[Question #316] HPV

35 months ago
I apologize to be on this forum and bothering you doctors again, but I was hoping you could help clarify some things for me. 

In June I got a Pap smear and my results were as follows: 
HPV- not detected
Pap smear diagnosis- atypical: epithelial cell abnormality. 
Cytotechnologist- CDH CT(ASCP)

My doctor then told me that my pap came back fine, except there was an indication that I had inflammation of the cervix. She said this could be from anything like spotting, sex, and so on. When I got my pap I was spotting with brown discharge, so she said she thought it was most likely due to that. She said everything else was normal and not to worry, but to come back and get a pap in 6 months as a precaution. She did not say I had an abornornal pap though. Prior to June I had not had sex in about a year. I now have a new doctor and got my pap again today. She scared the crap out of me. She said my "atypical" pap could mean that I'm becoming infected with hpv, but my previous doctor said this was not the case and that I do not have hpv. My new doctor said hpv could take 1-2 years to show up on a test. I am literally worried sick waiting for my results.

Does this mean I have hpv?
Am I getting hpv? I still have not had sex in over a year & a half now. 
Do my results mean I had an abnormal pap?
What do my results mean?

I'm so confused :( 

Edward W. Hook M.D.
Edward W. Hook M.D.
35 months ago

Welcome back to our Forum.  I'll be pleased to comment.  My suspicion is that either your doctor is being overly conservative or that he/she is mis-informed.  Signs of inflammation and variation in the cells seen on PAP smear is rather common and is referred using a variety of terms including "atypical squamous cells of unknown significance" or ASCUS.  Standard practice is to test PAP smears showing ASCUS for HPV because a portion (typically less than 50%) of ASCUS is caused by HPV.  If caused by HPV, further evaluation (often colposcopy) is recommended.  Many other things, hormonal variation, physiological change, minor infections, also are associated with ASCUS.  In your case you were tested for HPV and the test was negative and therefore need to be concerns about having cervical HPV infection at this time. 

Thus, nothing you have reported makes me concerned that you have HPV (I should add however that even if you were to have HPV, this is not a big deal- before the HPV vaccine became available, over 85% of adults could be shown to have or have had HPV.  Less than 1% of such persons co on to have cervical cancer.   Thus, not that you do, but if you had HPV, this would not be something to be concerned about.)

I hope this comment is helpful. Please do not worry.  EWH

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35 months ago
Thank you for explaining all of this to me Dr. Hook! I understand what my pap results mean now. 

So, do you believe that I am becoming infected with hpv like my doctor said?
Or is HPV not the cause of my ASCUS? 

Also, during the examine she found a bump on my labia minora. She said it was an inclusion cyst and underneath the skin, and not to worry. She said to soak in hot baths if it becomes tender. But then she said it would never go away. I never even knew you could get bumps underneath the skin on the labia minora. 
Is this true?
Do inclusion cysts really never go away? 
Edward W. Hook M.D.
Edward W. Hook M.D.
35 months ago

If you had HPV you would have a positive HPV test.  Your negative test indicates that you do not have HPV

Inclusion cysts are benign and may persist for long periods of time.  EWH

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