What happens when you have abnormal cells on your cervix...
WHAT IS CERVICAL DYSPLASIA ANYWAY?
Cervical dysplasia AKA Cervical Intraepithelial Neoplasia (CIN) is a fancy way of describing any cell abnormalities on the cervix. Cervical dysplasia is v. common and affects between 250,000 and one million women* every year in the US alone! Though it’s often caused by HPV, cervical dysplasia is distinctly different, referring to a condition that can (but doesn’t always) result from the virus.
So basically, if you are told you have cervical dysplasia, you are being told that abnormal cells were found on your cervix.
THAT SOUNDS BAD. DOES “ABNORMAL CELLS” MEAN I HAVE CANCER?
No! There are varying grades of cervical dysplasia. Abnormal cells (also called lesions) can be categorized a couple ways. “Low grade lesions” or, the fancy way of saying it, “low-grade squamous intraepithelial lesions” means that early changes in cell growth have been detected. “High-grade lesions” aka “high grade squamous intraepithelial lesion” means more advanced changes have been detected.
Most strains of HPV go away on their own, but sometimes low and high-grade lesions can develop into cancer, which is why it’s important to catch any changes early on by getting regular pap smears and pelvic exams (more on this below).
If you are told that abnormal cells have been found, it may give you some peace of mind to know that these cells progress slowly—the lesions will usually go away on their own but if they don’t, it can take 10-15 years for cells to progress into cancer, if they ever do.
HOW DO I KNOW IF I HAVE IT?
Unfortunately, cervical dysplasia is notoriously low profile – meaning there aren’t always symptoms, so many people who have it don’t know. Getting a routine pap smear (whereby your provider collects and tests your cervical cells) is the only way to find out if you have cervical dysplasia, which is why they are so important! It used to be standard to get a pap smear every year, but because cervical cancer can take years to develop, the medical field now supports less frequent testing and recommends a pap every three years starting at age 21 until age 29. Once you hit 30, it’s recommended that people with a cervix get a pap and HPV test every five years until age 65, at which point they can stop testing.
People who have had abnormal pap smears, or are immunocompromised (those living with HIV, lupus, etc), are recommended to have more frequent examinations. If this is you, it’s important to speak to your practitioner about the best course of action for pap smear frequency.
While many don’t experience symptoms, there are some signs to look out for:
- Painful intercourse
- Painful urination
- Spotting in between periods
- Heavier, longer periods
These symptoms can also mean a bunch of different things, they are not unique to HPV or cervical dysplasia (they mimic symptoms of a yeast infection, bacterial vaginosis, or many other different infections). If you’re experiencing any pain, spotting, or heavier, longer periods you may want to ask your medical provider to run some tests to rule out possible causes.
WHAT IF I HAVE AN ABNORMAL PAP?
We know this can be kinda scary sounding, but an “abnormal pap smear” is kinda vague and can mean a bunch of different things – it can indicate HPV or a different kind of infection, or just plain old “unusual” cells on the cervix. If you have an abnormal pap smear, your practitioner may ask you to come back in for a second pap or another more specific exam to get a better sense for what is going on.
THE HPV / C.D CONNECTION
Most cases of cervical dysplasia are linked to HPV. This is because some strains of HPV can cause cell growth on the cervix. According to the Sidney Kimmel Cancer Center at Johns Hopkins, HPV causes 99% of cervical dysplasia.
If you have HPV your doctors or medical professionals may also recommend having more regular pap smears and pelvic exams to keep tabs on those cells and ensure they don’t become cancerous. If they do, early intervention can be incredibly helpful.
You can now take a HPV test from the comfort of your home! Order it here.
OK. I HAVE IT. IT’S CERVICAL DYSPLASIA. NOW WHAT?
