Cervical cancer affects many women worldwide. It is one of the few types of cancers which is almost preventable through early detection thanks to pap smears/pap tests. Every woman is responsible for taking care of her own health in the best way possible. Receiving regular pap smears through your gynecologist is one way to achieve this. A pap smear is a procedure that detects abnormalities and changes in cervical cells, which can sometimes lead to cervical cancer.
If you receive a call or message from your gynecologist saying you have an abnormal pap smear. It means you have changes in your cervical cells that need management and treatment to avoid any chance of cervical cancer development. Even if your pap smear result is positive, you should not worry because some abnormalities are normal, especially if you had recent sexual intercourse. We invite you to contact All Women's Care for the early management of abnormal pap smears to halt any chance of cervical cancer development, which is deadly. We serve all patients in Los Angeles and the surrounding areas.
An Overview of Abnormal Pap Smears
Visiting your gynecologist often can be scary and uncomfortable, but sometimes it is necessary, especially if you are sexually active. Before the pap test, it was almost impossible to notice cancerous cervical cells that grow to cervical cancer. Pap smear checks for those abnormalities to make sure your cervix and vaginal canal are healthy. For that, you have to schedule regular pap smear with your gynecologist at least once every three years to examine the condition of your cervical cells
If your gynecologist sends you a message or calls you to visit his/her clinic to discuss your pap smear, that might mean you have some abnormal cervical cell changes. Other times if your pap smear is normal, your gynecologist might never even call you. Depending on the types of abnormalities you have in your cervical cells and other predisposing factors, your gynecologist may recommend you schedule frequent pap smears. There are also abnormal pap smears that do not require any medical action because the cervical cell changes can disappear on their own with time. However, a frequent pap smear is essential to monitor the cell changes behavior because some abnormalities may persist and become cancerous with time.
If you test positive for an abnormal pap smear, your gynecologist will advise you on the next step to take depending on the cause of the abnormality in your cervical cells. An abnormal pap smear results do not mean you've cervical cancer already. However, your gynecologist will advise you to increase the frequency of pap smears. Other times, he/she could recommend a closer examination of the abnormal cervical cells through diagnostic procedures like colposcopy.
Although abnormal pap smear results might be frightening and scary, sometimes, early detection of abnormal cervical cell changes can help the gynecologist treat and monitor the abnormalities.
What Causes Abnormal Pap Smears?
If you have an abnormal pap smear, it is important to know the causes to avoid them in the future or know which action to take to manage the abnormal cervical cells. After detecting abnormal cervical cells, we will have to conduct further examination of your cervical cells to determine the cause of the abnormality or changes for appropriate treatment. Below are the causes of abnormal pap smears you should be aware of:
Human Papillomavirus (HPV)
Human papillomavirus, a sexually transmitted infection, is the leading cause of cervical cancer because it affects the skin. HPV is a common, sexually transmitted infection that can affect both men and women. Some strains of HPV are very dangerous and require treatment as soon as possible because they can lead to the development of precancerous cervical cells.
Since HPV does not show any symptom or associated complications, it is advisable to schedule regular pap smear with your gynecologist, especially if you're sexually active. It is during a pap smear that the gynecologists conduct HPV tests to ensure your cervix is healthy, although you can schedule a separate appointment. You should also discuss with your romantic/sexual partner about the HPV test results for easy management of the infection. Most of the time, HPV can disappear on its own, but it is essential to closely monitor it because it can refuse to disappear, leading to cervical cancer.
Cervical dysplasia is the abnormal change of cervical cells, which can cause cervical cancer when left untreated. It is mostly associated with HPV infection among women under the age of thirty years. Mild cervical dysplasia may resolve without treatment, although careful observation and examination through pap smear are essential to monitoring the kind of abnormal changes in your cervical cells. However, any cervical dysplasia which persists for more than two years will require treatment to remove the unusual/abnormal cells.
Cervical cancer is progressive and grows over time. Meaning if detected early, the cancerous cells can be removed as a treatment option. There are numerous ways we can remove precancerous cervical cells before they grow to cervical cancer. The earlier we detect precancerous cervical cells, the better since they are easily manageable at an early stage.
Trichomoniasis and Other STIs
Trichomoniasis is a common, sexually transmitted infection (STI) in the US, which is usually more common in women than men. Trichomoniasis infection is an STI caused by a protozoan parasite known as trichomonas vaginalis transmitted through sexual intercourse. If you have trichomoniasis, you may experience the following symptoms:
- Vaginal odor
- Vaginal discharge
- Vaginal itching
- Vaginal warts
These symptoms could also be due to other STIs like herpes, gonorrhea, or yeast infection. It is essential to schedule an appointment with a gynecologist whenever you experience the above symptoms to establish the cause of those unusual symptoms for appropriate treatment to avoid further abnormal pap smears.
