January 14, 2012 11:58 AM   Subscribe

Slightly freaking out over a lady-parts medical issue, and wondering if anyone has been through this.

I get regular paps. Was told a recent one was abnormal - negative for HPV but with abnormal cells. A few days later, regular intercourse with my long-time-partner led to a lot of bleeding, which has never, ever happened before. Went back to the doctor. Answered lots of embarrassing questions about the sex; doctor examined things and determined there were "abnormal abrasions" in two spots that led the the bleeding, which was exacerbated by the sex, but not caused by them. She medicated me up in there, and I have to go back next week for a colposcopy and biopsy of the area. She said that the negative HPV was a good sign, but seemed to rule out a lot of other "normal" things that might have caused the abnormal pap or the bleeding (no infection; no latex allergy; unlikely to be normal sex with my regular partner; negative for other STDs). She did say that not all cervical cancers are caused by HPV, so it was a possibility, but not one she wanted me to be concerned about until we know more.

Despite that, I'm concerned. She didn't seen able to offer me any other explanation for what was going on. I try not to google medical conditions. I'm hoping someone out there has had this done and it has led to nothing. I'd also like to know if I should expect this biopsy process to be extremely painful?

Thanks in advance.
posted by anonymous to Health & Fitness (14 answers total) 2 users marked this as a favorite
I've had abnormal paps wherein HPV is ultimately the culprit. Have never had the bleeding thing you're talking about. So I can't speak to the HOLY SHIT SOMETHING FREAKY IS WRONG WITH MY LADYPARTS panic you're probably feeling.

But it was scary as hell to get that abnormal pap smear. Colposcopies are awkward. Biopsies hurt, I'm not gonna lie.

At the end of the day, you are going to be OK. Whatever the news is. Whatever this means for you and your lady parts. You, anonymous, as a person, are going to get through this.
posted by Sara C. at 12:18 PM on January 14, 2012

Oh, just noticed the last sentence of your question. While biopsies hurt, they are not "extremely painful". Just regular painful. I'd describe it as the same level of pain as getting a tattoo - especially since the worst of it was the actual biopsy process itself. I felt a low-level twingey sting for the whole 5-10 minutes of the procedure, and it felt like an ETERNITY until it was done. Once I was finished the pain mostly subsided. I went home, had a glass of wine, took a tylenol, and laid low for the rest of the day.
posted by Sara C. at 12:21 PM on January 14, 2012

I had a colposcopy/biopsy due to testing positive for HPV. The doctor gave me a ginormous pill before it started -- Aleve or Advil, in some ridiculous dosage -- which did help with the pain. Make sure to take some painkillers beforehand. Also, I got very pale after it was done and the doctor had to bring me a can of juice to drink before he let me go, so you might want to have something like that on hand in case the office isn't prepared. The procedure wasn't horrible but it was uncomfortable, kind of like an internal pinching feeling. I don't remember it lasting for more than a few minutes. My boyfriend drove me to and from the doctor's office, and I'd recommend getting a ride if at all possible. I remember just feeling very gross and crampy when I got home, and wanting to be alone and lay down and cry, so certainly don't plan to go back to work or anything after the procedure.
posted by jabes at 12:21 PM on January 14, 2012

Are you on hormonal birth control? Several years ago, I had been on it for quite some time without a problem, then I suddenly started getting abrasions during regular sex... turns out that thinning of the lady-parts tissues can be a long-term side effect for some women on HBC, which can lead to trauma even from non-traumatic activities (the doc who examined me actually asked me straight-out if I'd been raped). This led to me switching to other HBC options, and eventually going off hormones entirely, which solved the problem for me.

I had an abnormal pap several years later and had a biopsy (which turned out fine), which I recall feeling moderately uncomfortable/pinchy but also fairly quick. Call ahead of time and ask if it's OK to take some Tylenol or Advil before the procedure, and maybe even half a tranquilizer if you're really nervous. (If you take a tranquilizer, they'll require that you have someone drive you home.)
posted by scody at 12:24 PM on January 14, 2012

Feel free to freak out (I think it's an understandable response), but understand that these things happen, and a lot of times, what looks initially really bad turns out to be meh.

On my end: I had the HPV, went in for the colposcopy, came back with advanced dysplasia (not cancer, but right on that edge), freaked out, got LEEPed, and then was told (after a test was run on the tissue that was removed)... that the dysplasia was minor and that everything looks beyond good now. Have had 3 normal paps since.

So, it was weird: at first I was told that biopsy results were worrying, and that I should get everything taken care of ASAP. Then, once they did that, they said that subsequent tests indicated that things weren't as bad as the colposcopy indicated. Kind of a head trip, but it's done now. Yay!

Some things:

1. Yes, my colposcopy/biopsy hurt. That said - it was done by a recent MD, under supervision, who also botched inserting the speculum, of all things. When I said, "ow!" the supervising doctor seemed really surprised. It shouldn't hurt. And even though it IUD insertion hurt far more, and I plan on getting another one when this one wears out, so, you know...

2. No one is going to know what is really going on until the colposcopy. So go ahead and get that done.

3. Even if you have to go for a LEEP procedure, try not to get too freaked out about what some people report about side effects and future pregnancy shiz. If you go to a good OB/GYN with lots of experience, you'll have a good outcome, with nothing to really worry about. I mean, I even read some reports that women were forced to remove their IUDs for the procedure; when I went to my doctor (who is consistently ranked as the #2 OB/GYN in this state), she was all, "that is so unnecessary, I am going to laugh."

