Total confusion

[dancinblond]

I had to post my questions as "other" because nothing quite seems to fit my situation.  I am 55 years old (older than anyone I have ever seen ask a question regarding HPV.) Until I was diagnosed with HPV I had never had an abnormal pap smear.  I also have never had any other STD.  Actually, I only found out about all this because when I had a pap smear, well it will be 2 years in October now, I was going out of the country and thought I had a bladder infection.  My OB GYN decided to do a pap because it had been awhile since my last one (about 2 years).  As long as she was doing this, and because of the irritation I was having, I asked her to check me for all the common STD's also.  I had never even heard of high risk HPV at the time, although I knew HPV was the wart virus and could cause genital warts.  By the way, I have still not really gone through menopause.  I have been having menopausal symptoms for a couple of years now, i.e. irregular cyles at times, periodic hot flashes, night sweats at times, but have not really gone through it yet.  Anyway, all the STD tests came back negative, but initially I came back positive for HPV (I did not even know I was being tested for HPV, which as I mentioned I knew nothing about at the time), but the cytology was normal at that time, no dyplasia.  My doctor wanted me to come back within 3 months for a colposcopy.  When I did, she saw two small areas of infection.  She did not do a biopsy, but made sure to get scrapings from those areas etc.  This time the pap came back as mild dysplasia.  The next one, six months later, again with colposcopy was the same.  She commented last time that it was a very "light" infection.  That time it came back AS-CUS but still positive for HPV.  She does not think there is a point in doing a leep procedure at this time.  She feels with very mild dysplasia like this, the odds of it resolving, or not progressing are good, and that the virus is as likely to recur after the leep, or recur in some other area.  Another oncology/OB GYN doctor agreed it was very mild but thought I should have the leep, although he said at this point it was not dangerous to just watch it.  I am a mess.  It seems that if I am exposed to another strain of the virus, that could be pretty dangerous for me.  I have remained in a relationship all this time, that probably is never going to work out, because at least we can have normal, unprotected sex.  (We had been together 9 months already when I found out about this).  I cannot even begin to imagine trying to get into a new relationship going throug menopause and having an STD, that no one my age has ever heard of.  I think this has not resolved for me, because of the immense stress I have been under the past two years.  I lost a job, got another one I loved, my mother had a stroke and ended up in a nursing home just a month later, my sister auctioned off the house I was living in, I had to rent an apartment I could not really afford, I have been in this off and on relationship that has been very stressful, and then after getting a raise, lost the job I had because of a change in the Physical Therapy Board of Ohios rules regarding anyone working in a PT office not directly licensed under their board. (I am a licensed massage therapist under the Medical Board of Ohio.)  Now I am collecting unemployment in the worst ecomomy in history, and hoping not to lose my health coverage or my apartment.  I have now been reading about HPV for 2 years, and find all the information confusing and conflicting.  Condoms help protect you , but not really.  It is more dangerous to have this infection when you are older as it could have been there a long time.  Then I read on one site that it is LESS likely to progress into anything more than "mild" when diagnosed at this age.  I wish I could get the vaccine so that at least I would be protected from the other strains I may not have, and warts.  But, they are only now testing up to age 45, so I don't see it ever helping me.  I just do not know what to think, or do frankly.    

[ibizan]

Wow r u my twin?I live in Ohio 2!I had ur diagnosis two years ago at age 51.Was celibate for 10 years and got in2 a relationship foolishly did not use condoms and got high risk HPV.I got the LEEP 8-07 and it was a breeze. coming up on 4th pap..if it is normal i can go one year tween paps.I have been celibate now for almost 2 years so at least i will know no xposure to a new strain!Many women our age have heard of HPV..it is increasing in them getting it.The doctors in this forum state that condoms will protect 60-90%...but yes it is disheartening that one still has a 10-30% chance of still getting it.Your health should be number one....and your mental health will improve if u ditch the unhappy relationship.....I had too.....and don't worry about a new one.....I know what u mean about low prospects at our age.....i've never been a woman who will trade off sex for companionship......I flew solo for ten years and thought i finally found a good team player and i was wrong!and solo i can fly again.I disagree with ur doc not wanting to do the LEEP with u.....i think it should be done..get that HPV out of there...the odds of it re-occurring are low as my doc told me and i am evidence of......not re-xposing myself to a new strain has helped immensely.If u want relaible info on HPV...go to the Experts forum-std's to the right of this page...Drs.Hook and Handsfield have 30 yrs.of xperience tween them.Click on2 this...u will see a search box at top of page wehre they answer ppl;s questions...typ in HPV transmission and read.Also google the LEEP procedure.....mine was  a breeze!

