[Question #7442] Abnormal pap smear

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57 months ago
Firstly, thank you for this amazing service. 
Some background and then my question. 
Both my wife and I when we got married had no previous sexual experience or partners. However, over the past two years, I have has about six or seven encounters with escorts. The most recent one was about three months ago. I have not shared this information with my wife. During all the encounters I used a condom. However, on one occasion the condom broke in the middle and then I stopped right away and put on a new one. On another occasion I noticed that the condom receded upwards for a brief part of the time. Besides for that, I think they were used correctly but as I has read on the forum it is hard to prevent all contact. 
My wife recently went for pap smear and the results showed that she was negative for HPV however it did show some other abnormality. I believe the abnormality was something to do with some cells being inflamed. I believe the doctor said, nothing further is required but my wife wants to take another pap smear because of this. 
My wife is 29 and neither of us got the vaccine. So here is my question.
Does that fact that she had this abnormality show up on her test prove that I had a sexual encounter with someone other than her? (Please assume she has not had any partners besides for me)
Being that it showed HPV negative but an abnormality is there a chance it can develop into HPV? 
Similarly, being that it showed up with some abnormality what is that chance that it can down the road develop into something that would be worrisome or could indicate that she was infected by someone who was exposed?  
Also, what pap smear test results would prove that I was exposed to another partner and which ones can be attributed to something else?
Thank you very very much for this service and looking forward to your

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H. Hunter Handsfield, MD
57 months ago
Welcome back to the forum. Thanks for your confidence in our services.

Signs of inflammation are among the most common abnormalities in pap smears. Usually do not indicate any important health problem. They have absolutely nothing to do with HPV, and they rarely are due to any STD at all, and certainly there is no reason to attribute it to your non-marital sexual experiences; indeed, there are NO "pap smear test results that would prove [you] were exposed to another partner." The cause of the inflammation usually never becomes apparent. Gonorrhea and chlamydia are potential causes, but there is no chance you have either one; in the event her doctor tests her for them, and if they were to be positive, it would be from some other sex partner of hers -- not you. (I'll point out an obvious fact:  when one person in a partnership finds a need for sex outside the partnership, often the other has done so as well.)

Judging from your previous discussion with Dr. Hook a year and a half ago, and these questions, it is clear you are obsessed with and very guilty about your sexual experiences with other partners. But there is no realistic chance they have anything to do with your wife's current pap smear abnormality. She should discuss the finding with her doctor. But probably nothing is wrong at all -- and certainly nothing related to HPV.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD
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57 months ago
Hi Doctor, 
Thank you very much for your prompt reply. 
I don't think I would say I am obsessed or feel very guilty. It is more that I am just trying to understand from a rational and medical perspective what are the risks and potential medical effects of those encounters. 
With that in mind, perhaps you can elaborate a little more about:
1. The inflammation that I mentioned, you said it is common and usually the source doesn't become apparent. What usually happens with that inflammation, does it generally naturally go away after some time or what? 
2. How likely is it that I can get HPV from one or a few protected encounters with an escort and then pass it to my wife? 
3. Is there anything else statistically relevant that I should be concerned about that I could catch from a few protected encounters? 
Thank you
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H. Hunter Handsfield, MD
57 months ago
1) We aren't really pap smear experts except in relation to HPV; this is a domain for a gynecologist or pathologist. To the best of my knowledge, inflammatory changes on pap smear typically clear up on their own, but this is something your wife should be asking the doctor who did her pap smear.

2) Very low chance. Re-read your thread with Dr. Hook a year and a half ago. I agree with his comments there.

3) Having had only condom protected encounters, it is unlikely you have any STD from those events and hence nothing to pass on to your wife. You already know that HPV is the single most likely possibility, since condoms are only partly protective against HPV. Although unlikely you were infected, nobody can say it's impossible. However, most HPV infections stay silent and cause ho nealth problem, so probably you and your wife will never have any issues with it. This really isn't something for you to be so worried about. As for other STDs, if you haven't had standard STD testing since your last non-marital encounter, you could do that for reassurance. In that event, I would recommend blood tests for HIV and syphilis and a urine test for gonorrhea and chlamydia (although if you had either of these 18 months ago, they would have cleared up by now). In absence of symptoms, I would recommend against testiing for any other STDs, such as herpes.
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