I have been sexually active for roughly a decade with 6 partners. I have been on the pill on and off for roughly a decade as well. I have a previous history of obesity and as a medical student,I get by on little sleep. I am a non smoker with a moderately healthy diet and high caffeine intake. I drink alcohol about once per week.
After nearly a decade of normal paps, my most recent pap came back abnormal with a diagnosis of high risk HPV and suggestion of low grade lesions. I am currently waiting for my coloscopy results. I am very aware that there is no way of knowing when or from whom I picked up this virus. Needless to say, I have spent the past 36 hours inundated with HPV literature, and still, I am quite confused.
1. I have a new partner of 6 weeks. At last time of intercourse (36 hours ago), I bled after intercourse. Is this suggestive of fast-track progression to stage IA cancer?
2. My partner and I are both in our late 20s. I know that the likelihood of him having contracted a silent HPV infection prior to our relationship is very high. I am going to disclose my HPV diagnosis to him. Is it likely that I could have already infected him via oral (unprotected) or vaginal (protected) sex? Most importantly, should we not have protected vaginal sexual intercourse or oral sex until my paps come back completely normal?
3. What is the best way to fast track myself to clearance (barring that I don't have cancer)? My PA said that age is on my side, but I am still very frightened. Also, with my school schedule, it is impossible for me to get more than 5 hours of sleep per night.
4. I have already had mono and currently have HSV-1. Is there any link between cervical dysplasia, and these other two extremely common viruses?
5. With regards to virology, what makes some cervixes susceptible to dysplasia? (It should be noted that my brother also has high risk HPV and that he had to have several anal lesions removed.)
You should know if you are a med student that cervical cancer is rare, almost non existent with good gyn care. You should also know that cytology is an imperfect test and the new liquid Paps often produce more ASCUS and LSIL results which for the most part means nothing. Additionally the HPV test has specificity at approx 50% for higher grades of CIN and far less than that for an ASCUS Pap. Furthermore the HPV test is not a reliable test for women under 30 even with an ASCUS Pap. You should also know that there is a high rate of lab error with the Pap, especially with ASCUS which means may be normal or not and they just were not sure and LSIL in 80% of women means HPV but not in all women. I’m not sure if you had the HPV test because it is hard to tell from your post if you were diagnosed with Pap only. The HPV test should not be done with a LSIL result, usually colposcopy is recommended. You will probably have either a normal colposcopy or maybe one that would indicate CIN 1. Obviously a normal colposcopy would be no dysplasia caused by HPV and CIN 1 for most women resolves. Your partner probably has already been exposed and there is no way to know if he has HPV or not, condoms would be recommended. I’m not sure why you are talking to a PA and not a Dr. and I hope the Dr. did the colposcopy and not the PA. No one knows what makes some cervix’s more susceptible to HPV, the current thought is either environmental or genetic but there is no definitive data and most HPV infections are transient in nature especially under 30. Oral cancer is very rare and I would not worry about it.
And I would be curious to know why you believe that your brother has high risk HPV. Is this a concrete diagnosis that he had a wart biopsied and tested by PCR?
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