Girlfriend's Abnormal PAP

[probneurotic]

Dr.

My girlfriend called a few weeks ago in tears saying that she had an abnormal pap smear and was worried sick (about HPV, cancer, etc., I guess she read it all on WebMD).  I reassured her saying that they usually do a repeat Pap and 9/10 times it comes back normal.  Weeeelll... she called today saying they "stuck this microcope up there and poured acid on it.." a colposcopy and took some biopsies.  The tests come back on Wednesday.  
I am mainly worried because I try to be a standup guy, and really open about our relationship.  I was tested before we started dating to make completely sure that I wasn't bringing any extra "friends" to the table. My gon and chlamydia swabs were normal, my HIV test was neg., my RPR was neg., and my HerpeSelect was neg., TWICE (All about two years ago and I have DEFINITELY BEEN MONOGAMOUS).  Now I feel like despite my efforts, I still was irresponsible and "gave" her something.  She is really worried.  She comes to me with these problems because I am a medical student, expecting unbiased medical advice, but to be honest, I am scared and feel aweful for putting her through this emotional and physical discomfort and just dont know what to do.
Now its got me worried sick.  I fear what the tests will say.  Did I give her a dangerous strain of HPV (16, 18)?  What else could she have?  Am I going to need to worry about this in future relationships? (I had a previous girlfriend have an abnormal pap too, coincidence?)  I just feel dirty and guilty that I could have done this to her.  Do you have any advice to make ME feel better, or more importantly, things I could tell her to ease her anxiety?

Thanks

[H. Hunter Handsfield, M.D.]

Your GF's andnormal pap probably is due to HPV, but not necessarily a high-risk type such as HPV 16 or 18.  If either you or your partner ever had sex with someone else, including genital apposition without penetration, that is the source of the infection.  I cannot predict which of you had it first, but you can be sure you are (or have been) infected with whichever HPV strain she has.  But almost everybody gets genital HPV infection somewhere along the line; it is inevitable.  The presence of HPV usually is not an indication that another STD also is present.  The main thing of importance now is that your GF follow her doctor's advice and treatment, which will prevent herr from ever developing cancer.  Otherwise, totally forget about this; it has no implications for your fidelity, your sexual future together, or your future sex lives with other people.

As someone already commented (below, but before this response), in the fairly near future an effective vaccine against 4 of the most common HPV types (6, 11, 16, 18) will be on the market.  It won't help people already infected, but prevent lots of infections as time goes on.  However, contrary to the main emphasis in the media reports, preventing cancer isn't really the main benefit of the vaccine.  The usefulness will come in reducing the number of abnormal paps and the number of people who need the often-expensive health care that result, and perhaps most important, will reduce the number of infected women and couples who go through the sort of anxiety you and your partner now are experiencing.

For additional information about HPV, see the link at the top of the STD forum "STD Quick Facts and Articles"; or the information provided by the American Social Health Association (www.ashastd.org) or CDC (www.cdc.gov/std).

Good luck--  HHH, MD

[ryn21]

To my understanding, many women have abnormal pap's from time to time.  I can't comment on why, but i really dont think its a cause for serious concern.  The doctor will further clarify, but if your tests came back negative before, why would you worry in the first place.  You seem like a smart guy, and i give you a lot of credit for being good to your women.  Dont worry so much about it, you dont even know what it is.  It could be nothing.

[Alias Lola]

Hi,

I can totally sympathize with your girlfriend.  I had an abnormal pap several years ago and was devastated to learn that it was caused by HPV.  BUT.. after reading up on it and talking to others and, of course, asking Dr. H some questions, I learned that it is so common, that most of us (women and men) get at least one strain of HPV within our first three or four sexual relationships.  Most people just never realize they've been infected because HPV is usually transient in nature and the immune system can suppress it and/or totally eradicate it from the body.  

Don't beat yourself up over it.  There is no test for HPV in men. And unless a man has the strain that causes actual warts, and warts actually appear, you'd never know you had it.  I know this isn't much consolation.  I sure wasn't the least bit consoled by that at first.  But the truth of the matter is that HPV happens!!  If you're sexually active, condoms or not, you're bound to get some strain of HPV...unless, of course, both persons in the relationship have never been with others.  
Statistically, 80 percent of women have had or will have HPV by the time they're 50 (most will never know, though).  But that's why women are urged to have pap smears yearly.