Other Hamless abnormal Pap Smear Causes
Other harmless reasons can lead to abnormal pap smear results that have nothing to do with an infection or cervical dysplasia, for example:
- Insertion of tampons in the vagina
- Recent sexual intercourse or use of lubricant in your vaginal area
- Lab error
- Recent menstruation or close to menstruation
- Use of powders and sprays around the vaginal area
Before visiting your gynecologist, you should avoid using tampons or sprays in your vagina at least 48 hours before a pap smear because they can affect the pap smear’s accuracy. An abnormal pap smear does not necessarily mean you've cancer or precancerous cells, so there is no need to panic. Your gynecologist should advise you on the outcome of the test. Therefore, you should be kind to yourself and follow your gynecologist's instructions if you receive an abnormal pap smear.
How often you should visit your gynecologist for pap smear depend on various factors which puts you at risk of abnormal cervical cell growth, for example:
- Your age
- HIV infection
- Weak immune system
- Exposure to diethylstilbestrol (DES)
Typically, if your age is between 21 and 29 years, you need to have a pap smear every three years. On the other hand, if your age is between 30 and 65, you should have a pap smear after three years, or have both pap smear and HPV test after five years.
What Happens After Detecting an Abnormal Pap Smear?
Whatever happens, after detecting an abnormal pap, smear aims to prevent any chance of cervical cancer development through more frequent pap smears. If you have an abnormal pap smear, we can only help you manage your cervical cells’ changes by first determining the abnormality’s cause.
A specialized tool is inserted in your vagina to scrap away some cervical cells for close examination under a pathologist’s microscope to determine the abnormal pap smears’ cause. After a thorough examination of your cervical cells, the pathologist will classify abnormal pap smear results according to the type of changes present in your cervical cells. Here are some of the terms your gynecologist will use to describe these changes in your cervical cells:
Atypical Squamous Cells of Undetermined Significance (ASCUS)
A gynecologist uses this term to describe flat and thin squamous cells that grow on a healthy cervix surface. A pap smear can reveal these abnormal squamous cells' presence, but these changes do not mean precancerous cells are present. We will have to analyze your pap smear sample again to determine if these changes are due to infection of high-risk viruses like HPV that promote cervical cancer development.
If there are no underlying infections like HPV, the abnormal cell changes causing abnormal pap smears should not be of great concern. However, it is advisable to keep your gynecologist close as you monitor these cell changes to know if they are disappearing.
Squamous Intraepithelial Lesion
When your gynecologist uses this term, he/she has found precancerous cells in your cervix. If these cervical cell changes are high grade, there is a higher likelihood that the lesion may develop to cervical cancer sooner. On the other hand, if these changes are low-grade, the likelihood of developing cervical cancer may take years.
Atypical Glandular Cells
Glandular cells produce mucus and usually grow near the opening of your cervix and within the uterus walls. Glandular cells may appear abnormal, but it does not indicate there is the presence of cancer. We may need to conduct more tests to determine the cause of the changes and whether these cells can become precancerous over time.
Squamous Cell Cancer or Adenocarcinoma Cells
Squamous cell cancer or adenocarcinoma cells are severe and may appear abnormal enough to convince a doctor that the changes are due to cervical cancer. If these cells are present, your doctor will conduct colposcopy to determine the cause of these changes in your cervical cells.
The doctor uses a lighted magnifying device to examine your vagina and cervix during colposcopy to determine the cause’s abnormal cervical cells. During colposcopy, the doctor may apply some iodine or vinegar solution on the wall of your vagina and cervix to enhance the problem areas' visibility, causing abnormal pap smears.
Suppose your doctor detects an issue during colposcopy. In that case, he/she will have to take a small sample of your abnormal cervical tissue for a closer examination under a microscope by the pathologist in the lab. Colposcopy is very crucial as it enables a doctor to determine the cause of the abnormal pap smear results for appropriate treatment.
Even if you have these risky squamous cell cancer or adenocarcinoma cells at All Women's Care, we will provide you with every type of service you need to halt cervical cancer development.
Treatment and Management of Abnormal Pap Smears
Treatment and management of abnormal pap smears depend on the severity of changes you have on your cervical cells and the cause. Mild abnormal pap smear may not require treatment at all because they can disappear on their own with time. However, if your cervical cells' abnormality persists after more than two pap smears, your gynecologist will recommend treating the abnormal cervical cells. Treatment of abnormal pap smears may involve removing or destroying the abnormal cervical cells through various treatment procedures. Here are ways of eliminating and destroying abnormal cervical cells
Removing Abnormal Cervical Cells
A gynecologist can conduct multiple surgical procedures to remove the area of your cervix with abnormal cells through the following methods:
Cone biopsy is a simple surgical procedure that cannot last more than twenty minutes, and usually, you are asleep or unconscious because your gynecologist will put you under anesthesia. The gynecologist removes a cone-shaped tissue from your cervix for examination under a pathologist’s microscope during cone biopsy.
During the cone biopsy surgery, your doctor will insert a speculum inside your vagina to open it up slightly for easy screening of your cervix to identify the abnormal areas. Then, he/she will cut a cone-shaped sample of your abnormal cervical tissue for examination under a microscope by the lab pathologist to determine the type of changes you have.
