Abnormal Bleeding
Overview
What is an Abnormal Pap?
A Pap smear is done to detect changes in your cervical cells that may develop into cervical cancer. If the results of your Pap come back positive it means that abnormal cells were found in the cervix. It doesn’t mean you have cervical cancer as an abnormal Pap often indicates there have been cell changes due to other causes. The Pap often can detect the human papilloma virus (HPV), the main risk factor for cervical cancer. HPV infects at least 50% of sexually active people at some point in their lives. Certain strains of HPV also increase the risk of vulvar, anal, throat and penile cancers in men. Fortunately, the immune system often suppresses the virus to undetectable levels before it can cause serious harm.
Regardless of the reason for an abnormal Pap, follow up is required as directed by your doctor. An abnormal Pap may indicate any of the following:
- An infection or inflammation.
- Herpes.
- Recent sexual activity.
- HPV or genital warts.
- Dysplasia, which are abnormal cells that can be pre-cancerous.
- Abnormal uterine cells, which could be a sign of precancerous changes in the uterus.
Symptoms
Abnormal Pap Symptoms
Abnormal Paps usually cause no symptoms, which is why regular screening is important. Some women may experience irregular vaginal bleeding, especially after sexual intercourse, if they have precancerous or cancerous abnormalities of the cervix.
Diagnosis
Abnormal Pap Diagnosis
If your Pap is abnormal, your St. John’s Physician Partners gynecologist may recommend a colposcopy. This procedure uses a special magnifying instrument to get a close-up view of the tissues of the cervix, vagina and vulva. This procedure allows the doctor to more effectively diagnose precancerous changes as well as genital warts. During the colposcopy, your doctor may obtain a tissue sample from suspicious surfaces to be examined under microscope. This tissue biopsy is the only way a definitive diagnosis can be made.
Treatments
Abnormal Pap Treatments
If your cervical biopsy indicates you have precancerous tissue in your cervix, your doctor may recommend a Loop Electrosurgical Excision (LEEP) if your Pap or tissue samples showed cells that were abnormal. LEEP is performed using a fine wire loop that has a low-voltage electrical current to cut away a thin layer of abnormal tissue to allow healthy tissue to grow. Most women do not have problems after the LEEP procedure; however, you are more likely to deliver your baby early if you get pregnant after the procedure. There are a few risks to the LEEP such as infection, bleeding and scarring in your cervix. A LEEP procedure usually takes 10 to 20 minutes and can often be done at your doctor’s office.
Your doctor may recommend cryosurgery to treat cervical, vaginal, endometrial and vulvar lesions. Cryosurgery is localized therapy since it only treats disease at a single site, but cannot treat cancers that have spread to other areas of the body. The downside of cryosurgery is your doctor can’t confirm that he or she has treated all of the abnormal tissue. Cryosurgery is a safe and easy to perform procedure for treating women without impairing their fertility. It is often done in your doctor’s office.
Your doctor may recommend Gardasil®, a safe HPV vaccine in use in the US since its approval by the FDA in 2006. With the HPV vaccine, routine pelvic exams and Pap smears, there is a strong chance that cervical cancer can be eradicated. That’s why it’s recommended in younger children since it works best because their immune systems is more robust and before they become sexually active. Teens and young adults up to age 26, and adult men and women 27 to 45 are encouraged to be vaccinated. While the HPV vaccine is not a cure, it does offer long-lasting protection against future HPV exposure. If you’re pregnant you should not get the vaccine.
Specialists
