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Low back pain, have not had PAP smear, have one partner, scheduled for pelvic exam. Concerned

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Practicing since : 2001
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I haven't had a pap smear in five years due to being niev about cervical cancer. I have never had an abnormal pap smear only one partner but don't know if I ever got tested for hpv. I am so scared because I have been having low back pain and my periods have been 24 days instead of 28 but I am 40 and thought I might be going through perimenopause. I am going to have a pelvic exam next Friday but I am so concerned. Please can you make me feel a little more at ease.
Posted Sat, 25 Aug 2012 in Vaginal and Uterus Health
Answered by Dr. Michelle Gibson James 2 hours later

The guidelines for screening for cervical screening using pap smears was recently changed by the US preventive services task force from annual screening to a pap smear every 3 yrs between ages 21 and 65 yrs , for persons between 30 and 65 who do both HPV and pap smears every 5 yrs.

The reason for this change is that the pap smear detects the earliest changes and the cancer normally takes a long time to develop.
For example though HPV is necessary for cervical cancer, not all types of HPV leads to cervical cancer ( 90% fo HPV actually clears on its own in a few months to years and do not lead to cancer)

Only 5% of HPV infections will actually lead to precancerous changes in the cervix and of those precancerous changes only one fifth will actually progress any further in a 5 yr period.

If you had a previous normally pap smear 5 yrs ago, then even if there were any early changes in the past 5 yrs it would not usually have progressed to cancer in that time period.

Precancerous changes, though they can go back to normal, are usually treated with laser therapy, cryotherapy ( using cold therapy), something called LEEP which is basically excision of the area.

Cervical cancer actually does not usually present with back pain, the most common symptom is vaginal bleeding, though some women also have a smelly discharge, discomfort in the vaginal region and burning on urination.

The fact that you have only had one partner is also good because certain factors place a woman at risk for cervical cancer, these include: multiple partners, sex at an early age, promiscuous partner, history of sexually transmitted infections.

The normal accepted frequency of the menstrual cycle is 21 to 35 days- anything in this range is considered acceptable.
The causes of increased frequency are stress, improper nutrition,excess exercise, medication or perimenopause as you stated.

So basically cervical cancer develops slowly unless the person is immunocompromised in some way, the early changes are easily treated if present and it does not usually present with back pain and increased frequency of periods.

Having said that, your doctor will obtain a full history and conduct a through examination and investigations to assess your symptoms and determine the exact cause.
It can only be definately ruled out by the pap smear.

I hope this eases your mind, feel free to ask any other questions
Above answer was peer-reviewed by
Follow-up: Low back pain, have not had PAP smear, have one partner, scheduled for pelvic exam. Concerned 18 minutes later
Thank you so much. I am going next Friday to get checked out and do feel better. Just regret my decision in not going. Thank you for your service.
Answered by Dr. Michelle Gibson James 5 hours later
Hi, you're welcome and I really wish everything works for you.
Above answer was peer-reviewed by
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