LSIL on Pap Smear - Still Have Questions

[xCoelacanthx]

I recently had a pap smear that showed LSIL. I've done a quite a bit of research on it and from what I've gathered, I feel like I can conclude that it results from HPV, it probably isn't too big of a deal and it has the potential to go away on its own, a lot of people carry HPV, and the like. I still have a couple questions though. The final L stands for lesion, and I associate the word 'lesion' with some sort of open or healing sore. Is it alright to have sex after you've received LSIL as a result for a pap test, or will that further disturb your body's ability to heal it? If it's caused by HPV, which is an STD, that means even if the LSIL goes away, I'll still have HPV for the rest of my life, correct? And this one's a bit more out there since I know there are several different types of the virus but I had gotten the HPV vaccine before I was ever sexually active and supposedly that prevents some of the strains that cause genital warts and they like, but could the type I have still cause visual symptoms such as warts?

[Mandarin92]

I recently had a Pap done and they said they found abnormal cells and I am scheduled for a coloposcy but I didn't tell the doctor that I had unprotected sex with my boyfriend 24hrs before my pap and I just found out that sex before a pap can make the pap appear abnormal. Could this be a cause of th abnormal results and the positive HPV?

[Hollyv]

Remember there is still a lot that is not known about HPV. Many physicians do not even understand all there is to know about HPV as the studies are still evolving and being done. There are a couple of theories—1. HPV is a transient infection, especially in women under 30 and it usually resolves (it is often a transient infection in older women also but they need to be followed more closely); 2. Some believe and a much older theory that once HPV has cleared that it remains dormant in your system and can flair in future years under the “right” circumstances—stress, compromised immune system, other forms of cancer or with environmental or hereditary factors. I believe #1 or there would be far more cases of cervical cancer. In 2009, the OB/Gyn medical associations stopped recommending Paps and HPV tests for girls under 21, as cancer was rare but HPV was common. Studies were done and HPV cleared in younger women (went away). Furthermore, HPV does not cause cervical cancer, only persistent HPV does (HPV that does not clear within 2 years or so years and causes significant cervical dysplasia) with other environmental and hereditary factors not yet known cause cervical cancer.

The short story is that once your Paps are normal again, you will not have to disclose that you had HPV and you can consider yourself clear. It is a common virus that occurs often after becoming sexually active. Women that are sexually active in the 14-19 yr.old age group have a rate of 24.5% infection and women in the 20-24 yr. old age group have a 44.8% rate of infection (almost 50% of sexually active women). Gardasil does not protect you against all strains of HPV and in the United States the most common types of HPV in a 2007 study were HPV 62, 84, 53, 89 and 61. These are not the HPV strains that Gardasil protects against.

Once your Paps are normal again you can have a sexual relationship with your new boyfriend. It would be unusual for this to reoccur in you and once you are clear you will not pass this to him. Good luck!!

[xCoelacanthx]

To further elaborate, I had gotten HPV from my first boyfriend who didn't know he had it but he'd had a partner before me who I'm guessing it originally came from. He's the only person I've ever had intercourse with, so I know it's from him. But several months ago we decided to go our own ways.

For the past month, I've been with a new guy who I quite enjoy. I haven't had intercourse with him, and didn't plan to after finding out about my abnormal Pap. I made sure to tell him about it and he doesn't want to leave me or anything, but he isn't sure about how to respond to my possible having of HPV. Since I only recently received the abnormal Pap, I don't know exactly what strain or anything it is yet. I have to go back to my doctors this week to find out more about it, but I got the HPV vaccine which covers a couple of the major strains and I've never had any physical symptoms.

Should my newer boyfriend be worried about possibly getting it from me? We would always play around suggestively but never actually did anything serious, and now he's quite disappointed that he doesn't think he'll be able to do anything with me without getting the HPV himself.

[xCoelacanthx]

You say once the Paps are normal again, I'll no longer have to disclose the information. But won't I still be carrying HPV? Won't I still be about to pass it on to any potential new partner?

[Hollyv]

LSIL means low grade squamous intraepithelial lesion. Most Dr.’s will say that if your Pap result is LSIL you have HPV. However this is a subjective interpretation of the Pap. Actually a high number of people that have LSIL have HPV and that number is approx. 80% therefore 20% do not have HPV or the Pap was not read properly. But physicians consider that LSIL means HPV based on the 80% number. The only way to confirm this is with colposcopy and a biopsy. LSIL may indicate mild dysplasia which is determined by the amount of dysplasia (abnormal cells) seen visually and/or with biopsy, it relates to skin thickness and not a lesion in the traditional sense of an open sore. Usually with a LSIL pap a colposcopy is the recommended approach to confirm. Most LSIL clears in 6-12, sometimes as long as 24 months. It is usually a transient infection that goes away depending on your age, usually faster in teens and 20’s. If you have HPV once you have cleared it, you should not have a problem with this strain again and you should clear the virus and your Paps go back to normal. Warts would be caused by low risk HPV and not high risk HPV, so the LSIL pap will not cause genital warts. If you are in a monogamous relationship, you probably already share the same strain so you can be sexually active. If not, it is your choice but recommended not to have sex until you clear as condoms are not a 100% effective and if you do you should tell a partner until you know that your Paps have returned to normal. Once they are normal then you will not have to disclose this information any longer.