Is it bad to have HPV in your body?
October 18, 2013 8:56 PM   Subscribe

I'm on my fourth consecutive abnormal pap smear and resulting colposcopy. I know HPV is super common and I am fine with it being in my body, but am I just going to test positive and have abnormal cells forever?

In 2008, 2009 and 2010 I had abnormal pap smears which showed HPV. Each time I got a colposcopy,and each time I got a biopsy which showed no abnormal cells. I didn't get a pap smear the last two years because I HATE the inevitable biopsy; it hurts and is scary. This year I sucked it up and got one; and guess what, the HPV is still there and I'm getting another colposcopy and probably gonna have another biopsy.

Is it that abnormal for HPV not to clear after 5 years? Is there a risk to having it in my body? I called the nurse at my gyno office and she said it's "neither abnormal or abnormal." I am feeling a little anxiety right now and I am NOT a hypochondriac at all. Does anyone know?
posted by pintapicasso to Health & Fitness (13 answers total) 5 users marked this as a favorite
Best answer: The risk is for the abnormal cells to turn into cancer - that's why it's so important to get the Pap smears and have the follow up treatments done.

I apologize if I am stating the obvious but if you are asking whether there is a risk to having it in your body, I was wondering if you understood that HPV's effects causing abnormal cells on your cervix are pre-cancerous changes and having those cells removed is preventing you from developing cervical cancer.

I think you should talk to your doctor about the fact that you're skipping Pap smears because you're afraid of the biopsy. If I were your doctor, I'd be more than happy to give you a one time dose of Percocet and Ativan (or whatever would help get you through the procedure) rather than have you skip a potentially lifesaving cancer screening with a known history of risk for cancer.
posted by treehorn+bunny at 9:19 PM on October 18, 2013 [15 favorites]

I think you need to talk to your doctor to get more information and to figure out how to make the coloposcopies more comfortable. I had an abnormal pap and several coloposcopies and I completely understand how awful they are, plus I had awful cramps afterwards. I completely understand your anxiety about this, it's really awful and uncomfortable and scary. I started taking a mild narcotic painkiller before the coloposcopies and it helped tremendously.

However it is really important for you to keep getting those paps! I *think* what was happening to you is that you had some abnormalities but they didn't really change for the better or the worse. With most women it either goes away, or it gets worse and you have to have surgery. You need to keep getting tested because if it gets worse you need to explore your options. I actually had to get surgery because my cells got worse, but they didn't get too bad because my doctor kept checking. The surgery really wasn't bad and I have been in the clear for over a year now.
posted by radioamy at 9:28 PM on October 18, 2013

Oh, I apologize, I realize I misread your question as stating that you DID have precancer/cancerous cells on the biopsy.

My edit window has passed, but I would revise my answer above to say that having the Pap, colposcopy and biopsy is the way to identify pre-cancer/early cervical cancer, and that is why having it done is so important. Also, if your biopsy results showed cancerous cells, sometimes the biopsy itself can remove all the abnormal cells, which prevents you from needing a more involved procedure if the cancerous changes progress. Here's some more information from Planned Parenthood.
posted by treehorn+bunny at 9:45 PM on October 18, 2013

Best answer: My Aunt had HPV, and didn't get a pap smear for 8 years. After some back pains, she was diagnosed with cervical cancer, and she was dead less than six weeks later. I apologise for the melodramatic tone, but please talk to your doctor about ways you can get this screening done that you will feel okay with. It could potentially save your life.
posted by smoke at 10:09 PM on October 18, 2013 [13 favorites]

I tested as positive for HPV and had normal paps for a couple years, always followed (after the first year when the HPV hadn't cleared for 12 months) by a colposcopy and sometimes a biopsy/endocervical curettage when nothing was found on the colposcopy.

Last year, even though I still had a normal pap, we did the whole thing again. Which, yeah, is scary and totally sucks. The colposcopy was fine, but on the ECC they found adenocarcinoma in situ which we treated via cone biopsy and things look fine (I'm not even testing positive for HPV post-cone). It is very possible that if my doctor and I hadn't followed up conservatively that by the time we found it things would have looked significantly more grim. I am really really glad I kept going in even though it was anxiety-producing and a total pain in the ass, and continues to be the same with the close followup I'll have for the rest of my life. I encourage you to keep being responsible for your health even when it does suck. I'm really glad I did.
posted by charmedimsure at 10:15 PM on October 18, 2013 [1 favorite]

I had a bunch of abnormal paps when I had the Mirena IUD. I think this is sort of common (anecdotally anyway, I don't think there's been any study proving this), but anyway you should consider that possible explanation if it's at all relevant to you. The other thing is: if you didn't have a pap for those two years, you don't actually know if it was negative or positive during that time, so you can't necessarily say for sure that you've had it be positive for 5 consecutive years--it may well have cleared and then just reappeared in the recent past, just in time to show up positive on this recent pap.
posted by gubenuj at 10:25 PM on October 18, 2013

as far as my understanding goes, there are many different strains of HPV, several of which cause cervical cancer. this is the type of HPV of which we need to be wary. your body works to eradicate the HPV, but while it may eliminate one strain it could still be fighting off another. since HPV is passed so easily from person to person (even with protection) you could be picking up new strains at any given time. so this could explain the continued positive HPV results on the pap. personally i had positive HPV results for several years in a row - had to go in for a colposcopy and had some abnormal cells removed. the cells were tested and no cancer was detected. this past year my gyno said that if my pap came back positive again she would want me to come in for a colposcopy again with a follow up after three months. thankfully it came out negative this year.

the above paragraph is just from my own personal research online and summary of my understanding of how HPV works, so some of it may not be entirely correct. please talk with your doctor about any questions you may have and don't be scared of the paps or the recurring HPV - it's better to know that it's there or not there, and that you are doing everything in your power to monitor it routinely and fight back immediately if anything is detected.
posted by cristinacristinacristina at 10:29 PM on October 18, 2013

there is a LOT of great information from the cdc site on cervical cancer and HPV here.
posted by cristinacristinacristina at 10:33 PM on October 18, 2013 [1 favorite]

This was before all the current stuff, they didn't call it HPV back then (warts, yay), but I had it in 1983 (stage 3 out of 5 being the worst) and I had what was then call a cryocautery to burn it off. Not sure if they do that now. Then I had paps every 6 months for 3 years and then back to once a year. All normal from then on out.

