Normal then abnormal, normal then abnormal pap smears. What to do?
January 5, 2012 9:54 AM Subscribe
How normal are cycles of normal then abnormal pap smears?
About 4 years ago (2008ish), I was diagnosed with HPV. I had a colposcopy around that time that came back without anything alarming and we commenced six month pap smears. In 2009, I was told that I was no longer testing positive for HPV. I have still been on six month pap smears ever since. The reason? I get one normal one and then I get an abnormal one. It's back and forth. My doctor said that this "chasing" game is normal and that as long as I'm still testing negative for HPV, he isn't too worried.
But I just got back another abnormal pap after having a normal one six months ago. I have to have two normal ones in a row before I can go back to yearly paps. I am starting to get a little frustrated. The last time it came back abnormal, I was assured that it was nothing to worry about. When do I start worrying? Should I maybe seek a second opinion? Should I be having more serious conversations with my boyfriend of almost 3 years about this, especially since we no longer use condoms?
I have a call into my doctor's office to ask them a few questions as they just called with the results via message. But I am curious if anyone has had a similar experience or has any advice on how best to handle the situation.
About 4 years ago (2008ish), I was diagnosed with HPV. I had a colposcopy around that time that came back without anything alarming and we commenced six month pap smears. In 2009, I was told that I was no longer testing positive for HPV. I have still been on six month pap smears ever since. The reason? I get one normal one and then I get an abnormal one. It's back and forth. My doctor said that this "chasing" game is normal and that as long as I'm still testing negative for HPV, he isn't too worried.
But I just got back another abnormal pap after having a normal one six months ago. I have to have two normal ones in a row before I can go back to yearly paps. I am starting to get a little frustrated. The last time it came back abnormal, I was assured that it was nothing to worry about. When do I start worrying? Should I maybe seek a second opinion? Should I be having more serious conversations with my boyfriend of almost 3 years about this, especially since we no longer use condoms?
I have a call into my doctor's office to ask them a few questions as they just called with the results via message. But I am curious if anyone has had a similar experience or has any advice on how best to handle the situation.
I eventually went with the rule that I didn't Have to make or go to an appointment in six months, that's just the recommendation. Since my colposcopy I've just gotten a pap every year or two and my doctor tuts and says I should've gotten one sooner, does the pap and we move on. But I haven't gotten as many abnormal results as you (because I've allowed less tests), so ask your doctor if you should start worrying - they should have a good answer, and if they don't, go for that second opinion, for sure.
posted by ldthomps at 10:50 AM on January 5, 2012
posted by ldthomps at 10:50 AM on January 5, 2012
I had abnormal pap smears and HPV too. My rule of thumb is that if my doctor doesn't look worried, I don't get worried. The time to get worried after bad colposcopy results, not after abnormal pap smears.
Regarding serious conversations with your boyfriend - this honestly is not a huge deal. Have one conversation, then be done. My husband freaked out and then got over it. I bet he has forgotten about the entire thing now.
Honestly I forget about this diagnosis until I get my notification for appointments in the mail (or read a post like this). It is so low on my list of things to worry about that it does not even register as anything higher than mild annoyance when I see the appointment reminder in the mail.
How do I keep from worrying? I worry about other things - job, house, kid, husband's health scare (unrelated), etc. My day to day life crowds out the need to care about this. YMMV obviously.
posted by crazycanuck at 11:05 AM on January 5, 2012
Regarding serious conversations with your boyfriend - this honestly is not a huge deal. Have one conversation, then be done. My husband freaked out and then got over it. I bet he has forgotten about the entire thing now.
Honestly I forget about this diagnosis until I get my notification for appointments in the mail (or read a post like this). It is so low on my list of things to worry about that it does not even register as anything higher than mild annoyance when I see the appointment reminder in the mail.
How do I keep from worrying? I worry about other things - job, house, kid, husband's health scare (unrelated), etc. My day to day life crowds out the need to care about this. YMMV obviously.
posted by crazycanuck at 11:05 AM on January 5, 2012
As an oncology nurse who works with hospitalized women who have cervical cancer, I would urge you and anybody else in a similar situation to follow the doctor's recommendations for follow-up testing. Having a biopsy during a colposcopy is certainly no fun, but it beats the treatment for full-blown, invasive cervical cancer by a looooong shot.
If your doctor says the normal-abnormal-normal cycle is common and not worrisome, that is good news. If you're not sure you trust your doctor on this issue, there is no harm in getting a second opinion from someone else. Are you seeing a GYN or just going to a general practitioner for these pap smears and information? If the latter, perhaps a visit with a GYN specialist would help ease your mind.
