Human Papilloma Virus (HPV) and Dysplasia
Health Services > Sexually Transmitted Infections > Human Papilloma Virus (HPV) and Dysplasia

There are around 70 strains of HPV currently known. Some strains are known to cause precancerous and cancerous changes in the cells of the cervix (and sometimes the vagina and vulva), and some are known not to. There is no readily available and affordable test to tell the strain(s) you have. If HPV is part of your cervical biopsy diagnosis, you should have your cervix followed closely with more frequent Pap smears. Other things you can do are to not smoke cigarettes, keep your stress level down, get enough sleep, exercise and eat well. Some people think taking a multi-vitamin is a good idea.

Also remember that you may have come in contact with this virus a long time ago - there is no way to know who you got it from or how long you have had it. Medical experts believe that about half the people in the world may be carrying a strain of HPV.

Do I need to use condoms?

Condoms are an important part of decreasing your risk for STI's, including HPV, but they are not 100% effective. HPV is passed by skin-to-skin contact, and the condom only covers the penis.

If I have treatment to my cervix (Cryotherapy, LEEP), will I get abnormal Pap smears in the future?

Maybe, and maybe not. No one knows how the virus will behave with each individual person. The important thing is to have your Pap smears on the recommended schedule and follow-up on any abnormal Paps as directed. Remember that this is the reason for having Pap smears - to find things early when they can be treated, and to prevent cervical cancer.

Can I still have babies?

Yes, HPV rarely interferes with pregnancy or delivery. You should let your OB provider know of your HPV history, abnormal Pap(s), colposcopies, and any treatment that has been done to your cervix.

DYSPLASIA

What is dysplasia?

Dysplasia is an abnormal cell change on your cervix that is considered pre-cancerous. Dysplasia begins in a mild form, moves onto moderate, then severe. Sometimes dysplasia is reported as cervical intraepithelial neoplasia or CIN I, II, and III. After severe dysplasia comes carcinoma.

What is the difference between carcinoma in-situ (CIS) and invasive carcinoma?

Carcinoma in-situ is cancer of the cervix that is fully contained in the epithelial tissue of the cervix. It has not passed deeper beyond the basement membrane. Invasive carcinoma has broken through the basement membrane and into deeper tissues. These two types of carcinoma are treated differently. CIS can usually be treated with LEEP or cone, where invasive carcinoma will require a treatment program of more extensive surgery and chemotherapy.

QUESTIONS RELATED TO TREATMENT OPTIONS FOR DYSPLASIA AND HPV

What are my treatment options for HPV only?

Cryotherapy can be done if your biopsy shows HPV only, however, it is important to know that HPV is not cured by Cryotherapy or any other treatment. We do not know if Cryotherapy has any effect on causing the virus to become inactive. We do know that Cryotherapy can push the squamo-columnar junction (SCJ) up closer to or into the cervical canal. The SCJ is important because this is the place where most abnormal cell changes happen. If the SCJ is in the cervical canal, it can make it harder to evaluate the cervix by colposcopy in the future.

What are my treatment options for mild dysplasia?

If you've never been diagnosed with mild dysplasia before, you may have Cryotherapy or wait four months and get your Pap smear done again. Most of the time, abnormal changes on the cervix clear up by themselves without treatment (although it's really important to have more frequent pap smears). Knowing that, you may want to just wait four months and have a Pap smear - the cervix may have gone back to normal. The other option is to have Cryotherapy, which should get rid of the dyplastic cells on your cervix. It will not cure HPV.

After a colposcopy, whether you have treatment to the cervix or not, you will be asked to have follow-up Pap smears every four months for one year, then possibly every six months for the next year.

If your Pap smears do not return to normal by the end of one year or if they become more abnormal, you will need to have another colposcopy. Basically, we want to follow your pap smears closely to make sure your cervix returns to normal.

What are my treatment options for moderate and severe dysplasia?

For moderate dysplasia you may need Cryotherapy or LEEP. A lot depends on where the moderate dysplasia is on your cervix, if you have been treated for dysplasia before, your age, and how large an area of your cervix has dysplasia. For severe dysplasia you will need to have LEEP performed.

QUESTIONS RELATED TO TREATMENTS

What is Cryotherapy?

Cryotherapy is freezing of the cervix. This will cause the top layer of cells to die then slough off. In the next few weeks, new healthy cells will grow back.

What is LEEP?

LEEP stands for Loop Electro-Excisional Procedure. A thin wire loop is used to remove the abnormal tissue from the cervix. LEEP cauterizes the cervix in the process to control bleeding and it leaves you with a piece of tissue that can be sent to the lab to confirm that all abnormal tissue was removed.

QUESTIONS RELATED TO PAIN

Will Cryotherapy hurt?

Most people say that the Cryotherapy was less uncomfortable than the colposcopy and biopsies. You may have Ibuprofen or Tylenol prior to the Cryotherapy, if you would like. Everyone is different, but most people have some mild cramping while the Cryotherapy is happening (we freeze 3 minutes, wait a few minutes, and freeze again for 3 minutes). Some mild cramping may occur on and off for the rest of the day, but others may not notice this. Ibuprofen or Tylenol and a heating pad should help.

Will LEEP hurt?

Most people say that LEEP was less uncomfortable than the colposcopy and biopsies. You will have your cervix numbed with Lidocaine prior to the procedure (cervical block). You may have Ibuprofen or Tylenol prior to LEEP. You may also have the option of taking Valium and Vicodin, but for these you must have a driver, and the cost will be $20.

QUESTIONS RELATED TO MEN

How is HPV diagnosed in men?

HPV can be diagnosed in men if they have genital warts.

Can men get Dysplasia?

HPV can cause precancerous and cancerous changes in men, but this is rare. Usually, if a genital wart is not responding to traditional treatments, a biopsy will be taken.

Does my partner need to be examined?

Not usually. Most of the time, the wart virus is in the skin, but it can't be seen. However, if your partner thinks he has warts that can be seen, he can make an appointment for an exam at a Planned Parenthood clinic.