Two of my most popular series on this blog are my discussions about birth control and natural alternatives, and my experiences with abnormal pap smears. Unfortunately, it’s time for an update on the latter topic. That being said, I know this can be a squeamish topic for some. In fact, I wanted to call this post “Let’s Talk About My Vagina Some More” but thought that might scare some of you away. Heh.
As awkward as these topics can be, I think it’s really important to be open and honest about reproductive health, and I learn a LOT from your comments on the subject – so here we go!
A little history:
- Part I: In October 2009, after having an abnormal pap smear that revealed “pre-pre-cancerous” cells, I had a colposcopy. A colposcopy is a biopsy of the cervix. In my case, the doctor removed four samples, each as small as a pinhead.
- Part II: I got the test results back and was devastated to learn I had high-risk lesions, known as moderate dysplasia. These lesions were “pre-cancerous” and more serious than the initial results.
- Part III: After speaking to several holistic doctors to get their opinion on my options, I decided to go with my gyno’s recommendation and have the loop electrosurgical excision procedure (LEEP) in November of 2009. LEEP involves cutting off the outer layer of your cervix.
Now, the most common cause of abnormal pap smears is HPV, the human papillomavirus. I would totally own up to having HPV if I did – it’s quite common! 50% of sexually active individuals will have HPV at some point in their lives. But test results show that I do not have HPV, which was confusing to my first doctor. Why was I have abnormal paps? No one knew!
After getting the LEEP procedure done, I had to come back in for a pap smear every three months. They even held my birth control prescription hostage to ensure that I’d actually come back! After five or six clean paps, I went in for my annual exam last week and expected another normal test result, which would free me from the requirement of constant paps.
(You can tell where this story is heading, can’t you?)
The nurse called yesterday and informed me that my pap came back abnormal, indicating low-grade dysplasia consistent with HPV (even though the test also says I’m still clean for HPV). The nurse told me the doctor recommends that I come back in for another biopsy to confirm the pap’s results. I told her I’d have to think about it.
Since then, I’ve been furiously researching abnormal paps on the Internet. Turns out there are a lot of reasons why a pap smear can come back abnormal:
- Having sex too close to the pap smear
- Smoking cigarettes, as it weakens the immune system and creates inflammation in the body
- Bacterial or yeast infections
- Build-up of synthetic estrogen hormones (xenoestrogens)
- Using a cervical cap or diaphragm
- Using birth control pills
Of course, I jumped all over that last point! Although I choose to use birth control pills currently because it works best for our family planning goals, I am not a fan of ingesting hormones on a daily basis for years on end. So many doctors and commenters have told me that most research indicates birth control is ‘harmless’ and can actually reduce the risk of certain cancers, but I just don’t believe it. Call me paranoid. Call me a skeptic. But I just don’t see how artificially regulating your hormones can be free of side effects.
In case you’re interested, here’s a quick summary of the Birth Control posts (the comments on all of these posts are really great!):
- Part I: I discuss my concerns with not getting my period if I were to go off birth control.
- Part II: I wrote about our discussion to go off period control and try the Fertility Awareness Method.
- Part III: I talked about my experiences with birth control withdrawal (which doctors assured me wouldn’t happen, but trust me – it did!) and how FAM worked for me.
- Part IV: I discussed my decision to go back on birth control after my period disappeared during marathon training, making it impossible for me to rely on the FAM method.
So – back to birth control pills and abnormal paps. Some studies have shown that women who use birth control pills for many years may have an increased risk of cervical cancer (Source). In fact, one study determined that women who used the pill for 5 years or less had a 10% greater risk of cervical cancer compared to those who don’t use the pill; users of the pill for 5 or more years had a 50% – 60% greater risk of cervical cancer compared to the control group. When I read that, I was like “WHAAAAAAAAAT?” But then I read the conclusion: Researchers think that women who use birth control are less likely to use condoms, which therefore increases the odds they’ll get HPV. Hmm.
However, other doctors say that there IS a definite link between taking hormones and an increase in cervical cancer, especially when taking a combined estrogen pill. Studies suggest that birth control pill users’ cervical cancer risk drops back to normal A DECADE after going off the pill (Source).
Where does all this information leave me?
- I’m not ready to have a biopsy. It’s expensive and painful.
- Instead, I asked my doctor to consider recommending that I get a follow-up pap in two months to see if I still have abnormal cells. She is thinking it over.
- The Husband is putting me back on a protocol of natural supplements and vitamins to help reduce cell abnormality in the cervix. Folic acid, for example, has been shown to reduce the risk of abnormal paps.
- Mainly, I am concerned about jumping the gun and get the LEEP procedure again. If the biopsy was bad, the LEEP is worse (not trying to scare anyone, that’s just how it is). Also, LEEP can create scar tissue, making it harder to get pregnant.
- I’ve decided to go back off birth control pills and try the FAM method again. Hopefully, my period will stay regular, and we won’t get surprised by a baby.
So – that’s Part IV of the very crazy pap smear story. Mostly, I wanted to tell this story to reiterate my belief that we should trust our doctors BUT we should also weigh that information carefully. Don’t do something just because you’re scared. Get educated. I really think it’s important to be your own health advocate. For example, no one talked to me about the birth control-cervical cancer connection or told me that I should take folic acid supplements! Obviously, I don’t want cervical cancer, but I always don’t want unnecessary medical procedures that might make it difficult to get pregnant down the road.
On a lighter note, I searched Google images for “abnormal pap smears” and these gems showed up:
I don’t know why pap smears make your shoulders hurt, but apparently, they do. Heh.
Can you relate to my pap smear fiasco? What are your thoughts on birth control pills?