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Abnormal PAP, chlamydia positive - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Sexually Transmitted Diseases
Answered by

General & Family Physician
Practicing since : 2004
Answered : 40 Questions
User :   Hello. I m kind of shaking because I m so scared right now. I went for a pap and std screening at the end of March. I got a call on April 7th (the day before my birthday) saying I tested positive for Chlamydia and was shocked. I ve only been with 2 guys (with the 2nd one currently) and was not expecting to hear that. I was also told your pap came back a little abnormal but that is probably because of the Chlamydia. Now my current boyfriend went and got tested and came back negative for everthing. So I know he couldn t have given me Chlamydia. My ex says he was tested for everything 4 weeks ago and is clear, too. Which really has me confused. But that is a different story. Fast forwarding: I call the doctor s office the other day with questions about Chlamydia and was told that HPV causes abnormal paps. Now I am barely getting over the idea that I ve only been with 2 men and not only do I have ONE STD, but two???!!!! I didn t even take an HPV test, but they told me HPV causes abnormal paps. So my question is why wasn t I told this weeks ago??? That seems more serious than the Chlamydia. Also, why wasn t I told to come in and retest and take an HPV test? I have read online in numerous medical articles that a bacterial infections such as Chlamydia can cause an abnormal pap also. Should I just get an HPV test to ease my mind. This seems serious and I don t know why I was told my pap was a little abnormal like it was no big deal and told to call back with a number to a pharmacy for my prescription
Doctor :   Hello,
User :   hi
Doctor :   Give me a moment to review your query.
User :   okay
Doctor :   OK
Doctor :   Regarding the chlamydia
User :   okay
Doctor :   this can be present for many weeks or many months and be asymptomatic
Doctor :   Sometimes it may cause a discharge or pelvic discomfort
Doctor :   you had no symptoms correct?
User :   yeah, i think i was starting to get a FEW symptoms
User :   but only recently
Doctor :   I understand.
Doctor :   Also,
User :   I had a yeast infection in February and that's when I notice things were a little off
Doctor :   the chlaymdia certainly does not cause abnormal paps as you suspected
Doctor :   How much do you understand about HPV?
User :   Well I know a girl who had Chlamydia and her pap was abnormal too
User :   I know HPV leads to cervical cancer if it's the high risk type
User :   and the low risk type causes warts
Doctor :   I suppose chlamydia could disturb the pap result but the HPV is the one which causes true cellular changes in the cervix
Doctor :   There are many types of HPV
Doctor :   I think it's reasonable for you to have a screening test done to see if you have a high risk strain
User :   I also read another girl online who had Chlamydia and her pap kept coming back abnormal and she was given meds 3 different times. She says the 3rd set of meds finally worked and her pap went back normal
Doctor :   What med did they offer you?
Doctor :   for the chlamydia
User :   azithromycin?
User :   i think that's spelled correctly
Doctor :   I see
Doctor :   what dose?
User :   4 pills
User :   I believe 250 mg a piece
Doctor :   OK
Doctor :   that is generally the effective dose
Doctor :   you can rescreen to make sure you are negative after treatment
Doctor :   for peace of mind
User :   okay
Doctor :   Now,
Doctor :   regarding HPV - I understand this can be very concerning
Doctor :   Your body could possibly clear the HPV as well
User :   yes, why did they say it was a little abnormal like it was no big deal?
Doctor :   There are several different ways paps are interpreted
User :   okay
Doctor :   you may have had what is called some "atypical" cells
User :   I would think it would be "your pap is abnormal. We need you to come back in ASAP!!!"
Doctor :   Not necessarily
Doctor :   It is not regarded as an emergency
Doctor :   but it certainly needs to be followed up
Doctor :   Generally in my practice we do the HPV screen
Doctor :   and then
Doctor :   another Pap 3 to 6 months in the future
User :   I'm just confused as to why I was told my abnormal pap was because of the Chlamydia
Doctor :   Yes,
Doctor :   As I said, it is possible that chlamydia might discturb the normal cells of the cervix
Doctor :   but it would be from a differebt mechanism compared to how HPV works
Doctor :   So I think it's prudent for you to treat the chlamydia
Doctor :   and repeat the pap with HOV screen
Doctor :   HPV
User :   what if the HPV comes back negative?
