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Had an abnormal pap. Started periods, having pain in vagina. What is this?

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Practicing since : 1999
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Hi im XXXXXX! I had an abnormal pap which they said also came back with HPV I am going next week to see an obgyn but recently started my period and I'm having lots of painful pressure in my vagina feeling like everything is going to bottom out. What is this or what can I do to help the complete discomfort? Thank you
Posted Wed, 17 Oct 2012 in Vaginal and Uterus Health
Answered by Dr. Timothy Raichle 46 minutes later
Hi XXXXXX I would be happy to help you with your question.

First of all, the pap smear is a screen for PREcancerous cells of the cervix. Sometimes the HPV is done to determine the level of concern, but a positive HPV test is VERY common. The OBGYN will look closely at your cervix to determine where the abnormal cells came from. In all likelihood, this visit will go very well, and I would recommend thinking of questions beforehand.

Next is the issue of your painful vaginal pressure associated with the onset of your cycle. I think that this sense is probably related to inflammation or irritation of the vagina, likely related to a common vaginal infection, such as yeast.

If you had or have any itching, or there is any history of yeast infections, then the easiest way to treat this is with a pill called Diflucan. You would have to call your doctor for a prescription.

Without an exam, it is very difficult to sort out exactly what is going on. In the meantime, I would avoid tampons, and consider calling your doctor if you think yeast is a possibility.

If you can provide me any further clarification, I would be happy to help you sort this out further (e.g. have you had kids, history of STD's, abnormal discharge, etc)

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Follow-up: Had an abnormal pap. Started periods, having pain in vagina. What is this? 18 minutes later
I do have a 2 year old delivered c section and I do not have itching just extreme discomfort with pressure and clotting it very bad at this time. I was tested for stds and they all came back good. I have had discharge lately but didn't think anything of it honestly. I haven't had any signs of a yeast infection. And intercourse is becoming very uncomfortable I might add that she seen a palop on my cervix during last exam 2 weeks ago. I also started the nuvaring and had it in for 9 days when asked to remove it because of the procedure I'm supposed to have on these cells
Answered by Dr. Timothy Raichle 18 minutes later
Here is what I will add based on what you have said:

1. There is no reason to remove the Nuvaring before the procedure - they could have removed it that day for the 10 minutes that the procedure took.
2. The polyp is a clue - they are common, associated with irregular or heavy bleeding, and often when you see one at the cervix, there might be more up higher within the uterus
3. The other possibility of relaxation of the pelvic floor, or prolapse related isssues contributing to this sensation of pressure.

Here is what I recommend:

1. Ask why you had to take the Nuvaring out (as they are putting you at risk for irregular bleeding and pregnancy)
2. Ask for an ultrasound for the following reasons: pelvic discomfort, pain with intercourse, heavy bleeding with clots and endocervical polyps
3. The ultrasound will likely be scheduled for a different day - ask that they sit down with you to review it IN PERSON and discuss options for control of your heavy bleeding.

To be honest, I think that you have brought up a lot of issues that can be addressed in an effort to seriously improve your quality of life. But, if the OB/GYN is not giving you time or answering your questions, then find a new one. Remember, you deserve to be treated well and given the time you need!

Good luck - I hope it goes well! - DR XXXXXX
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Follow-up: Had an abnormal pap. Started periods, having pain in vagina. What is this? 9 minutes later
Thank you!
They asked me to take it out because I would have been on my monthly for my appt which was scheduled ASAP and they didn't want my cycle to affect the procedure!
Thanks Again Dr XXXXXX I really appriciate you giving me a bit of relief yet good questions to ask that I really would have been to nervous to ask. I am ready to be me again and I'm ready for results!
Much appriciated XXXXXX
Answered by Dr. Timothy Raichle 1 hour later
Okay, that is what I thought might have been the case - just thought I would throw that out there as a question.

Don't worry - you don't have cancer and you are not going to get it as long as you go in for the evaluation and follow their long-term instructions.

Good luck and don't lose too much sleep over all this.

Dr. Tim
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