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Abnormal pap smear-questions
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Abnormal pap smear-questions

Hi Doctor,
I just got a call from my doctors office saying I had an abnormal pap smear- ASCUS came back positive. The nurse said she thinks it is related to HPV, I don't know how she was able to tell exactly all she said was it showed ASCUS and that the doctor informed her that it was probably related to HPV. I was with the same person for 5 years in a mutually monogamous relationship and had many pap smears while with him and they were all normal. A few months ago we broke up and I slept with another guy unprotected.  I recently got back together with my ex-boyfriend (the one I dated for 5 years). I got fully blood tested for hepatitis, HIV, HSV-2 (not hsv-1 cause i get cold sores) and syphillis (syphilis) and swab tested for gonorrhea and chlamydia and had a pap smear about 5 1/2 weeks after I had slept with that other guy when my boyfriend and I were broken up. Everything came back negative except today I got a call that my pap smear was abnormal and that a swab test had come back positive for gardinella. I have a few questions:

1) Could an abnormal pap smear mean that I have the kind of HPV that gives you genital warts? I havent noticed any yet but was wondering if this means I could have that type and they might show up soon or later on?

2) Could an abnormal pap smear be related to any other STD's such as genital herpes or HIV? When I look things up online it seems to say that it can definitely be related to herpes and other STD's which worries me because I know those things can take awhile to show up on a blood test and don't always cause symptoms.

3) Should I tell my boyfriend about this? I'm so worried I could have put him at risk for something or given him something. The nurse I spoke to said she was going to have the doctor call me back but she seemed to indicate that I probably got whatever caused this abnormal pap from the guy that I had slept with when my boyfriend and I were broken up since I've never had abnormal paps before. I'm so worried about this....
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300980_tn?1194933000
Welcome to our Forum. My sense is that your doctor and/or his nurse may have overstated things.  ASCUS stands for "Atypical Squamous Cells of Unknown Significance" .  In studies of ASCUS less than 1 in 4 women have HPV – in the remainder there are many other possible sources of irritation of the cervix and in many women there is no obvious cause and the ASCUS is gone at the next PAP smear (typically 6 months later).  Even if your ASCUS is due to HPV (and as I've said, it may not be), then there is not a reason to worry.  For better or worse, at present HPV is a "fact of life" and most people have it or will have it at some point in the future.  Despite this fact, only a tiny minority of persons with HPV get the consequences of infection (primarily women and primarily cancer and pre-cancerous lesions).  HPV is the most commonly acquired STD.  Over 85% of sexually active women will have HPV infection at some time in their lives.  The figure for men is less well studied but similar.   In some HPV will cause genital warts, in others it will not cause warts but may lead to changes in PAP smears.  In nearly everyone who gets HPV, warts or otherwise, the infections will resolve by themselves without therapy in 8-24 months.  In a very small minority of women, HPV infection can persist and lead to the pre-cancerous lesions that PAP smears detect and which can then be treated.  With this as background, let's address your questions:

1.  All types of HPV cause warts however most often the HPV infections detected on PAP smears do not cause visible genital warts.

2.  There are many possible causes of ASCUS, HPV being one of them. Other infections can be associated with ASCUS while in many women, it is not clear what causes ASCUS an it is gone at the time of the next PAP smear.

3.  I see no reason to talk with your BF at this time as there is nothing to indicate that you have HPV or, for that matter, any other STD.  My advice would be to talk to your doctor about this.  I would not recommend HPV testing at this time and would simply talk with your doctor about when to repeat your PAP smear.

Hope these comments help.  EWH

BTW, you do not mention having received the HPV vaccine at this time. You may wish to do so, it is recommended for all women under age 26 or less and is appropriate more many women over this age.  EWH
12 Comments
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Thank you so much for your helpful responses doctor. I'm definitely going to speak to my doctor more about this tomorrow to get a more clear understanding of my results and what I should do from there. Just one more question, could this abnormal pap, or ASCUS as it is called, be due to a genital herpes type 2 infection? I've never had an outbreak or anything and was blood tested at 5 1/2 weeks after exposure and was negative but I just worry about things like that especially being that I'm back with my boyfriend now and would never want to put him in danger of anything.
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300980_tn?1194933000
I see no reason for you to worry that this might be HSV, given your lack of an outbreak an negative tests.  EWH
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Avatar_n_tn
Is 5 1/2 weeks after exposure long enough time for a conclusive hsv-2 test?
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300980_tn?1194933000
I repeat, you have no reason to test for HSV.  To do so is a waste of time and money and carries a higher risk of giving you a falsely postive result than of actually diagnosing HSV.  EWH
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Avatar_n_tn
Thank you so much doctor, I'm sorry for the repetitive questions I just worry about those kind of things and whenever I read things online it seems to point to genital herpes or HPV as a possible cause and it just freaked me out. I will try to get ahold of my anxiety.
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Avatar_n_tn
Just spoke with my doctor and she said my pap showed ascus and it showed it was positive for hpv. Should i be worried about warts? She said the pap tests for high risk kind. Should i tell my.boyfriend about this now? I have an appt next week.with my doc but im just so nervous and dont know what to do or expect until then
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300980_tn?1194933000
Discussing your HPV with your BF is probably a good idea unless you think he will have trouble dealing with it.  For better or worse, at present HPV is a "fact of life" and most people have it or will have it at some point in the future.  Despite this fact, only a tiny minority of persons with HPV get the consequences of infection (primarily women and primarily cancer and pre-cancerous lesions).  HPV is the most commonly acquired STD.  Over 85% of sexually active women will have HPV infection at some time in their lives.  The figure for men is less well studied but similar.   In some HPV will cause genital warts, in others it will not cause warts but may lead to changes in PAP smears.  In nearly everyone who gets HPV, warts or otherwise, the infections will resolve by themselves without therapy in 8-24 months.  In a very small minority of women, HPV infection can persist and lead to the pre-cancerous lesions that PAP smears detect and which can then be treated.  For men there is far less risk of any sort.  EWH
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Avatar_n_tn
Thank.you, last question....is the hpv types detected on the hpv test the kind that cause warts? I read on the CDC website that the hpv test does not test for wart-causing hpv but only the high risk kinds linked to cervical cancer. It specifically said the hpv test detects hpv types linked to cervical cancer, but not the types of hpv that cause.warts. I figured this is a trusted website but I wanted to ask you is this true?
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Avatar_n_tn
Thank.you, last question....is the hpv types detected on the hpv test the kind that cause warts? I read on the CDC website that the hpv test does not test for wart-causing hpv but only the high risk kinds linked to cervical cancer. It specifically said the hpv test detects hpv types linked to cervical cancer, but not the types of hpv that cause.warts. I figured this is a trusted website but I wanted to ask you is this true?
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Avatar_n_tn
The only reason I ask is because I told my bf and hes freaked out hes gonna get warts and thinks im disgusting
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300980_tn?1194933000
Correct, the HPV type present in most ASCUS is not the type that typically causes warts.  Warts are not that big a deal if he were to get them but this is unlikely to happen.  EWH
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