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SerendipSis 12-03-2009 06:14 AM

newbie with LSIL- lots of questions!
Okay, so I have just gotten an abnormal pap back with an LSIL diagnosis ... I am living in Europe and my doctor isn't very helpful. She says come back to get tested (another pap) in 6 months. And won't check for whether it is a high risk HPV (maybe in May)... and indeed,never said anything about HPV, I am just guessing from what's come back on a google search with LSIL

I have read on this forum that you can't really pinpoint the time of infection, is that true?

I was in a monogamous relationship for 19 years, and he was my only partner ever-- though my ex was not faithful, and had had partners before me. I Just began sexual activity again this year ... and have had two partners.

I have two questions:
1. COuld I have developed LSIL in just a few months time? Is that likely? Even possible?
2. If not likely, and probably came from my ex, will I have probably infected my more recent partners?? Does LSIL mean a current infection, or simply that I was infected sometime in the past?

I have been under a lot of stress with the long, drawn-out divorce, and assume this has suppressed my immune system ... but also began oral contraceptives 20 months ago (ex was against my using them); and have been surrounded by second hand smoke for ever and ever ... perhaps some risk increase there?

In any case, I really am wondering if I need to go back and tell my 2 past partners that I may have infected them -- or wonder if one infected me.

Thoughts/answers GREATLY appreciated. thx!

Pickle Eyes 12-03-2009 06:37 PM

Re: newbie with LSIL- lots of questions!
Hi SerendipiSis, I'm glad you've gone for your pap. HPV and its negative effects to the cervix is very confusing. There are so many if/then situations, so many strains of HPV, etc. Add to that the fact that you are not in the USA (where many of us are) and the fact that not every country has the same guidelines for following up on a "bad pap."

I assume you are over 30. I also assume you've been pretty consistent in getting your paps, annually.

Not every doctor runs the HPV test. Some doctors just assume if there is cellular change to the cervix that HPV is involved. Greater than 99% of cervical dysplasia (CIN I/mild dysplasia or higher) is caused by high risk HPV. In the USA, many doctors are now offering the HPV/dna test to women over 30 when they perform the pap. The two tests together dramatically increase the reliability of the pap; together the accuracy rate is greater than 98%.

The cellular changes (I don't think) don't necessarily mean there is an active infection (again, I'm not sure). A positive result on an HPV/dna test *does* mean there is an active HPV infection. That is important to know. This is why I think it is so important to have the HPV test.

When it comes down to who might have infected you and/or how long the dysplasia has been present there are several things to consider. When was the last time (that you know) that your ex was sexually unfaithful? My bet is that he exposed you to the strain(s) of HPV which results in your LSIL. I don't know how long it takes for cellular damage to become detectable by a pap. The pap, by the way, is only a screening tool. It is possible it was one of your more recent sexual partners. Like you've read, there is almost no way to know for sure.

Can second hand smoke cause a problem? I'd think yes. I've read that second hand smoke is as bad or worse than smoking. Smoking definitely negatively impacts the health of the cervix and increases the speed at which irregular cells grow (ie cancer). Smoking deprives the body of oxygen; cancer is anaerobic - it thrives in an oxygen depleted body.

I don't know if waiting 6 months is appropriate for a woman over 30. I'd think not, but I don't know what the current recommendations from the major medical associations are. I know in a woman under 30, that waiting 6 months and retesting is typical. Women under 30 are more likely to be able to reverse the negative impact of HPV on the cervix.

I think it is a good idea to do a few things: get a copy of your pathology reports and maybe your doctor's notes on your visits; ask to have the HPV/dna test run; if/when you are sent for a colposcopy (in lieu of waiting 6 months for a re-pap) ask for an ECC (endocervical curettage).

Are you able to get a second opinion or have your doctor perform an HPV/dna test? If so, I strongly suggest you do that OR ask for your doctor to go ahead and do a colposcopy (and ECC) and HPV/dna test.

I hope that helps!

SerendipSis 12-04-2009 08:13 AM

Re: newbie with LSIL- lots of questions!
Hi! Thanks for the quick response. I will speak with my regular doctor (not the one who conducted the internal) and perhaps he will be more willing to do the HPV/dna test, pointing out that I am well over 30!

I do wonder, though, are women under 30 more likely to be able to reverse the negative impact because they are younger and better immune systems?? ... Or is it simply they were infected long enough ago that it has cleared ... and inmy case, if I was just infected by a recent partner, than I need those years to clear it as well??

who knows? IN any case, thanks! We'll see what the doc says.

Pickle Eyes 12-04-2009 06:43 PM

Re: newbie with LSIL- lots of questions!
I *think* it is because the body of a younger woman is more resilient and can bounce back from many things, including HPV.

Let us know how you are doing!

tanya58 02-14-2011 08:09 PM

Re: newbie with LSIL- lots of questions!
I'm going through something similar and I was told that with HPV you could have gotten it anywhere from 10 years ago to 4 wks. ago and it just depends on how long it takes and if your body fights it off or not. I've heard 80% of women have or have had hpv in their lives and never know! Crazy but they say do not accuse who you'r currently with because there is really no way to find out who or when you contracted it. Even though your current partner may have hpv also you never know who gave it to who. I know the first thing we want to do is point blame, it's not worth it. Hopefully we can just catch this before it goes any further. Good luck with everything.I've had the colposcopy and awaiting my LEEP on Monday,presidents day, good luck and just do what the dr. says, I am and hopefully it all turns out well!

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