First off, don’t panic. Cervical dysplasia is NOT the same as cervical cancer – nor does it guarantee you will have cervical cancer in the future. While getting labeled with cervical dysplasia sounds super scary and intimidating, it can be addressed simply by working with your practitioner on a course of treatment that works for you. Low grade cervical dysplasia can go away on its own, but in more severe cases, a doctor may recommend getting treatment to remove the cells. Some of those treatments include: cryotherapy (a procedure that uses chemicals to freeze off abnormal cells so new cells can grow), LEEP (aka Loop Electrosurgical Excision Procedure is a procedure that removes abnormal cells by using a small electrical wire loop to scrape them off), laser ablation (uses a laser and heat to destroy cells), conization (sometimes called a cone biopsy, which basically removes the cells from the cervix with a scalpel, laser or using LEEP).
Self-care and mental health are essential to taking a holistic approach to your healthcare. High levels of stress have been linked to the progression of cervical cancer. Self-care and stress reduction are personal and can range from practicing yoga, to meditation, or talk therapy (find practitioners here!). What’s good for the mind and body is good for the cervix!
There are a few things that you can do to lower your chances of cervical dysplasia progressing into something more serious, like cervical cancer:
- Because high-stress levels have been linked to cervical cancer, making some lifestyle adjustments to help you take it slower may be helpful. Try going to bed early. Adapting a deep breathing practice. Starting up yoga or meditation. Going on long walks etc.
- Smoking cigarettes have been linked to cervical cancer
- Make sure you are getting all of your proper nutrients– feed your cervix well!
IS IT CONTAGIOUS?
Cervical dysplasia itself is not contagious. However, HPV which is often the root cause, is. Check out our HPV guide to learn more.
EFFECTS ON FERTILITY + PREGNANCY
Cervical dysplasia will not directly affect your fertility or pregnancy, however, it is possible some of the treatments may. So, if you are getting treated, be sure to ask your care provider about how your recommended treatment plan may affect your fertility and any subsequent pregnancies.
Additionally, stress can affect fertility, and hearing a scary sounding diagnosis of cervical dysplasia without fully understanding the diagnosis can be, well, stressful! So, we are glad you are reading this! Hopefully, it will make you feel more informed and empowered to take the courses of action you need to feel less stressed about your diagnosis.
Because HPV and cervical dysplasia are so linked, the best way to protect yourself from cervical dysplasia is to protect yourself against HPV. HPV is extremely common, and if you’re reading this you probably know somebody who has been exposed to what Bedsider calls, “the common cold of sexually active world.” Most people who have sex will have some form of HPV, but there are some ways to protect yourself against the virus.
- The Cervarix and Gardasil 9 vaccines are two vaccines that have been approved by the Advisory Council on Immunization Practices and the Center for Disease Control. These vaccines help prevent against HPV strains 6, 11, 16, 18, 31, 33, 45, 52, and 58 which are the strains often linked to cancer.
- If you are sexually active, safer sex (using barrier methods like these body-safe condoms or dental dams) can help provide a little extra protection, though, HPV can also be passed through skin to skin contact.
- And, we can’t say this one enough – get those pap smears! Regular paps are essential for monitoring any changes. Find practitioners here!
Cervical dysplasia and CIN sound super scary! But here are the takeaways from this guide:
- Cervical dysplasia is NOT cancer. A diagnosis means you will need to keep an eye on abnormal cell growth and potentially get further tests to fully determine what is going on. Most of the time “abnormal” cell growth is no biggie and the cells go back to “normal.” Do things that make you feel GOOD. De-stressing will be helpful!
- GET REGULAR PAP SMEARS! It’s the first line of defense since so often there are no symptoms for cervical dysplasia!
- If you are diagnosed and treatment is recommended, be sure to ask your provider how each treatment may affect your fertility and any subsequent pregnancies if you are wanting to have children at some point.
WHOA! CHECK THIS OUT…
Dr. Cornelia Liu Trimble, director of the Cervical Dysplasia Center, is working on a technology that prevents pre-cancerous lesions from turning into cancer by teaching the immune system to differentiate between precancerous and cancerous cells via killer T-cells. Check out her Tedx Talk!
Also, you can now test yourself for HPV from the comfort of your home. Order your kit here!
