Eversion of the transformation zone & HPV?

Hello,

First of all, thanks so much for taking our questions and helping ease the anxiety and uncertainty many of us face... :-)

I have just been told by my GP that I have eversion of the transformation zone or cervical ectropion (are these the same?). I had been spotting after sex for a couple of months and I decided to have it checked... and now I'm so scared!!! I am especially worried that it may be a sign of cervical cancer. I have a history of HPV (well, not sure!)... Some more info:


2008: 2 paps, both normal. All paps ever before were normal
2009 september: LSIL, normal colposcopy, ECC showed only cervicitis
2009 december: 2 normal paps, normal colposcopy, no high risk HPV (but low risk detected)
2010 may: LSIL (no colpo)
2010 december: normal pap (no colpo). Gyn says all looks healthy!
2011 march: GP says cervical ectropion; waiting for appointment with ob/gyn
I have been on the Nuvaring for a couple of years now
I'm in my late 20s
No smoker, no children, no stds, lots of stress though, constant condom use (but used to have a long term boyfriend years ago)

And now, this... I thought the bleeding might just be something of the birth control but my GP says it could be linked to cervical dysplasia and I read on the internet that it can be a sign of early cervical cancer? More specifically, my questions are:

1. Is it possible that the cervical ectropion is linked to low risk HPV? Could LSIL evolve that fast into cancer (slightly over a year)? I am also worried the paps and colpos missed something high in the canal and/or my HPV test was a false negative

2. Or could it all be the Nuvaring? Could the Nuvaring cause LSIL to show in the pap (an inflammation I guess)? Can one have LSIL without HPV? Could Nuvaring cause cervical ectropion?

I'm terrified of what may come next!!!

Thanks a million for your help!

[Elaine Brown, MD]

Hi!
Almost certainly, your Nuva Ring has caused the ectropion/eversion which is caused by hormones and almost certainly NOT caused by HPV or even less likely cervical cancer.
Women in their 20s very rarely develop cervical cancer, and almost all of them clear any hpv infection, especially the low grade strains.  Your doctors are doing the right thing by watchful waiting.  It is only quite recently that we have realized that we should not be so aggressive in treating hpv infections in women under 30. Previously we treated almost everything with some form of cervical surgery.  
Go ahead and keep your ob/gyn appointment, but don't stress!  
Have you had the hpv vaccine?
Good luck!
Dr B

[scaredinphilly]

Many thanks for your reply!

Yes, I had the full course of Gardasil a couple of years ago...Hopefully that will help.

Is it possible that LSIL is caused by low risk strains? I thought it was mostly high risk HPV, but that's not what my test showed. I'm just concerned it must have been a somehow 'false negative' (for high risk)...

I'll let you know how my gyn appointment goes. Hopefully it's the NuvaRing! :-)

Thanks!