QuestionI am a 27 YOF. I am in the process of figuring out an abnormal pap test. My colposcopy came back with severe dysplasia and I am scheduled for a leep soon. I have been on birth control since I was a teenager. It was first prescribed to control ovarian cysts. Now I also use it as it was intended. I have been with the same partner for the last three years. Last year, while on the nuva ring (using it properly and proper timing)I thought I became pregnant. My OB/GYN at that time assured me that was not the case over the phone without an exam. I had positive home pregnancy tests, missed three periods, had very sore breasts and morning sickness throughout the day. Towards the end of the 2nd month I had severe cramping one day and passed a large mass of tissue that looked like a golf ball encased in tissue. (she assured me this was old blood?)
Now I have a new Doc and with the leep... During the last few months, my periods (or abnormal bleeding?) last for two weeks and sometimes three. I have always had ovulation pain on my right side. Just kind of take it as that's the way my cycles are. Now I have diffuse pain in my lower abdomen most every day. Is the leep a test and a treatment? How likely is it I will have to have more treatment? I mean, with the "vinegar test" I understand that shows changes on the surface but how can they tell how deep into the tissue it's gone? Might I have to consider a hysterectomy? How did it progress to sever dysplasia so quickly? I am a non-smoker. I understand the part dealing with HPV, but I am still very scared. I would like to have kids one day. Am I still at risk for being told I have cancer? Can you help answer any of these questions? Very worried, anxious and scared about my future.
AnswerNone of what you mentioned has any effect on the PAP smear (birth control,ovarian cysts, pregnancy, miscarriage, old blood from the cervix, irregular periods, bleeding longer than 14 days, or pain in your abdomen). An PAP is merely an examination of the cells that are scraped off the surface of the cervix. The results can show ASCUS (atypical squamous cells of undertined signifance), LSIL (low grade sqamous intrepithelial lesion, HSIL (high grade intraepithelial lesioin) CIS (carcinoma in situ) and invasive cancer. If you also have a suspicious HPV (Human Papilloma virus) you are at risk for cervical cancer. Therefore a colposcopic exam is done. This s an examination of the cervix with a device that magnifies the cervix 17 time. The cervix is dabbed with vinegar (acetic acie). If there are any cells where the cytoplasm is greater than the nucleus, these cells will turn white. We take a biopsy of these white areas (as well as some other areas) and the results of the pathology report will tell us if it is mild, moderate, or severe dysplasia. (Dysplasia is merely a "disorder" of cells on the cervix. A LEEP procedure shaves off the top layer of the cervix and gives us a diagnosis as well as a cure. If the top layer of the cervix is removed, the disease will be also removed. You will definitely have to have a PAP smear every three months until it shows a normal result. I doubt that you will need a hysterectomy unless there is a pathology report showing CIS or cancer. If you have severe dysplasia, it certainly can progress to cancer of the cervix if you do not follow it cafefully. That depends on the results of the LEEP. If your periods last for more than 14 days, you should have a D&C to see if anything is going on inside your uterus. It sounds like you have some "dysfunctional uterine bleeding" and your cycle should be regulated. DUB is due to some hormonal imbalance and can be treated. Good Luck.
