Over the past 9 months or so I have had post coital bleeding (sometimes lasting up to 3-4 days after sex). I finally had a pap smear done a month ago and the results came back as LSIL consistent with HPV. (Naturally the fact that it was saying that I had low grade pre cancerous cells scared me! Then I felt really dirty because of the HPV.)
My doctor referred me to a gyno, who stated to me that he believed that a termination I had (14 months ago), had torn and it had caused lesions. (By this time I was quite upset and not sure what to think.) He did a swab I believe, not sure what that actually entailed, but he made me bleed after it. (I bleed for about 2 days after that). He then prescribed me with doxycycline and metronidazole and told me that he wanted to freeze the cells right there and then. However the hospital did not have the equipment to do it. So he booked me in for a cautery of the cervix. On the admission form he wrote "chronic cerivicitis".
I had the cautery of the cervix 8 days ago and three days ago began to notice a rather offensive odour coming from down there and the discharge had not slowed down at all. I went to the hospital last night and he did another swab I believe and I again bleed afterwards and it has slowed down tonight. When he was inserting the speculum he caused me to almost jump through the wall from the pain in my lower abdomine. He then told me that he could see where the cells had been burnt away and they looked to be healing rather well but he believed I had a bacterial infection. He also did a pelvic exam, where I am having a intermittent pain down the left side. He then prescribed me with Zithromax.
Everywhere that I read on the net about the about the antibiotics they are giving me is for chlamydia and gonnorhea, however I had an std check around the same times as the pap smear and they all came back o.k.
Can anyone please give me any advice as to what might be wrong with me?? I would love to be able to have a normal sex life, to find an answer to what is wrong with me and feel as though something maybe getting over looked.
Hi ness79. I am a nursing student and so I have a drug book. I looked up Zithromax in the book and it says it is indicated for nongonococcal urethritis or cercvicitis. This sounds like what you have. Actually this antibiotic is used for a wide variety of infections including ear infections and pneumonia. Good luck with your treatment and remember to finish the whole course of antibiotic
Thanks for the response. I actually spoke to the A&E doctor today that saw me the other night and he believes I have an infection, he just does not know what anti biotic is going to work as I am allergic to Penicillin. I have taken the Zithromax (which was 2 tablets, and it was for 500mg) and the bleeding has not stopped, if anything it is getting worse and the smell went away yesterday but is back again today. I feel as though I am not getting anywhere with this at all. He advised me to go to my GP today and get them to give me more anti biotics, but I feel like a pill factory at the moment!!
I really do feel that there is an underlying cause here and no one is investigating further. When I had the cautery done, would they have done anything else to make sure that no infection was anywhere else in my body or would they have just burnt the cells away and then put me straight into recovery??
Another question that I have is, is it HPV that they are giving me the antibiotics for or what do they mean when they say bacterial infection??
I saw my GP yesterday and she has now prescribed me Clindamycin @ 150mg, however she called me today to say that she got the results from the hospital from the swab that they took and it shows a bacterial infection and that I need to go see her next week for her to up the dosage.
What does this all mean?? I think they main thing that I would like to know is whether HPV is a bacterial infection??
HPV is a virus. Antibiotics are NOT effective against HPV.
The antibiotics are for the bacterial infection that you have.
Clindamyacin is very effective for bacterial infections of the cervix.
By the way, did you get a copy of your pap test?
When they say you have HPV is it a low risk or high risk strain?
At some point after the infection has healed you should get a repeat pap smear to see if the pap returns to normal regardless of your HPV status.
HPV depending upon the strain that you have can often resolve itself on its own.
If the pap continues to be abnormal AFTER the infection has cleared, then you should be scheduled for a colposcopy and/or biopsy to get a definitive diagnosis as to what is really going on.
