The Test Results are Back and We Need to See You…

As everyone knows, once a female becomes a woman, it is time to begin the embarrassing, annual visit to the gynecologist and I am no different. I make the appointment and dread the visit. This appointment is rarely one that can be made today and one sees the doctor tomorrow. My experience has been that the appointment must be made months in advance so there is a lot of time for dread. No matter, I understand the importance of this exam so I show up.

In 2015, I showed up and I was told that the guidelines had changed and the annual exam was no longer necessary. The new guidelines pushed the exam to every three years. I happily got dressed and left the office.
The happiness did not last long and as 2016 progressed, I began to worry that the annual exam was needed. I was not having any issues but I simply needed to hear, “your test results are negative for abnormal cells”. So, I scheduled an appointment and jumped right up on the table with a smile on my face. I was ready!!

Several weeks later, I received the call. “Your results are positive for abnormal cells and we need you to come in” and I made an appointment for the next day. However, within about 20 minutes, my world began to slow way down and I knew that by the next morning, I would be a wreck. I could not spend 24 hours with Google, knowing that something was not right inside me, and not go crazy with worry. So, I called back and, thankfully, was able to make an appointment for the same day.

My return visit resulted in my being told that I am “just slightly off normal” and that there is a “slight indication of human papillomavirus” (HPV). The doctor performed a  colposcopy, which I had never heard of, by looking through a high powered magnifier to take a very close look at my cervix and the surrounding tissue.

In the end, there was nothing for concern and I am free to go about my life. No need to be alarmed, no need to confess past sexaul sins, no reason to blame my partner for infecting me with a virus, and no need to believe that I am going to die of cervical cancer. I can say all of this now with a calm and certainty that I did not have prior to Google searches and visiting my doctor.

During my Google searches, HPV and abnormal pap smear were inextricably tied. This was alarming because I have always heard that HPV is the precursor to cervical cancer and that it is not a common virus. However, in addition to linking of HPV and the abnormal pap smear, the search information was overwhelmingly informative and seems intent on STOPPING the hysteria that accompanies HPV.

One thing that I very quickly learned and my doctor corroborated is that there are many types of HPV and only a few are tied to cervical cancer. I learned, that anyone who has been sexually active likely has had or will have some form of HPV. The type of HPV that causes warts does not lead to cervical cancer.

I also learned that HPV can remain dormant for days, weeks, months, or even years so it is impossible to tell where one got it. No need to blame anyone and once you have it, your body will cure it in due time.

Thank goodness for Google and good doctors. My crash course actually made me feel better about the situation and I always happy when I can become smarter about a topic.

I am providing the information below with the hope that I can help another person feel better if they receive the “We need you to come in.” call.

Here are some of the key things that I learned about an “abnormal pap smear and HPV.

1. Occasionally a Pap report will show an infection caused by yeast or bacteria, or even some changes in your vaginal tissues due to low estrogen levels in menopause. These results are easily dealt with and are unrelated to HPV or cervical cancer.
2. Abnormal results typically mean one of three things: There is an inflammation that is probably nothing to worry about, you have HPV, which is really common and no big deal, or your doctor has identified potential precancerous cells.
3. A colposcopy is a little more in-depth than a pap smear. For a colposcopy, the doctor will brush acetic acid (produces a slight vinegar-like smell) over the cervical tissue and look at it with a special light and lens. The acid allows abnormal cells to become more visible. If abnormal cells are seen the doctor will proceed with a biopsy.
4. “If you’re sexually active, the likelihood is almost 100 percent that you’ll be exposed to HPV at some point in your life,” explains Michael Cackovic, M.D., an ob/gyn at the Ohio State Wexner Medical Center.
5. Cervical cancer can—like other cancers—be deadly; however, with routine screenings, cervical cancer has become extremely rare in the U.S. and is often caught in the early stages (thanks to pap smears) and removed before it can spread. Most times, it grows very slowly, and can take 10 or more years for abnormal cells to turn into cancer.
6. While there’s a very good chance you may get HPV in your lifetime, it’s also extremely likely you have a benign version and it will clear up on its own. The chance of spontaneous clearance is about 80 percent within 2 years, The majority of women may harbor it only for 1-2 years before clearing it, or have repeated infections that they also clear. In fact, there’s no reason to even know whether or not you have a harmless strain of HPV; it doesn’t really help or hurt.
7. Abnormal cells can often turn normal over time, so getting abnormal pap results doesn’t mean a cervical cancer diagnosis is guaranteed to follow. It could mean nothing, Cackovic says, but you should always go through the next levels of testing to find out. The next step is a colposcopy, a test using a special device to closely examine your cervix, vagina and vulva, to look for masses of abnormal cells.
8. According to the American Congress of Obstetricians and Gynecologists, there are more than 120 strains of HPV. Approximately 15 strains are linked to cervical and other cancers—anal and oropharyngeal (cancer of the tonsils and area under the tongue)—and approximately 12 cause genital warts.
9. Most HPV infections clear up on their own and don’t cause any problems.  Researchers now think that when the HPV clears up it stays dormant in your body unless your immune system is later compromised in some way, in which case the HPV may become active again.  When the HPV is dormant it appears that it is not passed on to a partner.
10. There is no need to stop having sexual contact with your partner if she is tested for the virus and finds out she has HPV. The virus is commonly exchanged between sexual partners, and by the time HPV is detected, it most likely already has been shared between the two of you. And, once a particular type of the virus has been exchanged, there is little risk of a “ping-pong” effect – in which you and your partner keep re-infecting each other with the same type. (In other words, you don’t need to worry about passing the same type of HPV back and forth.)

11. When detected early, the prognosis and survival rate for cervical cancer is very high. That’s why it’s so important to visit your gynecologist for an annual exam, and be diligent about regular cervical cancer screening.