Doctor :   Then a repeat pap in 3-6 months
User :   I've done a lot of reading online and numerous women said they had abnormal paps and were examined further to find that they didn't even have HPV
Doctor :   true
Doctor :   interpretation of pap smears depends on the pathologist
User :   another lady said that if your pap is abnormal they automatically assume it's HPV
Doctor :   if they see a couple of cells that look irregular then they will note it on the report
Doctor :   this is to be extra safe that they don't miss anything that could get worse
User :   my boyfriend says I need to stop freaking out because I am not even 100% sure I have HPV
Doctor :   Let me reassure you
User :   and he said it does seem like an overlook on their part to not tell me that weeks ago
Doctor :   I agree with your boyfriend
User :   you do agree with him? lol
Doctor :   try to clear your mind of this until the retest is done
User :   so if i get a retest and my pap comes back normal, can I just assume in my case that it was the Chlamydia?
Doctor :   That would be a safe assumption yes
User :   wow
Doctor :   BUT
User :   I've been wrecking my brain the last 3 days
Doctor :   you absolutely should have a re-test of the pap in 3-6 months
Doctor :   Erial,
Doctor :   I cannot imagine how stresdsful this has been for you
User :   I don't want to sound redundant, but since Thursday, I've been doing a lot of research on this
Doctor :   not at all - please go ahead
Doctor :   I am speaking with my wife regarding your case
Doctor :   she is a pathologist
User :   and have read that although HPV is the main cause of abnormal paps, an abnormal pap doesn't mean you necessarily have HPV either. I read that an infection of an sti can cause abnormalities
Doctor :   This is true
User :   she's a pathologist? Well that's convenient :-)
Doctor :   and we would expect these changes to resolve over time after infection is clear
Doctor :   Serial pap smears is the key
Doctor :   to document and confirm healthy cervical tissue
User :   I had an HPV test 4 years ago and I never had a call back saying I had it
User :   and I was with my ex boyfriend during that time
User :   on and off about 3.5 years
Doctor :   I see
User :   actually, I was with him when I had the test done
Doctor :   I see
Doctor :   Well
Doctor :   Sometimes, labs will reflexively test for HPV if the pap is abnormal
Doctor :   not sure how the lab in your case operates
User :   Yeah, I've been stressed since Thursday when I called the office back.
Doctor :   Well
Doctor :   to clear the air,
Doctor :   a repeat test would be helpful
User :   I didn't have an HPV test done this time. It was going to cost another $200 bucks just for that particular test
Doctor :   Verify with the lab that read your pap first
Doctor :   see if they can run a HPV test on your previous sample
Doctor :   If not then I fear you may have to pay the additional fee
User :   dont they get rid of those samples?
Doctor :   Depends on the lab
Doctor :   can't hurt to ask
User :   that's a lot of samples to keep. lol
Doctor :   Very true!
User :   I also read that 80% of the population has or has had HPV at some point
Doctor :   Sounds a bit high
Doctor :   but it is prevalent
Doctor :   I would estimate 60-65%
Doctor :   depending on location
User :   Yeah, that's what I read because they say many people get or have been exposed to HPV but their bodies get rid of it so lots of people never know that they've had it
Doctor :   absolutely
User :   and then I read half of the male population are carriers of HPV
Doctor :   Yes
Doctor :   Men are the vectors so to speak
User :   So unless I marry a virgin (unlikely at the age of 28) lol, I'm going to be exposed to it
Doctor :   Potentially
User :   would it be too late for me to do the vaccine?
Doctor :   You can ask your physician
Doctor :   if you're negative
Doctor :   he or she may offer you vaccine
Doctor :   it may not be covered by insurance though
User :   I don't have insurance
Doctor :   since guidelines are up to age 26
Doctor :   I see
User :   yeah, I just turned 28
Doctor :   well
Doctor :   it would be an investment for you
Doctor :   but peace of mind is worth it for many
Doctor :   including myself
User :   but most people I know have had lots of sexual partners by age 26
Doctor :   Yes
User :   I'm on my 2nd
Doctor :   Try not to think in terms of numbers
Doctor :   Purely from chance it only takes one partner to transmit
User :   ah, I see
Doctor :   Its very possible you are HPV negative
Doctor :   Our time is drawing to a close Erial
Doctor :   any final questions?
User :   ummm
User :   oh!
User :   a girl online said she ended up with HPV and she has had the vaccine
Doctor :   This is unlikely
Doctor :   Seems as if our time is expired
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