QuestionI am age 36, one child, one prior pregnancy that was terminated in my 20s. Currently trying for baby #2.
I had an abnormal pap in late 2004 (mild dysplasia) and then another abnormal pap in 2/05 (severe dysplasia). So, my doctor did a LEEP a year ago (3/05). I just had my fourth pap smear since the LEEP - my doctor had me come every three months. They have been OK/normal so far.
I understand this is caused by HPV. He told me the new HPV vaccine is only for young teens and that technically the dysplasia is gone. However, I still have to return for frequent pap smears (I think it will be every six months now, if today's was OK) to make sure my cervix is healthy.
Have you had patients who have had the dysplasia recur? I am hoping/praying that it is removed forever and that the HPV won't cause me future problems? Is it possible for me to get the vaccine at my age?
Thanks for all your insight - I do appreciate it!
AnswerThe vaccine is still, somew hat,experimental. However, if your PAP smears continue to be within normal limits, you do not have to worry. If, after six monthw, your PAP is normal, you can go back to having PAPs once a year. Were you tested for high risk HPV (DNA testing)? HPV can cause genital warts, but not all subtypes of HPV can increase your risk for cervical cancer. It is becoming evident that If you have the subtypes of HPV, your risk for cervical cancer is higher than if you did not have these subtypes. that is why we check HPV every time we do PAP. Often, HPV disappears after the age of 30. HOwever, if it is still present, we have to follow the patient carefully. If you have a normal PAP with high risk HPV, we merely repeat the PAP in 3 months. If you have an abnormal PAP with high risk HPV, we proceed to colposcopy. If the PAP shows severe dysplasia, another LEEP would be done. I do not know if you are a candidate for the vaccine at this time.
