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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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I had a pap smear and the results showed hpv

Answered by
Dr.
Dr. Purushottam Neurgaonkar

OBGYN

Practicing since :1992

Answered : 2204 Questions

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Posted on Mon, 18 Mar 2019 in Women's Health
Question: I had a pap smear and the results showed hpv high grade. I have been spotting for 3 months now and I have very light periods, they dont usually last more than 4 days and only one day will be heavy. I did blood work and it showed I had slightly low estrogen which is why I figured I was spotting (I work out a lot) I did a transvaginal ultrasound and a pelvic ultrasound and everything came back normal. Now I have to do a colposcopy so I am freaking out due to the hpv high grade results. I was wearing a tampon literally about 5 minutes before my pap smear (I was ending my period when I got the test done) would that affect my pap smear results. Can that cause my results to come back with hpv? If I hav cervical cancer would that have shown on my transvaginal ultrasound or pelvic ultrasound?
doctor
Answered by Dr. Purushottam Neurgaonkar 27 minutes later
Brief Answer:
Feedback. PAP report.

Detailed Answer:
Hi there,
Welcome to 'Ask A doctor' service.
I have understood your concern... I will suggest you the best possible treatment options.

First of all, please do not panic.

I would like to know about a few things in detail:

1. Do you suffer from intermenstrual bleeding?
2. Do you have any kind of vaginal discharge?
3. Are you sexually active?
4. If yes, do you practice safe and protected sexual activity?

If possible, then please upload/attach your PAP smear reports for review.

I'd suggest you maintain personal hygiene.
Keep private parts dry and clean.
Use of Lactic acid containing vaginal wash during bath time is recommended.

Secondly, PAP smear is more reliable in the detection of cervical cancer, as compared to the USG report. As sonography report can detect cancer of cervix only after a sizable change of the disease.

Please feel free to communicate with me again.

I hope this answer helps you.

Thanks.
Dr. Purushottam Neurgaonkar


Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Follow up: Dr. Purushottam Neurgaonkar 23 minutes later
I do not have intermenstrual bleeding. I just started spotting in November. When I would wipe in the morning after using the bathroom it was just like if I was spotting. It was not heavy blood or anything.

When I started spotting I saw my primary doctor and did bloodwork for everything. I showed him a picture of my spotting and he said it was so light and probably pcos and referred me to a gyno. On my blood work everything was normal except I had slightly low estrogen and slightly high prolactin.

My periods have always been very light they are usually done by the fourth day and the only "heavy" day is day 2. I work out a lot and have been for about 10 years, sometimes going two times a day.

I started taking multivitamins about a week and the spotting pretty much stopped but I smoked last night (medical marijuana) and had a little but of spotting this morning.

I do not have any vaginal discharge either.

I am sexually active and have been with the same person for 7 years and i am in a relationship with a woman. Which is why i find the hpv results so weird and why I was wondering if wearing a tampon prior to the exam would have affected those results.

The results said hpv detected and hpv mrna e6/e7 detected. I will upload the results on Monday night I am out of state right now but that's all it said.

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Follow up: Dr. Purushottam Neurgaonkar 4 minutes later
I forgot to add the results were High grade HSIL
doctor
Answered by Dr. Purushottam Neurgaonkar 2 days later
Brief Answer:
Calposcopy, cervical biopsy, then further treatment..

Detailed Answer:
Hi there
Thanks for appreciating the answer and reverting back to me.

I have gone through your reply.
It is of immense help to me to guide you further.

Considering the report if High grade HSIL,
we need to consider various treatment options.

1. As PAP smear reports are in favour of HSIL, I will suggest you to get calposcopy done and guided biopsy of the aceto- white areas or Lugol's iodine free areas is advisable.

2. Alternatively, calposcopy followed by loop excision biopsy, that includes wide area of cervical tissue,is the next option.

3. Depending on the reports of cervical biopsy further treatment options can be exercised.

4. Sometimes, with HSIL report on PAP smear or with HSIL report of biopsy,
Total Hysterectomy can be offered to the patient, depending on anxiety and patience of the patient.

In my opinion, it's better to go step wise and further decision should be taken after cervical biopsy reports.

I hope this answer helps you.
Thanks.
Dr. Purushottam Neurgaonkar
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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