[Question #6527] Chlamydia and HPV

15 months ago
3 years ago after 10 months in a relationship my my ex (who was a horrible man and I have since left) I began having intense virginal pain. I went to my OB who took a swab and then did a pap smear. 

Swab: HSV1 positive

Pap Smear:  Endocervival / transformation zone component present, Low grade squamous intraepithelial lesion (LSIL) encompassing  HPV/mild dysplasia (CIN1)

Swab CT/GC combo: CT POSITIVE

I took antibiotics for the chlamydia and have since never tested positive for it again. Never thought much of it until i recently befriended a woman who is now infertile due to Pelvic inflammatory disease caused by chlamydia. Now i am concerned. I have NO idea how long I had chlamydia before I was diagnosed.

1) how long can a female have chlamydia for?
2) since the chlamydia was detected on my pap smear does that mean it had reached my cervix?
3) how often does chlamydia lead to pelvic inflammatory disease?
4) how often does pelvic inflammatory disease lead to infertility?
5) how can i tell if i have pelvic inflammatory disease or the silent version? I have no symptoms?

HPV

1) how do i asses my cancer risk from my results? I have had 2 follow up paps since then which have been 100% negative
2) There is controversy online on if HPV really goes away...Do I have HPV still or no? am i contagious? should i disclose?
3) I have recently began a new relationship with a man who is a virgin. He is getting his HPV vaccines soon and wants us to go together, I got vaccinated
after my abnormal pap...would it hut me to get a second round of vaccine?

I know we have a character limit so I will ask more questions about my results int he 2 follow ups. Thank you so much for this service!
Edward W. Hook M.D.
Edward W. Hook M.D.
15 months ago

Welcome to the Forum.  Thanks for your questions:

Regarding chlamydia:

1) how long can a female have chlamydia for?
Persons can have chlamydia without symptoms for long periods.  A year or more without symptoms if untreated.

2) since the chlamydia was detected on my pap smear does that mean it had reached my cervix?
Yes

3) how often does chlamydia lead to pelvic inflammatory disease?
About 10-15% of women go on to develop PID without treatment.  People with the PID syndrome have lower abdominal pain and pain on intercourse.

4) how often does pelvic inflammatory disease lead to infertility?
About 15% of women with a single episode of PID will have bilateral fallopian tube occlusion and be infertile because of it

5) how can i tell if i have pelvic inflammatory disease or the silent version? I have no symptoms?
You cannot tell.  My advice is to not worry about it until you decide you want to be pregnant.  Even then, it may take up to a year of trying before couples conceive.

About HPV:
1) how do i asses my cancer risk from my results? I have had 2 follow up paps since then which have been 100% negative
The fact that your follow-up PAPs have been negative indicate that your HPV and the related PAP smear changes have resolved, as it does occur in over 99% of women with HPV.  The best way to be sure all is OK is simply to have your regular gyn examinations.

2) There is controversy online on if HPV really goes away...Do I have HPV still or no? am i contagious? should i disclose?
Scientific evidence now indicates that HPV may remain in the body, detectable by special tests.  If the infection is not detected on your routine exams however, you should not worry about transmitting the infection and with normal follow-up exams there is no reason to disclose.

3) I have recently began a new relationship with a man who is a virgin. He is getting his HPV vaccines soon and wants us to go together, I got vaccinated
after my abnormal pap...would it hut me to get a second round of vaccine?
The vaccine is highly effective and there is virtually no reason to get another round of vaccine unless the vaccine you got was the type that covers only 4 HPV types. The current vaccine covers 9 types, the 4 original ones and five more.  Between you getting the vaccine and your BF getting the vaccine, you should be fine without further vaccination.  I would suggest you continue with your regular GYN evaluations as recommended by your doctors however.

Hope this helps. EWH
---
15 months ago
Thanks for the reply..... I will try and see my health records to be sure which vaccine I received...

I read a recent study that was published last summer by Dr. Christine Johnson at University of Washington on the shedding of genital HSV1 after 2 years. The study concluded that after 2 years genital HSV1 sheds about 1% a year, similar to that of oral HSV2. I am 3 years past infection...since shedding is now about 1% a year, and transmission is known to be very rare, is disclosure of genital HSV1 necessary? 
Edward W. Hook M.D.
Edward W. Hook M.D.
15 months ago

Did you mean HSV (herpes)? r HPV which is what you asked about above.  In general disclosure is a personal choice but if you are referring to your negative PAP and studies for HPV I see no need to disclose. Similarly, genital HSV-1 is very, very rarely transmitted.  If you have genital HSV-1, your risk for transmission is very low, particularly more than 3 years after acuistion of infection.

This completes this thread which will now be closed without further replies.   EWH

---
15 months ago
Thank you so much for reopening the thread, I think there was some sort of mistake.

In my original post I mentioned I was diagnosed with HPV, chlamydia, and genital HSV1 all on the same day (I got all of them from a partner who I later figured out was unfaithful) 

My first follow up question was referring to genital HSV1, and not HPV



Follow up question #1:

 I read a recent study that was published last summer by Dr. Christine Johnson at University of Washington on the shedding of genital HSV1 after 2 years. The study concluded that after 2 years genital HSV1 sheds about 1% a year, similar to that of oral HSV2. I am 3 years past infection...since shedding is now about 1% a year, and transmission is known to be very rare, is disclosure of genital HSV1 necessary? 
Edward W. Hook M.D.
Edward W. Hook M.D.
15 months ago

If I were you I would not worry about disclosure of your genital HSV-1 infection.  For  variety of complex reasons, that shedding may be detected does not mean that transmission will occur.  Dr. Johnson's data help to explain why genital HSV-1 is almost never transmitted to others through sexual contact.  All of us on this Forum have repeatedly told other clients that genital HSV-1 in almost never transmitted to sex partners.  While disclosure is always a good idea, we understand that because of mis-interpretation of the significance of disclosure, some persons may decide not to disclose and have no argument with it.  Past genital HSV-1, like past resolved HPV are examples of situations where we do not feel that disclosure is essential.

I hope this helps.  This will complete this thread. EWH

---