Problems with colposcopy and biopsy?

This is a rather lengthy question.  Last November I had a routine pap done and was found to have hpv. There was no dysplasia or precancer just the virus.  I was sent to have a colpscopy done in Dec. and during that process they found a lesion and so did a biopsy.  No signs of cancer whatsoever.  When the brown bandaid like thing came out I started to burn and did so for about two weeks.  I assumed it was the healing process.  In February I went to the bathroom and had a light pink discharge and brown flakes were in the toilet.  I immediately began to burn again.  I waited about a week and went to the Dr.  They said I had a yeast infection (have never had one of these to my knowledge before).  I started on Monistat.  The nurse called with results of the test they performed and said no yeast infection.  When I asked if they did a yeast culture she said no but the test they did would show whether or not it was.  I stopped Monistat and burning and symptoms seemed to go away.  Recently I felt as though they were coming back and so did an entire 7 day treatment of Monistat.  Seemed better for awhile (like days) but now I have slight burning and itching again.  I am 50 years old and had only very mild period last month but none so far this month.  I am cramping and bloating with breast tenderness like I am going to start my period but haven't.  My question is could some of this burning and itching be due to the menopausal process?  Could a colposcopy and biopsy set of this kind of chain of events?  I have been so freaked out by this I went and had two hiv tests done even though I have been with the same man for six years.  Both were negative.  This is driving me nuts.  

[Elaine Brown, MD]

Hi!
HPV is like that!  It just drives everyone crazy!
Your question is a good one!
During a colposcopy acetic acid is used and that can definitely cause burning.  Burning from that would not reoccur though.  It is also possible that you had a yeast infection, sometimes the only symptom is discomfort, although usually there is a discharge as well.  Atrophic vaginitis is commonly seen when the hormone levels start to drop as women begin the perimenopausal process.  It would be extremely unlikely given your
history, that this represents any type of STD.  The HPV, you are probably already aware can persist for years--and may have been there for 15-20 years.

If you were my patient, I would probably perform a wet mount ( for yeast and BV)
and a culture for yeast/bacteria/chlamydia/ etc ( for peace of mind purposes)

If there was any evidence of yeast, I would treat with Diflucan which I think is the best medication for yeast, and won't cause a topical dermatitis. ( Sometimes treating a yeast infection with creams can cause a reaction worse than the infection itself )

If no evidence of yeast, you might benefit from Vagifem, or other estrogen containing
vaginal preparation.

I hope this helps!
Dr B