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HPV: Length of time before it shows up
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HPV: Length of time before it shows up

18 months ago I had my first abnormal Pap and diagnosis of HPV.  I have two children (the youngest is 2).  I've been reading online to find out more about HPV.  I'm trying to figure out when and where I got it!  I did have partners before marriage as did my husband.  We've been married for 7 years.  I don't know if I got it before getting married and it is just now 'active' in my system.  Or if it lies dormant that long?  Is this something I could have potentially gotten from my husband in more recent years?  Any information regarding how long it goes before showing up on Paps, etc would be great.  My Dr said that he should wear condoms to see if my body can fight it off if he is the carrier?  I'm still learning and not sure what I can do or should do to figure out where it came from and how I can 'fight it off'.  I've had abnormal paps every 6 months for the last 18 months.  I've had two colcoscopies that have come back normal.  Thank you!
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What were your Pap results? What HPV test did you have done?
It is possible that you have HPV and it is possible that you have false positive results. It is not unusual to have a mildly abnormal Pap after giving birth. I don’t like the HPV test because all it does is make women worry. I have posted in the past that the Pap and the HPV test are screening tests. They screen you to see if you are at risk for cervical cancer, but even most that are “at risk” never get cervical cancer. There was a study done at Harvard that said that 95% of coloposcopy in the US were done unnecessarily, which meant that 4-5% had abnormal cell results, not even cancer after colposcopy. The rest, 95 women out of a 100 had normal colposcopy, no disease. In the US they send women for a colposcopy for a one time ASCUS result and a positive HPV test. This appears to be excessive testing. Your colposcopy result shows normal, which means no disease (and you have had 2 normal results). If I were you, I would not be tested for another year as your colposcopy was normal. At that time I would only have a routine Pap and I would not have it reflexed with an HPV test. If your Pap were to come back abnormal again, then I would have an accurate HPV test done by DNA testing.

There was some evidence in a couple of studies that suggested that if a man wears condoms with a woman after she has an HPV diagnosis it may help to clear the HPV (the results were somewhat inconclusive and not 100%, in the area of 23% clearance rate) and that is probably why your Dr. suggested it. There were 2 small studies in Europe; the women actually had CIN (HPV lesion) which were actual lesions on the cervix (which you do not have because your colposcopy was normal). The results of this study regarding wearing condoms are controversial among the experts. I believe that it has more to do with your own immunity that helps to clear HPV (if you have it). Most physicians don’t understand HPV testing and then they don’t pass accurate information to the patient. They need to pass on the information that these are screening tests and the incidence of cervical cancer is low in the US. Your risk increases with multiple partners, smoking, a family history of cervical cancer and other factors. Most HPV is transient and regresses in 1-2 years. HPV is not a cervical cancer diagnosis, it increases the risk and even many women with HPV do not get cervical cancer. Before you try to analyze where you got this which is impossible you need to understand that your colposcopy is normal. Then it will be important the next time if you have an abnormal Pap to have an HPV DNA test done that will give you an accurate result and identify the HPV genotype (the number such as HPV 16 or HPV 52).

I understand your worry with 2 small children. The fact that your colposcopy is normal means there is no disease. You need to build your immune system with eating well and exercising and no smoking. I presume you were never HPV tested before. The HPV test that is on the market in the US can give unreliable results, so you need to rely on the colposcopy which was normal. The fact that all prior Pap tests were normal also indicates no disease and it is possible that you were exposed to HPV (either you, your husband or past relationships on both sides) but had a good immune system and there were no pap changes. Think of HPV as an infection that resolves in most women. Unfortunately, Dr.’s want to treat disease and when they see an HPV positive test they send you for additional testing. There are over 3 million abnormal Pap tests a year in the US and a small number of cervical cancer cases. Physicians don’t look at it as an infection that can resolve they look at it as a disease that needs to be investigated. Their thought is if the colposcopy comes back normal, then no problem and all is well they don’t factor the worry, concern and anxiety for most women (And the cost). They also don’t factor in the toll it places on relationships and the concern regarding if a relationship was monogamous or not. Last year they changed the guidelines for women under 21, no HPV testing or colposcopies. The reason they were actually doing more harm than good for a condition that resolves in most young women. The HPV test and colposcopies are also a huge revenue generator for the medical profession. It is unfortunate that many don’t really understand the natural progression of HPV and also can’t explain it to patients.
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