Procedures and Treatments for Cervical Abnormalities

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What do I need to consider if I have an abnormal Pap test result?

Your response to an abnormal test result may depend upon your personal beliefs and the severity of your test result. Most women experience some anxiety when they are told they have abnormalities. Remember that abnormal results are not cancer and that most women with an abnormal result do not have cancer. Many cervical abnormalities disappear after a period of time.

The following are some options for you to consider. You can allow six months and try self-help options. Or you might go for a colposcopy and consider medical treatments. Your decision about what to do will probably depend upon your life circumstance, your past experience with self-help, and the quality of your partnership with your doctor or nurse practitioner.

Self-help options

  • If you are heterosexual you can use female or male condoms for six months and then repeat the Pap test to see if your result changes. Some studies show that women whose partners used condoms had abnormal result reverse to normal.
  • Eat a healthy well balanced diet, one high in beta-carotene and the vitamin B known as folic acid (yellow and orange fruits and vegetables and dark green leafy vegetables, whole grains, peanuts).
  • Work with a traditional, complementary or alternative health practitioner to boost your immune system. Even if your finances are limited, it may be worthwhile to visit one at least once to get guidance on which natural health products to use and how much to take.
  • Cut down or quit smoking. Smoking is definitely linked with cervical cancer.
  • Wait six months and have another test. Maybe stress in your life will change or your body will be able to heal on its own.

Colposcopy

Colposcopy is not a routine exam. Specially trained gynaecologists use the colposcope to confirm abnormal Pap results. A colposcope is a type of microscope with a very powerful lens. It looks like binoculars on a floor stand. You will be on an exam table similar to when you have a pelvic exam. The gynaecologist will look through your vagina at your cervix with the help of a speculum and a bright light to examine the surface of your cervix. Sometimes there is a video monitor so you can see what the gynaecologist sees and she will explain what she sees.

The gynaecologist might also take a sample from your cervix (biopsy) or from the opening leading to the uterus (endocervical curettage). Many women find this an uncomfortable procedure. The biopsy sample is sent to a laboratory where a pathologist examines it and writes a report describing what degree of abnormality, if any, is found.

You need to know what is written in the pathology report to help you decide upon your next steps. The gynaecologist also writes a report about the colposcopy examination. (See FAQ Abnormal Pap Test for the classifications)

What medical treatments are available?

These three treatments are usually done in the doctor's office or as an outpatient in a hospital or clinic. You are usually given a local anaesthetic for the procedure.

LEEP (Loop electrosurgical excision procedure)
This procedure uses an electric loop to remove the abnormal cells.

Laser surgery
This method uses the heat from an intense narrow beam of light to destroy abnormal cells.

Cryosurgery
This method uses freezing or extreme cold to destroy the abnormal cells.

Cone Biopsy
This treatment removes a cone shaped piece from the centre of the cervix. It is usually done in an operating room and sometimes requires a general anaesthetic. A cone biopsy can affect future pregnancies.

Hysterectomy (removal of the uterus and possible removal of the ovaries)
This procedure used to be recommended to some women. Today this is not necessary unless you have actually have cancer.

After treatment what can I expect?

The effects of these different treatments range from minor discomfort to abdominal pain like menstrual cramps or a watery or dark vaginal discharge for several weeks. Ask your gynaecologist what to expect. She will also give you information about protecting your vagina and cervix in the weeks immediately after the treatment.

Your doctor will also schedule a follow-up appointment to check on your healing. Treatments are usually effective. She may also schedule another Pap test and colposcopy as part of follow-up. Then you will have Pap tests every 6 months until your results are repeatedly normal.

Where can I go for more information?

Reviewed June 2006.