Abdominal Pain

Hello I am a 35 y/o blk female who has been dx with a few ovarian and cervical complications:
First as teenager, I had a abnormal pap and had a coploscopy done w/freezing. No differential dx
I was dx with in late 20's with hsv-2 virus. Since then I have had only one major outbreak.
I have since that resume a normal careful sexual life in my second marriage, however recently starting about
1 year ago, RLQ abdominal pain, had several ultrasound w/ hemmorrhagic cysts ca-125- test 9.9 repeat ultrasounds multiple follicular cysts, I was place on birth control ( had a tubal after my first marriage gravida 2 para 2)
This year, I have had normal routine pap smear, normal pap but detected the hpv virus( precancerous  cells).
To confirm it was done twice in 2 months. She wants to repeat it in 6 months due to my hx.
I have since starting having more pain in intercourse, no discharge, no odor, should I alert my doctor, to repeat my ultersound or should I just be aggressive and ask for the colposcopy and get a biopsy?

Should I cease intercourse? (although I thought it may be best, she stated that it was ok, try to live a stress free live take a multivitamin, exercise and eat healthy not possible while in RN school)
From the time that I was 19 until I was about 28 I have had normal pap smears and when I got married, my husband were considering having a child? Is that even possible at this stage? She I be more overly concerned about the pain or do I have the beginnings of cervical ca?

Are there any suggestions recommendations.. Considering the scare I had last year about the ovarian issue. I am trying not to imagine the worse case scenerio. But I know what else to really do.
Thank you for time a patience in reading this matter.

[Elaine Brown, MD]

Hi!  I was just about to ask what kind of health care provider you were when you mentioned RN school! ;)
You most likely have had the HPV virus sinceyour teens. ( Almost everyone is exposed during their teens or early 20's).  Once the HPV (human papilloma) virus is in your system we currently have no  way of erradicating it.  In most cases a healthy immune system keeps it suppressed, but if your immune system is under the weather (too much stress, etc) HPV can show up again.  Now a days they are running two tests--BOTH the pap and the HPV test and this is confusing a lot of people who have always had normal paps, and still do, but also now are testing positive for the virus.
If you are vigilante about your paps (as I assume you are) you should never get cervical cancer. Also, now that we know more about the natural history of the virus, we are much less aggressive about treating it than we used to be--only about 10% of cases need treatment and in the other 90% surveillance is enough.
So, I would tell my patient: 1) watching it is fine--no need for more biopsies or therapy now. 2) DON"T go to every 3 year paps--continue with every 6-12 months 3) quit smoking (if you do--I hope a nurse doesn't!) 3)No reason for extra precautions with spouse (he most likely was exposed already years ago) 4)No reason not to have a child!
(except clinicals in nursing school)

Hope this helps!

Dr B