Abnormal Pap Smear Results After Abortion and Sexual Health Concerns

Q: Abnormal Pap Smear Results After Abortion and Sexual Health Concerns

Precautions before a Pap smear： 1. Avoid sexual intercourse the night before. 2. Do not schedule during your menstrual period. 3. Do not use vaginal suppositories. 4. Avoid douching. 5. Refrain from taking a bath in a tub. An abnormal resul

May abortion. Abnormal Pap smear in July. Issues related to vaccines?

Hello Doctor, I apologize for having multiple questions at once.

Medical History:
1.
I have had three abortions (in 2014, 2019, and 2023).

2.
I had an abortion in early May, and in mid-July, I received a notification about abnormal results from my Pap smear (I had sexual intercourse the day before the smear).

3.
I have been with my boyfriend for nearly two years.
A long time ago, we both underwent STI testing, and all my results were negative.
He has genital herpes type 2 (we are aware of the risks and have been using condoms since then).
He had gonorrhea in the past and was cured before we met.

My questions are:
1.
Could the abortions and sexual activity lead to abnormal Pap smear results?
2.
The nurse called to inform me of the Pap results and suggested I return to consult with the doctor about whether a biopsy is necessary.
Does this indicate a high likelihood of cancer? If not, why wasn't I advised to undergo a colposcopy first?
3.
If I return for follow-up tests and they are normal, do I need to undergo HPV testing or receive the cervical cancer vaccine?
4.
I am currently undergoing an endometrial biopsy at a hospital, and they plan to collect samples from my endometrium in early August.
Will this have any impact, given that I do not yet know the results of my cervical status?
5.
Is there a connection between my boyfriend's genital herpes type 2 and the abnormal Pap smear results?
6.
Would you recommend that my boyfriend undergo HPV testing or any other tests?
7.
Besides the possibility of me contracting herpes, are there any other implications of his herpes type 2?
P.S.
I am aware of my boyfriend's past sexual relationships and his herpes diagnosis.
Although I have adjusted over time, I have chosen to continue our relationship.
Therefore, I would like to know what I need to pay attention to regarding my health.
I am feeling a bit anxious and apologize for the numerous questions.
I hope to receive detailed answers.
Thank you.

Chun, 30~39 year old female. Ask Date: 2023/07/26

Dr. Chen Zhiyu reply Obstetrics and Gynecology

Precautions before a Pap smear: 1.
Avoid sexual intercourse the night before.
2.
Do not schedule during your menstrual period.
3.
Do not use vaginal suppositories.
4.
Avoid douching.
5.
Refrain from taking a bath in a tub.
An abnormal result from a Pap smear does not necessarily indicate cancer; further examination is required for the physician to confirm any other issues or concerns.
Please make sure to ask your attending physician about any questions during your follow-up appointment.
Thank you.

Reply Date: 2023/07/26

More Info

It's understandable to have concerns about your health, especially after experiencing multiple abortions and receiving abnormal Pap smear results. Let's address your questions one by one, providing clarity on each aspect of your situation.

1. Can abortion and sexual activity lead to abnormal Pap smear results?
Yes, both abortion and sexual activity can influence Pap smear results. After an abortion, the cervix may be more susceptible to inflammation or infection, which can lead to abnormal results. Additionally, recent sexual activity can introduce bacteria or other pathogens that may affect the cervical cells, potentially leading to atypical findings.

2. What does it mean if the nurse suggested a biopsy after an abnormal Pap smear?
The recommendation for a biopsy does not necessarily mean that cancer is likely. Abnormal Pap results can arise from various conditions, including infections, inflammation, or precancerous changes. A biopsy is a way to obtain a definitive diagnosis. The reason for not immediately suggesting a colposcopy (cervical examination) could be due to the specific nature of your results or the clinic's protocol. It's essential to follow up with your healthcare provider to discuss the results and the next steps.

3. If subsequent tests are normal, should I get HPV testing or the cervical cancer vaccine?
If your follow-up tests return to normal, it is still advisable to consider HPV testing, especially if you have had abnormal Pap results in the past. The HPV vaccine is also recommended for individuals up to age 26 and can protect against the types of HPV that most commonly cause cervical cancer. Discuss this with your healthcare provider to determine the best course of action based on your health history.

4. Will the endometrial sampling affect my cervical health?
Undergoing endometrial sampling should not negatively impact your cervical health. However, it is crucial to inform the healthcare provider performing the procedure about your abnormal Pap results. They may take additional precautions or provide specific recommendations based on your situation.

5. Is there a connection between your boyfriend's herpes and your abnormal Pap smear?
While herpes simplex virus type 2 (HSV-2) primarily causes genital herpes, it is not directly linked to abnormal Pap smear results. However, having HSV-2 can indicate a higher risk of other sexually transmitted infections (STIs), which could potentially affect cervical health. It's essential to maintain open communication with your partner about STIs and ensure both of you are taking necessary precautions.

6. Should your boyfriend get HPV testing or other screenings?
It would be prudent for your boyfriend to undergo STI testing, including HPV screening if he has not done so already. While HPV primarily affects women, men can also carry the virus and transmit it. Regular screenings can help both of you stay informed about your sexual health.

7. What are the implications of HSV-2 beyond potential infection?
Besides the risk of transmission, HSV-2 can cause recurrent outbreaks, which may lead to discomfort and emotional distress. It is essential to manage the condition with your healthcare provider, who may recommend antiviral medications to reduce the frequency of outbreaks and lower the risk of transmission.

In conclusion, it's crucial to maintain open communication with your healthcare provider about your concerns and follow their recommendations for further testing and treatment. Regular screenings and preventive measures, such as vaccinations, can significantly contribute to your overall health and well-being. Remember, you are not alone in this, and seeking support from healthcare professionals is a vital step in managing your health.

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