QuestionDear Doctor Rappaport,
I am 18 years old. I have no kids :) But, I thought maybe you could help me with a concern of mine. I have just recently gotten back a pap smear with atypical squamous cells of undetermined significance (I've memorized this by now). I was previously on birth control pills(desogen) and was told to get off of them because of possible complications they might cause (speeding up cell growth and such). After I got off of them, I started my period. Unfortunately, it has yet to stop and tomorrow will be day 13. My periods are always short, and this one shows no signs of stopping. My question is: should I be concerned that this is linked with the abnormal cells, or is it being cause by getting off the birth control? I have a follow up exam coming right after Christmas, and I am just concerned that at the rate this is going, my period won't stop in time. Also, a silly question... is ther anyway I can help stop my out of control period? I'm starting to get a little tired, lol. Thanks so much for your time. It is much appreciated :)
sincerely,
Emily
AnswerYou started bleeding because you stopped the birth control pills. As long as you do not bleed for longer than 14 days, it is no problem. However, if you bleed for more than 14 days at a time, you should call your gynecologist and get some Provera (10mg twice a day for 5 days). The bleeding will first get heavier and then will stop within a week. I do not know why you were told to stop the birth control pills. There is no connection to taking pills and an abnormal PAP smear. ASCUS (atypical squamous cells of undetermined significance) is the lowest abnormality of the PAP smear. As long as you do not also have suspicious strains of HPV (Human Papilloma Virus), we usually merely repeat the PAP in one year. If you still have ASCUS the next PAP, we usually look more closely at the cervix (colposcopy) and take some tiny biopsies to get a histologic interpretation. The specrum of abnormal PAP smears is: Normal, ASCUS, LSIL (low grade squamous intraepithelial lesion), HSIL (high grade squamous intraepithelial lesion, CIS (carcinoma in situ) and then Cancer (invasive cervical cancer). Our goal is to keep the PAP at Normal, ASCUS, or LSIL. If the colposcopic biopsies show a problem, we usually will freeze the cervix (cryotherapy) and the top layer of skin will slough off, leaving nice, pink, healthy cervical cells. Birth control pills does not have anything to do with this process and you do not have to stop the pills with an abnormal PAP. In any event, do not allow the bleeding to continue. Call your doctor if the bleeding continues.
