future sex decisions. I always use protection and limit the number of partners etc as is.

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Heather
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Hmm. The usual protocol after just one abnormal pap would be the schedule a second pap first. So, if this was your first abnormal pap, I'm surprised. But let's see what that biopsy shows, okay?

But seriously HPV is so not a death knell of anything. At this point, in fact, most sexual healthcare providers figure that HPV of some kind (there are around a hundred strains, though all of those aren't genital) is just kind of like an entry-gift to sexual life. Obviously, the strains which can cause cancers can be serious, and it all needs to be treated seriously because of those risks with those particular strains, but following through the steps is all that can be done.

In terms of your sexual life, obviously, since you've just had a biopsy, it needs to be on hold for a little bit anyway. In the meantime, you could also go and get a digene HPV test if you have the healthcare or cash to cover that: that's the test for HPV, not a pap smear. Then you could know for certain.

But how about we get to more of a diagnosis before we get to partner protocols? One step at a time?

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breath
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OK sounds good. One step at a time. I guess I have more info to make a decision in 2 weeks or so, when the biopsy results come back.

I am strongly leaning towards getting the Garsdil shot (although it's going to be $170 total) but I believe it's worth it for peace of mind and protection against other strains.

I don't know if it is really that helpful to pay for HPV test. It doesn't seem like a good way to spend the money since it's not like a vaccine and may well come out positive.

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Heather
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Well, I'd say it's helpful in terms of knowing. But I think you could wait on the biopsy first, since that will certainly give you more information, and its results may be such you don't need an HPV test to know.

For sure, the HPV vaccine offers you protection against the four strains of HPV most associated with sexual transmission and cervical cancer. But again, lets' rem,ember it might well offer you protection against all those strains, because you still have not been diagnosed with HPV.

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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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breath
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I see.

But isn't it true that abnormal pap smear is mostly always caused by HPV, and rarely by anything else? There is a small chance that it's a rare reason, but let's see.

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Heather
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No, I'd not say that, especially a first abnormal pap. Two abnormal paps in a row, yes, but I'd not say that about a single abnormal pap.

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Heather Corinna, Executive Director & Founder, Scarleteen
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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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breath
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I see. Thank you for the info. I'll wait and see when the time comes. The joys of adulthood life! [Smile]
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breath
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Im scheduled to take the Garsdil shot today (dose 1). I am wondering if it makes sense to take the shot now and to take the shot, even if I (hypothetically) have a certain strain of HPV ?

I know it protects against 2 cancerous ones and 2 genital warts one. I figured that if I take the shot now, I'll have some protection against the one with warts..

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Heather
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Again, for all we know, this will protect you from all strains, since we don't know yet if you have ANY strain of HPV.

Whether or not you want to vaccinate is one of those things that is your call. If someone can afford it, and doesn't have ethical or religious issues with vaccinations, period, I personally don't see any reason not to do it.

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Heather Corinna, Executive Director & Founder, Scarleteen
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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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breath
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Hello:

The results in are.
I went in for a pap smear, It came back "low grade".
Then I went back for a biopsy/colposcopy, which also came back 'low grade'.

The clinic at Planned Parenthood told me to come back in one year. They will do a HPV screening vaginally.

I have been told that I can have sexual relations with a condom . It's not on my priority list and I am not in a relationship, but it's good to know/have more info about my options for the next year.

So, am I good to go? Just have a healthy life style and relax this year?

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Robin Lee
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So long as you feel like you got complete information from your clinic, answers to all your questions, then yes, you're good to go.

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Robin

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breath
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1. Should I get the vaccine or not? If I have a particular strain of HPV and it clears within a year, does this mean that in the future, i will have more immunity from that strain?

2. Should I limit or stay away from condom-based sexual relations until next year? I am not very active as is, but want to know what's recommended/good idea.

Thanks

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Heather
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Do you trust your healthcare providers?

I ask because it seems to me that you're asking us things they either already told you, or where they should be who you ask and whose opinion comes frist.

If you do NOT trust them, then obvs, they're not going to be a good choice in healthcare provider for you, and if you can switch to someone else, we'd strongly advise you do.

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Heather Corinna, Executive Director & Founder, Scarleteen
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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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breath
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Thanks. I don't think I have much of a choice. It's Planned Parenthood, I only talk to the person whose job is it to give out results on the phone, they aren't a doctor, and I can't really sit down and have a long chat about things. I guess I will have to think this through and do some more research online.
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Robin Lee
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It's frustrating I'm sure that you can't just sit down and have a long chat. Rest assured though that the person who gives you the results over the phone is some type of medical professional or highly trained in this specific area of health care, and is passing along the doctor's recommendations. In other words, you're getting information from a doctor. It's the way a lot of medical practices, both clinics and private practices, do things.

Planned Parenthood has an extensive Web site, so that might be a good place for you to start if you feel like you need more information.

and...for next time, know that when you're at the clinic, in person, you can ask as many questions as you feel you need to, even writing them down ahead of time.

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Robin

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breath
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thanks! Yes, I will find better ways to "trust" the info that PParenthood is giving me and/or reflect on better ways to ease my anxiety/anxiousness so that I don't overwhelm yall.

Thank you .

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Heather
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Actually, if there WAS something to have a long chat about, most branches would have offered you counseling and the ability to talk more with an educator.

So, my guess is, if all they said was what they did -- which looks pretty similar to what we already have, btw -- in this case, it was probably because that's really all that needed to be said.

Also, you can always ask to have an appointment to talk with an educator at most PPs.

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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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Claire P.
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breath, if you're looking for simple ways to help ease your anxiety, one could be to make sure you have good amounts of vitamin A, C & E in your diet! To help boost your immune system and lessen the risk of cancer (although the latter should not technically be an issue according to your "low grade" status).
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