It is normal to experience some bleeding for up to six weeks after a cone biopsy, but if the bleeding persists, it is essential to consult with your gynecologist to treat the issue. After a cone biopsy, most women can naturally conceive, although removing extensive cone biopsy tissue can weaken the cervix, thus increasing miscarriage chances.
Large Loop Excision of the Transformation Zone (LLETZ)
LLETZ, also known as LEEP (loop electrosurgical excision), is a standard treatment procedure for cervical cells' abnormality. During LLETZ or LEEP, a gynecologist uses a thin wire with an electric current to cut the area with abnormal cervical cells while healing the cuts at the same time.
LLETZ is usually an outpatient medical service that generally takes less than fifteen minutes while the patient is under anesthesia. After LLETZ, you may experience some discharge or bleeding, but it shouldn't last more than four weeks. If you are experiencing a discharge with odor or continuous bleeding after four weeks, it is essential to contact your gynecologist.
Hysterectomy is another surgical treatment procedure for removing abnormal cervical cells, which is ideal for women who have had all the children they need or past menopause. Hysterectomy involves removing the womb (uterus), lymph nodes, and parts of your cervical cells, which are abnormal to halt any chance of cervical cancer development entirely.
Destroying of the Abnormal Cervical Cells
Destroying abnormal cervical cells can also help treat and manage abnormal pap smears allowing new healthy cells to grow. A gynecologist can destroy abnormal cervical cells in the following ways:
Cold coagulation involves the use of a heated probe to destroy abnormal cervical cells identified after colposcopy. In contrast to cone biopsy, cold coagulation cannot put you at risk of miscarriage during pregnancy.
Freezing treatment typically involves making cold blisters on your cervix to drain out the abnormal cells so that new healthy cells can grow in to replace them. A gynecologist uses a cold probe to freeze away cervical cells that appear abnormal. Suppose the abnormal cervical cell changes don't seem to disappear after several follow up tests with your doctor. In that case, other more extensive treatment procedures like cone biopsy or hysterectomy might be effective.
Laser therapy, also known as laser ablation, burns away abnormal cells in your cervix using intense light beams to grow new healthy cells. You may experience a burning smell during laser therapy, but it's nothing to worry about because that is how a laser works, and you can go home after the procedure.
Suppose you have a vaginal infection like gonorrhea or yeast infection, which causes abnormal pap smears. In that case, your gynecologist focuses on treating the infections to halt abnormal cervical cells' development using antibiotics and antifungals.
What Happens After Treatment of Abnormal Pap Smears?
Most women feel perfectly fine after treating abnormal cervical cells, although every patient is different because some can feel unwell for a few days. You might experience the following common symptoms after treatment of abnormal cervical cells:
Immediately after treating abnormal cervical cells, you may experience a period type of pain that your doctor will discuss with you before you leave the clinic. He/she will advise you to use painkillers such as paracetamol or ibuprofen to ease the pain. If the pain persists for about a week, you should see your gynecologist examine the cause of persistent pain.
Bleeding or Discharge
You should expect to experience some virginal bleeding or discharge immediately for about four weeks after treating abnormal cervical cells. Typically, vaginal bleeding or discharge after treatment of abnormal pap smears is normal but how long it should last depends on the treatment method.
Treatment of abnormal cervical cells when your periods are due may lead to heavy bleeding. Hence, it is advisable to carry out these treatment procedures in between the periods. If you notice sticky and smelly discharge or bleeding that lasts more than four weeks, you should contact your gynecologist as soon as possible. Until there is no more bleeding or discharge, you should avoid the following:
- Having sex
- Using tampons
- Using sprays or powders near your vaginal area
Make sure you talk with your gynecologist if you are unsure about anything you should do after treating abnormal cervical cells causing abnormal pap smears. After treatment of abnormal pap smears, you may need more follow up tests and HPV screening, especially if you are sexually active.
Follow up tests are essential to ensure the abnormal cells do come back again because some strains of HPV may refuse to disappear and may grow to cervical cancer. In case the abnormal cervical cells come back, although very rarely, your doctor will recommend further treatment to remove them altogether, for example, hysterectomy.
Unless you have had a hysterectomy, there is no other treatment procedure for abnormal cervical cells that can prevent you from conceiving. However, some procedures like cone biopsy can make your cervix narrow, leading to complications during delivery or premature birth.
Cervical cancer does not develop overnight. Therefore, frequent pap smears can detect cancerous cells early to remove them before they become a threat. Enrolling a reliable gynecologist’s services for regular pap smears is very important for the early detection of any abnormal cervical cells that can cause cervical cancer.
Find a Gynecologist Near Me
Since the introduction of pap smear, cervical cancer cases have significantly reduced because precancerous cells are easily manageable at an early stage. You should retain a reliable gynecologist like All Women's Care for your routine pap smear and management of abnormal cervical cell growth if you have an abnormal pap smear to prevent cervical cancer development. We invite you to contact us at 213-250-9461 to talk to our skilled gynecologists about any concern you may have about pap smears and the management of abnormal pap smears in Los Angeles, California.