SIL timeline and other hpv questions

[indiana55]

I understand that it may take years for signs of hpv infection to occur, but i am wondering what is the minimum time for the cell changes to occur that are associated with squamous intraepithelial lesions (SIL)?

My girlfriend and i have been dating for a few months now. We stopped using condoms after the first two months (when tests for other STDs came back clear), then another month later she had the pap test that yielded the SIL result. She blames me entirely for giving her HPV, and more than likely that is the case since i have had more partners than she had and more recently (tho' not since our relationship began). To my knowledge i never had any visible signs, and i feel absolutely dreadful.

It seems we're cursed. Ever since we've been dating, she's had a series of yeast infections and a urinary tract infection (possibly vaginosis?) and now this. Is it possible that all these infections are inter-related, in regards to hpv or something else, or that they were misdiagnosed? Some of her symptoms included a slight burning sensation of the labia after intercourse, and more recently (after her infections had cleared) a burning sensation deep inside upon my ejaculation.
Is this consistent with cervical dysplasia?

As for me, i once had discomfort upon ejaculation which i associated with the angle of penetration that caused a slight bend in my penis. Also, sometimes i feel a slight discomfort that seems to run through my urethra. this is so subtle and occasional that i don't know if its real or if i'm psychosomatically sympathising with my girlfriend. is there any tests or treatment i should seek out?

Whether the virus clears on its own, or if she chooses to have a medical procedure to remove the precancerous cells, are there any statistics out there in regards to recurrences?

I hope all these questions are within your scope of specialization. i appreciate any any anwers you can give. thank you.

[H. Hunter Handsfield, M.D.]

It is possible your partner acquired HPV from you, but it is equally possible she had it for a long time.  SIL, either low-grade (LSIL) or high-grade (HSIL) can develop anywhere from a few weeks to years after catching HPV, so that doesn't help one way or the other.  Tell your girlfriend that everybody gets HPV sometime, somewhere.  You'll probably never know whether you are currently infected with the same HPV strain she has--but if you are, it is equally probably that you caught it from her as the other way around.  Couples with HPV should just accept it and not worry about it.  With proper health care for her abnormal pap, nothing bad will come from it anyway--some inconvenience, but no serious health threat.

As for your other questions, the other things you describe are not directly related to one another.  All sexually active women are at risk for UTI.  It's not sexually transmitted, but sex tends to massage bacteria into the urethra.  Yeast infections are common in all women.

But I'm slightly more concerned by your symptoms, in combination with your partner having a couple of otherwise unexplained genital infections.  You should both be tested for gonorrhea and chlamydia. Most likely there's nothing there, and if the tests negative in both of you, I wouldn't worry about it.

I hope this helps.  Good luck--  HHH, MD

[monkeyflower]

I was struck by your comment that your gf "blames you entirely" for her HPV infection. Presumably she agreed to stop using condoms, yes? I sincerely hope she is not holding this over your head, and the responsibility you feel is your own. In my opinion, to hold you responsible for this is ungenerous and unfair to say the least. It's NOT your fault, nor hers. It's just one of those things...

Besides, I don't know much about HPV, but still I kinda doubt that an HPV infection could proceed so quickly. A month from the earliest possible infection to SIL? Sounds unlikely to me. I just checked PubMed, and this might help: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12953088&dopt=Abstract

[yoy]

If I recall the doc's prior responses on HPV- he says that anyone sexually active would most likely has a positive result for HPV-I think he said it was almost a certainty- further, someone might not have symptoms- so if your girlfriend had prior sexual relations without a condom, she may have had it and did not know it.  This seems to be one of those issues where finger pointing is a waste of time because no one knows who had what first.

[yoy]

One more thing, your post did not even sya you have HPV- I'm not sure if there is a male test for it, but how certain is your G/F that you even have it.

[indiana55]

I neglected to mention that she's already had the biopsy and its yielded the same results as the pap, i don't know if it's high grade or low grade. Now we're considering having the LEEP procedure done. I've been reading up on it--does anyone out there have any personal experiences with LEEP? any recurrences?

oh, and we got tested for gonorrhea and chlamdia (as well as syphillis and HIV) before we began having unprotected sex, and they all came back negative. We thought we were being so responsible. I know HIV might not show for up to six months after infection, but what about gonorrhea and chlamidia?

In answer to some of the other posts, I've never had any signs of HPV, but as you may know ,that's no indication. My girlfriend has had only a very limited number of partners, maybe 2 or 3, and the last one was over a year ago, possibly two years ago. While i've been more active. I always tried to be responsible: condoms, testing for HIV and other STD's every year or so, but i never even heard of HPV or its connection to cervical cancer until now. She did tell me that her ex-boyfriend from a couple years ago had been through an episode long AFTER they broke up in which he and his current girlfriend had to be treated presumably for genital warts. They found out b/c his current g/f had an abnormal pap. I've read that the strain of HPV that causes warts isn't the same that causes cervical cancer, but what about SIL? I was under the impression too that this ex was a virgin when they were going out, so there might not be any connection there.

At any rate, the blame game is silly, but i'm really worried about how stressed out my girlfriend is, i think its taking a toll on her immune system, and she needs a strong immune system to fight this thing off. I think that's one reason she had all those infections, she gets so stressed out it compromises her body's natural immunity.

[H. Hunter Handsfield, M.D.]

Your sexual history and hers makes it somewhat more likely that she picked up her HPV from you.  But truly there is no way to know, and it's still a reasonable possibility she was infected before your relationship began.

Even without treatment, 99% of LSIL or HSIL clears up on its own, ie does not progress to cancer.  LEEP and other treatments are designed to prevent an outcome that actually is uncommon.  If she follows through with that treatment and her doc's recommended follow-up afterward, she will be 100% protected from progressing to cancer, regardless of her stress.

It is a myth that stress suppresses immunity in the way you imply.  Stress has no bearing on her HPV or the other infections you describe.  Don't make things worse by getting into a guilt trip, either because she blames you or you blame yourself.  Her abnormal pap truly is not your fault, and it isn't fair to you for either of you to let that become the dynamic in your relationship. And if she is stressed, and if there is "blame" for that or for her HPV infection, it is hers as much as yours.  She is an adult who decided to become sexually active, and she is experiencing a common and essentially unavoidable consequence of that decision.  It's nothing more than that, and it isn't personal--it's a virus.  And not a particularly harmful one at that.

At least you don't have gonorrhea or chlamydia--which are more serious health risks than HPV anyway.  Chlamydia and gonorrhea tests tests are completely reliable within a few days of catching the infection, by the way.

HHH, MD

[Aussie5]

With regards to you asking about LEEP - yep Ive had it done twice and I had no pain or any probs, its just a simple procedure, a little light bleeding afterwards, nothing your girlfriend wouldnt have felt before with her periods. Its cleared up now and Im glad I had it done - Better to be safe and get it done now, then to be doing worse procedures for it later. In my opinion your girlfriend needs to realise what a caring boyfriend she has, be thankful for that and stop worring. There alot worser problems out there that other relationships deal with.