The good news is that, despite what a lot of people think, HPV rarely causes cancer.  Your girlfriend should just continue to see her doctor.  They might recommend waiting it out, to see what happens, depending on the grade of her cervical lesions, or they'll perform a LEEP (loop electrical excision procedure, I believe is what the acronym stands for) or cone biopsy to remove the abnormal cells.  I had a LEEP performed in 2000 and have had normal paps since.    

I hope this helps some.  

Lola

[It sure hurts]

Cervical Cancer Vaccine Breakthrough

A vaccine against cervical cancer could be available within a year following dramatic trial results.

The drug, Gardasil, was 100 per cent effective at preventing the precursor changes that signal the disease.

A total of 12,167 women aged 16 to 23 from 13 countries, including the UK, took part in the trial.

Half were given three injections of Gardasil spanning six months and half jabs of an inactive dummy drug. They were then monitored for an average of two years.

Cervical cancer affects some 470,000 women a year worldwide and 33,500 in Europe, killing more than 1,000 in the UK each year.

Gardasil is designed to protect against two strains of a virus called the human papillomavirus, or HPV, that trigger 70 per cent of cervical cancers.

The vaccine not only acts against the HPV 16 and 18 strains, but also strains six and 11, which cause genital warts.

The trial findings showed Gardasil to be fully effective at preventing high-grade and non-invasive pre-cancerous lesions associated with the 16 and 18 strains. Similar results were previously seen in a smaller trial of 277 women.

The new study, called Future II, is part of an ongoing phase III trial programme involving more than 25,000 patients in 33 countries.

None of the women was infected with HPV at the start of the trial and they remained infection-free throughout the treatment course.

Professor Peter Rigby, chief executive at the Institute of Cancer Research, said: "These results are extremely encouraging.

"Nearly 3,000 people in the UK are diagnosed with cervical cancer each year, so it is very exciting to hear it may be possible to drastically reduce this number in the foreseeable future.''

Pamela Morton, director of the cervical cancer charity Jo's Trust, said: "The successful development of a vaccine that will prevent cervical cancer cannot come soon enough.''

Dr Anne Szarewski, clinical consultant at Cancer Research UK, said: "These results add to the mounting evidence that cervical cancer vaccines offer great promise for the future. It appears we may soon be able to prevent the majority of cases."

Gardasil's manufacturers are on track to apply for a US Food and Drug Administration licence to market the vaccine before the end of this year. This will be followed by a licence application to the European Medicines Agency.

[ryn21]

Its good to hear of a vaccine for HPV, especially for women.  These types of breakthroughs are what we need.  Its reasuring to know that there are pharm. companies out there striving towards making successful vaccinations and cures for diseases.

[anis]

Hi, This is such a diffucult time for me, in august my pap came with a HGSIL and the result of a biopsy of a lesion I had in my vulva came with a VIN II-III.  The same week I knew my mom had cervical cancer, so all has been a nightmare so far.  I stared to searh about this and I've found that stop smoking and taking Isoflavones and vitamins  e,c,beta-carote,folic acid and selenium may be helpul. It seems to be boosting my inmune sistem in some way.  My colposcopy was performed and it shows a mild dysplasia now, and the lesion I had in my vulva is not visible too(It was swalowed before). I'm waitting to get ready everythig for a leep the next mouth.  My doctor says it's the best option for me but I 've searched for all of this about all this time and I don't know if there is a posibility of regression in my case, because the colposcopy showed a lower stage than the pap and the vulvar lesion it's not visible too, or it may mean that my actual condition it's getting worse  that I thing(microinvation).  I remember two doctors told me in the past that I can not wear any non cotton underwear by the time I got that slowed thing I was using other kind of stuffs and the inflamation (inflammation) was exactly on the line of the tong, in an article I foud that vin is also associated with chronic vulvar irritation.  I,ve been not tested for HPV yet, but I see that There is other factors that may cause this. what do you think? am I on the right track? I'm 29, and I'm planning to have a family   with my boyfriend and I don't wonna mess it up. I also has 38..6 ug/l prolactin level and I had a misscarrige already i't was because my hormonal levels were too low. that's why I'm traying to find a better option.

[probneurotic]

anis,

the doc usually wont answer questions submitted on and old thread like that.  You sound pretty worried,  so I  would suggest maybe paying the $10 donation to get your question personally answered.  I am definitely not trying to get money out of you for the site, I would just hate to see your question go without getting answered by the doctor himself.  Good luck, and keep up the healthly lifestyle, it can never hurt!!

[anis]

thanks for tell me that, I'm going to do that, tnaks for your concern about my question