Written by: Moriah Engelberg, Health Educator
Medically Reviewed by: Danielle LeBlanc BScN, RN
All content found on this Website, including: text, images, audio, or other formats, was created for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
Acharya, G., Kjeldberg, I., Hansen, S.M. et al. “Pregnancy outcome after loop electrosurgical excision procedure for the management of cervical intraepithelial neoplasia.” Archives of Gynecology Obstetrics. 272 (2): 109. https://doi.org/10.1007/s00404-005-0727-1
Association of American Public Health Professionals. N.d. “Health Matters Facts Sheets: Making Sense of Cervical Cancer.” Accessed January 14, 2019. https://arhp.org/reproductive-cancers/16-publications-and-resources/patient-resources/215-health-matters-fact-sheets-making-sense-of-cervical-cancer
Center for Disease Control and Prevention. 2015. “Inside Knowledge About Gynecological Cancer.”https://www.cdc.gov/cancer/knowledge/provider-education/cervical/recommendations.htm
Cooper, Danielle; Menefee Gary. 2018. “Conization of Cervix.” NCBI Bookshelf. National Library of Medicine, National Institute of Health. https://www.ncbi.nlm.nih.gov/books/NBK441845/
Hopkins Medical Center. N.d. “Sidney Kimmel Cancer Center: Cervical Dysplasia.” https://www.hopkinsmedicine.org/kimmel_cancer_center/centers/cervical_dysplasia/index.html
Khan, Michelle J., and Karen K. Smith-Mccune. 2014. “Treatment of Cervical Precancers.” Obstetrics & Gynecology 123 (6), 1339-1343. 10.1097/AOG.0000000000000287
Krantz, David; Thorn, Beverly; Klecolt-Glaser. 2016. “How stress affects your health.” American Psychological Association. https://www.apa.org/helpcenter/stress.aspx
Maclean D, Ollner A, Hosein SR. 2016. “HPV, cervical dysplasia and cervical cancer.” CATIE. https://www.catie.ca/fact-sheets/infections/hpv-cervical-dysplasia-and-cancer
Mendoza-Pinto, C, M García-Carrasco, V Vallejo-Ruiz, S Méndez-Martínez, A Taboada-Cole, I Etchegaray-Morales, M Muñóz-Guarneros, J Reyes-Leyva, and A López-Colombo. “Incidence of Cervical Human Papillomavirus Infection in Systemic Lupus Erythematosus Women.” Lupus 26, no. 9 (August 2017): 944–51. doi:10.1177/0961203316686708.
National Institude for Health. 2018. “AIDSinfo: Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents.” National Institute of Health https://aidsinfo.nih.gov/contentfiles/lvguidelines/glchunk/glchunk_343.pdf
Nelson, E. L., Wenzel, L. B., Osann, K., Dogan-Ates, A., Chantana, N., Reina-Patton, A., Laust, A. K., Nishimoto, K. P., Chicz-DeMet, A., du Pont, N. and Monk, B. J. 2008. “Stress, immunity, and cervical cancer: biobehavioral outcomes of a randomized clinical trial [corrected].” Clinical cancer research: an official journal of the American Association for Cancer Research, 14(7), 2111-8. 10.1007/s12160-007-9007-6
Planned Parenthood. N.d. “What is cryotherapy?” Planned Parenthood. https://www.plannedparenthood.org/learn/cancer/cervical-cancer/what-cryotherapy
Rooney, Kristin and Domar, Alice. 2018 “The relationship between stress and infertility.” Dialogues in clinical Neuroscience 20(1):41- 47 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6016043/#ref3
Thomas, T. 2016. “Cancer Prevention: HPV Vaccination.” Seminars in Oncology Nursing 32 (3):273-280.
Trimble, Cornelia Liu. 2015. “Kicking Cancer’s Butt.” Filmed December 2015 at TEDxBEaconStreet, Brookline, MA. 13:42. https://www.youtube.com/watch?v=hx3Cbj-_IIE
Wallace, Robin. 2011. “The common cold of the sexually active world: HPV.” Bedsider. https://www.bedsider.org/features/104-the-common-cold-of-the-sexually-active-world-hpv
Watson, Margot. N.d. “How often do I need a Pap smear?” Johns Hopkins Medicine. https://www.hopkinsmedicine.org/signature_obgyn/patient_information/ask_expert/gynecology-q-a/how-often-do-I-need-a-pap-smear.html