4. You may not even need a LEEP. So ignore what I just said.

5. What I was continually reminded of, by the nurses and MDs who worked with me, even in the Worst Case Scenario, the one that is NOT likely, you have to remember that cervical cancer is sloooow. Any weird test results or biopsy results or discoveries that are caught now are highly treatable. It's like: you're getting treated for a condition that is, technically, several years away. You're just getting all this done now so it never even turns into that case.

Good luck! It's scary, but then afterwards, it's totally not.
posted by sock puppet of mystery! at 12:29 PM on January 14, 2012 [1 favorite]

So, it was weird: at first I was told that biopsy results were worrying, and that I should get everything taken care of ASAP. Then, once they did that, they said that subsequent tests indicated that things weren't as bad as the colposcopy indicated.

Yeah, this is pretty much the story of both of my abnormal pap experiences so far. First, I was colposcopied and told, "whelp, there's nothing there for us to biopsy...? You're good!" Next time, I was colposcopied, biopsied, and told, "yeah, this is definitely not cancer-related at all, so you're good." Both times, the fear brought on by the various medical procedures was much stronger than the results of the procedures.
posted by Sara C. at 1:24 PM on January 14, 2012

I've had the colposcopy + biopsy stuff, and it wasn't that bad. It felt a little crampy, with some pinches and twinges. Not a great big deal. And nothing serious was found, so the abnormal PAP smear was also nothing.

Don't take ibuprofen (or anything else) without getting your doctor's OK first -- my doctors have always told me to avoid that for any procedure that involves the possibility of bleeding.

If no other reason can be found to explain the abrasions, you might ask about the possibility of Sjogren's syndrome. It's an autoimmune disease which can cause dryness in membranes which are supposed to be moist, including eyes, mouth and vagina. Tissue which is chronically too dry can be easily damaged.

Hope all goes well -
posted by Corvid at 1:25 PM on January 14, 2012

I've tested positive for HPV, had the colposcopy, but that only proved that "huh...there really isn't a lot in here we need to worry about after all," and they decided to just let things sit. The colposcopy didn't really hurt - it was uncomfortable while it was happening, and for the next 24 hours I occasionally passed something that looked like black sand (they warned me about that -- they said it was the iodine they'd put on my cervix to stop the bit of bleeding that did happen, mixed with the goop they put on it to make the abnormal bits show up).

But my obsessive googling at the time taught me that a lot of very harmless things can give an abnormal pap -- stress, a mild cold; it sounds like even sneezing funny could do it. All the colposcopy is doing is giving you information, and it's possible that information will be good.
posted by EmpressCallipygos at 1:25 PM on January 14, 2012

first: i admire your dedication to not google medical conditions, you're a smart person.

I guess I kinda wonder, with the abnormal cells, what the result was of your pap (ASCUS? ASCUS-H? did you get any more explanation of the abnormality reported?) -- if you had a negative HPV test, though, it's considered fine management (in fact, the guidelines) to just get a repeat Pap + HPV in 12 months (or 6 and 12 if you want). (barring details not in your post?). I admit, I am biased, as I see a lot of referrals to colposcopies that aren't really indicated (also, expensive), and it bugs me that you didn't get much more explanation.

But yeah, if you have abnormal cells but no HPV, the odds of something being real wrong are real small. small small. really small. i hate the pull the nurse card, but, seriously, it's small. as Empress put it, you're getting information, which is always something useful for future medical history (e.g., january 2012, negative colposcopy results, also useful information if you get another abnormal-but-no-HPV pap).

also - depending on your age/reproductive life plans, you want to get a LEEP if they want to get a biopsy. it has the least potential effect on any future pregnancy shiz, as sock puppet put it. you should also be able to call the doctor's office with questions about pain relief (like ibuprofen beforehand, if that's alright) or questions about the procedure, and they should get back to you.
posted by circle_b at 1:34 PM on January 14, 2012

As a possibility, I tend to bleed after pap smears. And would have increased bleeding if I had sex in the week after.
posted by geek anachronism at 1:50 PM on January 14, 2012

I had about 5 years of abnormal paps that didn't progress, and then one day (10 years ago) one was worse so I went in for the colposcopy then a LEEP a bit later. The biopsy didn't really hurt at all, so I guess there is a spectrum of responses.

I've subsequently had an uncomplicated pregnancy if that was concerning you.

(and my last pap was abnormal again after having 10 years of good ones, so I'll probably be on this cycle again. But really, abnormal paps are super super common.)
posted by gaspode at 2:43 PM on January 14, 2012

As circle_b says, you can have abnormal cells (ASCUS) without HPV, and it can just resolve. Like others in this thread, I had an abnormal pap, followed with a colposcopy (unpleasant, but not horrible), negative results, and clean paps for the 12 years or so since then. Sometimes your cervix just gets irritated, and sometimes - like on every other surface of the body - there are weird cells that need to be checked out. Good luck with your followup.
posted by judith at 4:09 PM on January 14, 2012

There's a big range to how painful people find that biopsy with the colposcopy. I've had a pretty high tolerance for some types of pain in the past, but I was whimpering on the table. I'm not telling you this to scare you -- I'm telling you so that you don't think that you're a freak or that it's a sign of something wrong with you if you find it painful.
posted by desuetude at 8:53 PM on January 14, 2012

I just had a colposcopy a couple weeks ago- no abnormal pap, but I've tested positive for HPV for a couple years so they thought a closer look was in order. The procedure itself was no weirder or more uncomfortable than a pap, and the biopsy she did was pinchy for a few seconds, but most emphatically no big deal. And it turns out that things are fine.

Obviously your experience may vary, and if you are very anxious about it I would call in ahead of time and ask to talk to someone about it, and also ask if they recommend you take something in advance for possible pain. I hope everything goes well and smoothly for you.
posted by My Top Secret Sock Puppet Account at 2:29 PM on January 15, 2012

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