In terms of how to handle the frustration/worry, as with most things in life, the best you can do is to control the things you can control and try not to worry about the rest. Things you can control include following your doctor's recommendations on follow-up screening, and quitting tobacco if you currently use it (it ups your risk of cervical cancer).
Good luck!
posted by vytae at 11:08 AM on January 5, 2012 [1 favorite]
If your doctor says the normal-abnormal-normal cycle is common and not worrisome, that is good news. If you're not sure you trust your doctor on this issue, there is no harm in getting a second opinion from someone else. Are you seeing a GYN or just going to a general practitioner for these pap smears and information? If the latter, perhaps a visit with a GYN specialist would help ease your mind.
In terms of how to handle the frustration/worry, as with most things in life, the best you can do is to control the things you can control and try not to worry about the rest. Things you can control include following your doctor's recommendations on follow-up screening, and quitting tobacco if you currently use it (it ups your risk of cervical cancer).
Good luck!
posted by vytae at 11:08 AM on January 5, 2012 [1 favorite]
Hmm...I've been in your same situation, normal then abnormal for a few years. I've had two normal in a row at this point. IANAD, but basically my doctor told me that my partner of 5 years and I were probably passing it back and forth to each other, but at some point it would probably be out of both our systems. I guess like 90% of infections go away after two years? I wouldn't worry too much, as long as you are getting checked up regularly. I mean everyone should get a once yearly pap, and two is a bit of a drag, but not a huge deal right? If it makes you feel better, most every girl I know has had a couple of abnormal paps in their day.
posted by amileighs at 1:22 PM on January 5, 2012
posted by amileighs at 1:22 PM on January 5, 2012
Pap smears can also be affected by your general immune system function and stress levels. Many women have an abnormal pap smear during pregnancy, for instance, as the immune system can be compromised at this time.
I would like to second that avoiding smoking is hugely important. Make sure that you are eating well, exercising, and getting enough sleep. You can try taking supplements of folic acid; there is anecdotal evidence that this can help clear the virus.
You may very well be passing HPV back and forth with your partner. It's also possible to have false positive or false negative pap smears, so that is a consideration. My best advice is to continue with your current pap smear plan. The vast majority of the time, your body will clear the virus on its own within two years. Good luck and try not to worry too much!
posted by natural log at 4:00 PM on January 5, 2012
I would like to second that avoiding smoking is hugely important. Make sure that you are eating well, exercising, and getting enough sleep. You can try taking supplements of folic acid; there is anecdotal evidence that this can help clear the virus.
You may very well be passing HPV back and forth with your partner. It's also possible to have false positive or false negative pap smears, so that is a consideration. My best advice is to continue with your current pap smear plan. The vast majority of the time, your body will clear the virus on its own within two years. Good luck and try not to worry too much!
posted by natural log at 4:00 PM on January 5, 2012
Yep, I'm in your same situation. I kind of treat it like the first commenter's friend does.
It's annoying to have to get pap smears every 6 months.
And when they come back abnormal, it's annoying to have to go back in for a colposcopy/cervical biopsy.
But I try and see it as, it's my body and although I certainly can't see my cervix, I'm happy to have someone who knows what they are looking at take a peek at it every so often. I've switched doctors and clinics so many times in the ~5 years that this has been happening and they've all treated it as no big deal. We (you and I) are probably passing it back and forth with our partners and it's flaring up when our immune system is busy fighting other infections.
FWIW, my fiance's sister was diagnosed with cervical cancer after an abnormal pap smear-->colposcopy-->biopsy and she kicked it's ass. So these twice-yearly annoyances may pay off in a serious way.
posted by pintapicasso at 1:24 PM on January 7, 2012
It's annoying to have to get pap smears every 6 months.
And when they come back abnormal, it's annoying to have to go back in for a colposcopy/cervical biopsy.
But I try and see it as, it's my body and although I certainly can't see my cervix, I'm happy to have someone who knows what they are looking at take a peek at it every so often. I've switched doctors and clinics so many times in the ~5 years that this has been happening and they've all treated it as no big deal. We (you and I) are probably passing it back and forth with our partners and it's flaring up when our immune system is busy fighting other infections.
FWIW, my fiance's sister was diagnosed with cervical cancer after an abnormal pap smear-->colposcopy-->biopsy and she kicked it's ass. So these twice-yearly annoyances may pay off in a serious way.
posted by pintapicasso at 1:24 PM on January 7, 2012
This thread is closed to new comments.
If you're not feeling like your doctor is addressing your questions to your satisfaction then why not go get a second opinion? The world is full of doctors. If yours isn't able to answer your questions to your satisfaction then go see another one.
posted by phearlez at 10:35 AM on January 5, 2012