Thank you so much for your response, I really appreciate it. Especially knowing that I do have an infection on top of the HPV, it is starting to make a bit of sense to me. Here is what my pap results say:
Diagnostic Catergory: Low Grade Squamous Intraepithelial Lesion (LSIL)
Adequacy: Endocervical cells are present. The smear is satisfactory for assessment.
Diagnosis: Squamous cells present show HPV effect.
Comment: Inflammatory smear with scattered atypical cells consistent with HPV.
Recommendation: A repeat smear is recommended in 1 year.
I saw the gyno and he did a swab and told me that I had got an infection after the termination as they may have torn my cervix a little bit?? He then stated that on the admission form that I had Chronic Cervicitis and that I was to be operated on within 90 days.
I have had the cautery done and would they have taken a biopsy then? I don't know if this is extremely serious or not??
Your pap at least in my opinion does not seem serious at all.
By not serious, ofcourse I mean NOT cancer. You result is
nowhere near that. Notice it says recommend repeat pap
in one year. The pathologist is remarking that what they
see is "consistent" with HPV which quite frankly doesn't mean very much.
A result of LSIL (low grade Intraepethial lesion) often means that HPV is present but unless you are tested for HPV and the test comes out positive, you really can't say with any certainty whether you indeed have HPV or not. Lesions can be caused by many things, only one being HPV. If your doctor believes the lesion might have been caused by a trauma from a previous procedure, then it is possible you don't have HPV at all.
It is also important to know if your HPV is a high or low risk strain. That will determine the likelyhood of whether your condition might progress to cancer in the future. A biopsy is not done during cautery as you are taking a piece of tissue off of the cervix for examination. To do so could risk an infection. In fact, that procedure should not be done if someone has an active infection. From what I read an active cervical infection is treated first. The cautery is done later if the pap continues to be abnormal. By burning the abnormal cells left behind, normal skin grows in its place and the problem is solved for good. Your infection could be the result of the cautery (hard to tell). Infection is a common complication of the procedure. Chronic cervicitis is often the result of an infection that was not completely cured on the first go-around. Quite common.
I had a pap very similar to yours in 1995 except it did not show HPV.
Ofcourse they were not testing for it back then. This pap followed a miscarriage that I had suffered only 3 months before so I often wondered if there was a connection.
But back then I was treated immediately with the clindamycin cream that you are on. A repeat pap then turned up normal but with mild inflamation. No cautery was done.
The following year I had another pap showing "reactive atypia". I was treated again with the same medication. The next pap was normal.
I had normal pap smears for the next 11 years until this november when my result showed, "ASCUS - HPV negative for high and low risk strains". Following a colposcopy which yielded the same result, I went for cryotherapy (similar to cautery except the freeze rather than burn the cells away) this past January. I return now for a repeat of the pap smear in April. I am hoping it will be normal but I do need to go for paps every 3 months for the next year. I'm summizing that the cause of my ASCUS was in reality a case of chronic cervicitis given my pap history AND that I had symptoms of what felt like a severe vaginal or cervical infection in October which was the month prior to getting this pap test result.
At some point you are going to have to have your pap smear repeated, perhaps 3 months from now? Your body has to get past the infection / cautery event before a repeat test can be done. Given your history and your concern about HPV I would make sure you get an HPV test along with the pap smear so that you can have peace of mind.
Thank you so much Marie, you have really placed my mind at alot of ease.
I personally think that I may have had the infection before I went in for the cautery and that the antibiotics that they gave me didn't work. When my GP did the pap, he stated to me that it looked rather red down there and to make sure that I went to my appointment at the Gyno. Then when I went to the Gyno he said that it was red and rather infected, wanted to freeze the cells there and then but had to opt for the cautery.
I have told my GP that I want 3 monthly paps after this, just for peace of mind. (Yes, I might be crazy for wanting them, but I would rather have peace of mind). I have to go back to my GP this week to get the antibiotics dosage upped, so will chat to her about the HPV as well.