[dancinblond]

Hi.  Actually, I have been reading about the leep procedure and every other aspect of this virus and dysplasia for close to 2 years now.  The question of the leep procedure is much more complicated than you realize.  First, let me say that my OB GYN has been in practice for 30 years.  I began to see her before she was even in private practice.  This year she was named as one of Cleveland's "Top Docs".  I also went to see an oncologist/OB GYN.   My doctor said that she has seen mild dysplasia frequently return after leep, and has seen it return on the vulva even after complete hysterectomy.  I cannot tell you the horror stories I have heard from the many, many women I have spoken to with this virus.  You just never know what it will do.  One thing about it resolving on its own, is that your immune system has undoubtedly supressed or eliminated that strain, everywhere it might be in your body.  With the leep, you have only removed cells from that area and even if you have normal paps after that, you just really don't know what is going on.  If the dyplasia becomes CIN 11 or worse, then there is no choice but to do leep to prevent further intrusion into the cervix.  Usually, if the virus is going to resolve on its own, it will do so in 2 years or less.  It will be 2 years for me in September.  But, it frequently never worsens if it is mild.  I am also currently unemployed as I mentioned in my profile.  I cannot afford a leep.  My insurance covers nothing until my deductible is met.  As long as it is safe to just monitor the condition, that is currently better for me.  You know the leep does nothing to get rid of the virus, the is NO way to get rid of the virus with allopathic medicine.  Only your immune system can do that.  The leep simply removes the abnormal cells, which sometimes also removes the virus contained in those cells, but you just never know what will happen.  It just really frustrates me that the vaccine is not available for all ages, because the most concerning thing about this is getting another strain of the virus, and condoms only offer some protection.  Also, the relationship that I have been in is really complicated also. Honestly, there are no easy answers in my case, but thanks for the feedback.  

[ibizan]

My gyno has been in practice for 25 years and is the only doc certified in this area for high risk pregnancies.I have read more good about LEEP than bad and glad that i had it.I have encountered more hopeful stories from those of us having LEEPS than the horror stories u state.Even researching this on the net and from  medical research articles my nurse practitioner sis sent me from the hospital in Oregon she works for point out the low incidence rate of dysplasia returning.I was told that at our ages the chances of the bad cells leaving the cervix are rare.I don't want them multiplying.Even if we could get the vaccine it does not protect against what we already have.Whats done is done.As for the relationship issue Eleanor Roosevelt stated no one takes advantage of u without ur consent.I would rather be alone and content by myself than be with someone who is a source of chaos.To me the worst kind of alone is remaining in a situation that holds no happiness for u.U paint a very bleak picture and i realize u have a lot on ur plate right now.Best of Luck 2 u!

[dancinblond]

Did you have mild dysplasia or did you have CIN11 or worse?  After having been in every six months for 18 months, my pap and colposcopy went from normal but HPV positive, to CIN 1 mild, to AS-CUS which is the most mild reading.  Because the virus persists, so does the risk.  But, I would have to be followed every six months even after I had a leep, so nothing for me would really change.  As I mentioned, if the dysplasia should worsen there would be no choice ,but I have to save every sent I have.  Not to mention that my work is extremel physical (even though I haven't found a real job yet, I have to do massage on the side to survive), so any kind of procedure that causes bleeding would be more of an issue for me.  The reason the vaccine issue is so upsetting for me is this:  I will be dealing with this current virus in whatever way is best at any given time with consult with my doctor.  She is being very conservative and very watchful with all of this.  The problem for me, is that in a new relationship, I would have to be so very concerned about getting a new form of this virus, because multiple infections can become really dangerous and this virus is so prevalent.  I actually know several women personally that have had all kinds of different recurrances after leep procedure.  It would be nice to be able to protect myself from future infection with a different strain, and from genital warts.  My doctor told me that all the OB GYN's thought that the vaccine would be available to all ages once the studies were done, and are very disappointed that it isn't.  She said there is even some evidence that current infections clear more quickly after vaccination,  even though the vaccination is not a cure.  It could be the because the immune system is stimulated.  None of this is anything being published to the public.  But, I would want to have the vaccine to protect from future infection, not to affect this one. There is no reason to assume that I have been exposed to all the strains the vaccination protects you from.  If the infection looks exactly the same at this next colposcopy visually to my doctor,  I will see about a biopsy and scraping of the endo cervical canal just to make absolutely sure nothing has spread.  If it has not, there is no harm in just keeping tabs for the time being.  I have read on some sites that it can take 3 years for certain strains of the virus to clear, so if there is no progression, there is no reason not to at least wait that long.  In my last discussion with my GYNO she went over all the possibilities.  She said "I could cut out part of your cervix (leep), but there are no guarantees that the virus will not just return".  I said that didn't sound like it would make much sense.  She said that she did not think at this point it would make any sense either, or she would have done it already.  So far, this is, as she has put it "a very mild infection".  In 90 percent of the cases of this kind of very mild dysplasia, it resolves on its own in 2 years.  I honestly think mine hasn't because of the incredible stress I have been under.  If my doctor feels at some point that I am putting myself at more risk not doing the leep, then there will be no choice, although I will never be able to pay for it.  As far as the "relationship" issue:  I am a ballroom dancer and got the boyfriend into dancing, and my dance world.  He is now friends with all of my social dance friends, and we had become dance partners.  There would be no possible way to completely avoid him if we entirely stop seeing each other, so trying to stay on a friendly basis is important, and tough to do.  I am not about to give up dancing, the only thing that still puts a smile on face, because I might run into him.  We are also doing a photo project together that is important to me.  Then on top of it all there is this STD and all its implications that I am dealing with.  I am not in an intimate relationship with him currently, my choice, we are basically just dancing.  But,  I can't even think about someone new at this point, and I am alone here.  I have no family here any longer except my mother in a nursing home.  She was my best friend and she has no short term memory left.  She recognizes me, but has no idea that I ever visited her before, where she is ,or what happened.   There is no one here to help me out with anything.  

Anyway, I am glad that your situation has resolved, and you can move on with your life.  

[ibizan]

i had CIN II with the ASCUS..i have had problems with dysplasia since age 28 and had a conization at 28..my mom took DES in 1954 and they have found a high rate of cervical cancer