So I guess keep getting tested and ask them what level you are at. Because they should be able to tell you that and you should not be walking around worrying about it and you SHOULD keep getting tested as like colon cancer and colonoscopies, it's so treatable at the early stages. That's why women need to get pap smears. It was a HUGE killer of women before testing. Huge.

So hey, 1983 and I'm still here after all that and constant testing. Don't be afraid. Just ask.
posted by Marie Mon Dieu at 10:34 PM on October 18, 2013

Just as a data point, I had the cryo-therapy thing five or six years ago. They freeze the first couple of layers of cells, killing them and (hopefully) the HPV, too. It wasn't too bad. I think the colposcopy was worse. You wear a pad for a few days while the dead cells um ... leak out. It's kind of like a heavy period, but more of the consistency of wet coffee grounds. For me, anyway, it cleared it right up and I've had normal Paps ever since.
posted by Weeping_angel at 11:47 PM on October 18, 2013

Best answer: Okay - the reason why the nurse said that it was "neither good nor bad" was because there are only some strains of HPV that cause cervical cancer. Some cause genital warts, some don't do much of anything. And there are about 200 different strains of HPV out there - actually, you know how all colds you get are a little bit different? HPV is kind of the same, in the sense that it's a bunch of viruses that are similar and in the same family, but the "symptoms" aren't all 100% the same. And only about a tenth or so of the viruses are the ones that cause cervical cancer.

The reason they do pap smears is to see if there are any abnormal cells on your cervix. There are a lot of benign reasons your cervix could have abnormal cells, though, so if you do have an abnormal pap they test you for HPV next to see if that's one of the possible reasons. The thing is that they only SORT OF know which strains of HPV are the dangerous ones, so that's why they give you a colposcopy next - to see whether there is any evidence that those abnormal cells are the kinds of abnormal cells that could be cancerous. They also try to figure out which strain of HPV you have. If they find "could turn into cancer" spots on your cervix, and your strain of HPV is one of the bad ones, then they go on to recommend the cryo-therapy.

If your colposcopy looks okay, and the strain of HPV looks like it's one of the less-dangerous ones, then they settle for "okay, let's just keep an eye on it and see what happens." There's some debate about how long it takes for a given strain of HPV to clear your system - the ballpark is a few years - because so many strains of HPV are so similar that if you test positive for HPV a number of years in a row, it's kind of hard to tell whether it's been that one same strain the whole time, or if it's been two or three or whatever.

And my own self as a data point, which may be some good news: I had an abnormal pap and tested positive for HPV in about 2003 or 2004. I had a colposcopy about then, but the results were so faint that the doctor said I could just wait and see what happened. I kept testing positive for HPV for the next several years, but my Pap smears were okay for the next 4 years. Then I had an abnormal one again in 2009, and was scheduled for another colposcopy, but the lab cancelled it and I never had it; then the year after that, my next pap smear was fine, and I was testing HPV negative.

So the good news is that yes, it is possible to have HPV clear your system (the somewhat bad news on top of that good news is that for me, it took a few years of involuntary celibacy). And it is also possible to be testing positive for HPV for a few years and be fine. But I was still having pap smears every year to keep an eye on what was going on under the hood, so I could catch it if the HPV did do anything bad to me. In my case, it just didn't really do anything. The recommendation, I think, is that if you're testing positive for HPV, you should get a pap smear once a year; if it's negative again, you can test once every three years.

Good luck.
posted by EmpressCallipygos at 4:57 AM on October 19, 2013 [3 favorites]

I had an abnormal pap smear and tested positive for HPV way back some 20 years ago, had a colposcopy done, and ended up with a cone biopsy. I think I *might* have had one more abnormal pap smear after that, but everything since then has been clear. I'd also like to add that I never had any complications during pregnancy after the biopsy.
posted by Kaleidoscope at 5:23 AM on October 19, 2013

Colposcopies totally suck and are indeed painful (and personally I am positive that if men had to do them, pain meds would be standard).
Ask for pain meds.
Also, talk to your doctor about getting a LEEP. It's pretty common for people who have not cleared the virus for several years running to get one. And once you do, it doesn't come back. If you don't know what it is, they basically take a larger cone-shaped section out than with the colp. It is considered real surgery so you get drugs and should make sure you have the option to stay home for the day if you feel bad after. A few friends of mine have had them and were back at work the next or same day. And they haven't gotten abnormal paps in the years since.

As far as your concerns about it continuing to be in your body, this is the exact reason you keep going and they keep biopsy-ing and checking. If they keep telling you to just come back and see, that means that something is a little off with your cells but that they are not worried that you have cervical cancer yet and still think you can clear it. If they didn't think you could clear it or that it would not be ok with once in a while monitoring, they would have ordered a LEEP or something else.
It doesn't really matter that it is in your body for 1 year or 4 years as long as nothing cancerous is spreading. And that is why you are checking. And it sucks to keep having to get colps, but it is exactly what you need to be doing. Get yourself a treat and be proud that you are taking care of your health.
posted by rmless at 9:04 AM on October 19, 2013

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