I have an appointment with the Gyno on the 18th and will be requesting follow up appointments with him down the track and will also request that he do a HPV test when possible. It is the waiting and not knowing what is going on that is really beginning to bother me. I am also beginning to stress out that it may cause me to not be able to have any more children. I already have one child (feel very blessed to have her) but would love another 2 or 3 children. Its all getting very scary.
But thank you again Marie, I do appreciate you going through all this with me.
As an update, I went to my GP today and she did another swab, and upped my dosage of antibiotics to 300mg x 4 daily. She also stated that she believes that my cautery may not have been done properly and that I need to speak to the Gyno as it could require me needing more surgery and this is possible as to why I am still bleeding. Feel as though it is a never ending story and they can't seem to get anything right.
what does your GP mean by "not done properly"? I would be curious to know.
What kind of "more surgery" does he/she mean.
does he/she mean a repeat of the cautery? or something else?
Were you on antiobiotics prior to the cautery?
that would indicate that you were being treated for an infection
before the procedure.
Like I said I believe the proper thing to do is to wait for an active infection
to heal before attempting cautery. That might be was the GP is refering to when he/she says it was "not done properly". But it's hard to say.
It's kind of like performing a tonsilectomy when there is an active infection in the tonsils. The proper thing to is administer antibiotics.
The infection goes away. And then with reasonably healthy tonsils in the throat, they are extracted before another infection develops. The theory being that your cervicitis is "chronic" and cautery should stop the recurrent infections.
Good luck. I would be interested in knowing the outcome of your situation.
All she said was (when she was down there was) "Oh it doesn't look like it was done properly", by this stage I was already near in tears and I asked her if she meant the cautery and she said yes. I then asked her would I need more cautery done and she said that yes it is very possible.
My GP is under the same impression that you are. They should have killed the infection before they operated on me. When I first saw the Gyno, he told me that I had infection, that he didn't think the antibiotics would cure it and that cauterization would need to be done. He prescribed me metronidazole and doxycycline and off I went.
My GP mentioned yesterday something about how she thinks that they maybe should have given me an injection of antibiotics before the surgery and then after the surgery before I walked out oral antibiotics. Neither were done.
I have to call my GP back on Thursday for another script and also hopefully we will have the results of the swab back by then. Then we will be able to tell if we are starting to get rid of this infection. Then 2 weeks today till I go back to the Gyno to find out if I need more surgery I guess. Will definitely keep you updated and thank you so much for answering all my questions and your support it is greatly appreciated!!
OK - so he did give you antibiotics prior to the cautery.
And the 2 that he gave are the mainstay for cervical infection.
I'm just thinking he may not have given the medication enough
time and did the procedure too soon.
When I was 30 years old, I had exactly the same thing. But the antibiotics caused me to get a REALLY bad yeast infection that never really seemed to go away. I was living on Monistat back then and it wasn't available over the counter so I was constantly at the Gyno's office.
Would you believe it has taken them 22 years to offer me cryotherapy?? And you ended up with a cautery before you even knew what was happening with you.
I'm so sorry you are going thru this. I personally know how awful this can be. By all means, let me know how you make out. It looks like your GP has a handle on things.
I am also awaiting the results for a urinary tract infection as I am in pain just before I need to go and am waking up at all times in the night needing to go. Hopefully I will have them results back by this Thursday as well.
I think I am just tired of the bleeding. It seems that everytime they go down there, they flare up the bleeding again. I have now been bleeding for a week and it is definitely not my period. My GP told me yesterday that they have to clear up the infection first and then we can look at controlling the bleeding.
You are right though, it is like I was in for the surgery really soon and didn't know what was happening to me and what exactly is wrong. Actually to be perfectly honest with you, I still don't know exactly what is wrong with me. All I really know is that I have a bacterial infection, that I had chronic cervicitis and needed cells burnt out. But to be honest, I don't feel that I have been told the whole lot of it.
Will definitely keep you updated and it is wonderful to finally find someone that knows exactly what I am going through!!