FAQ’s

A Pap smear is a screening test for cervical cancer. The current recommendations to begin screening are by the age of 21 or within 3 years after the onset of sexual intercourse. The frequency of Pap smears is variable for different women and should be discussed with your provider.

There are varying degrees of abnormalities on Pap smears. Many “abnormal” Pap smears are of only minor importance and often do not require more testing or any type of treatment. Some of the abnormalities, which require colposcopy (see below) and may require treatment include:

ASCUS – Atypical Squamous Cells of Undetermined Significance
– Can be positive or negative for high-risk types of HPV

LGSIL – Low Grade Squamous Intraepithelial Lesion

HGSIL – High Grade Squamous Intraepithelial Lesion

A colposcopy is a visual inspection of the cervix with a special microscope. If any abnormalities are detected, a sample (biopsy and/or cervical scraping) is taken, this is a diagnostic procedure.

Depending on the severity of the abnormality, treatment can range from observation to freezing the abnormal cells (cryotherapy) to removal of the affected tissue with a LEEP procedure, which removes part of the cervix.

HPV stands for Human Papillomavirus. It is a sexually transmitted infection that is estimated to affect 50-75% of all sexually active women. There are over 80 types of HPV; types 6 and 11 cause over 90% of genital warts, types 16 and 18 causes over 70% of cervical cancers. The vast majority of women infected with HPV will likely clear the virus without treatment; it is women who have a persistent high risk HPV infection who are most at risk for developing cervical cancer.

The HPV vaccine is a vaccine recommended for girls between the ages of 9 and 26. It provides protection against four types of HPV: Type 6, 11, 16, and 18. It is given as a series of three injections: first injection followed by a second one two months later and a third four months after the second. Based on the information available, it is considered extremely efficacious in individuals who have never been exposed to the HPV types in the vaccine. It does not eliminate the need for Pap smears, however, as disease can still result from viral types not covered by the vaccine.

Vaginal discharge can be normal, but it can also indicate that there is an infection present. There are three main causes of vaginal discharge:

1. Yeast Infection
characterized by itching and a thick cottage cheese like discharge
usually no odor
can occur after treatment with antibiotics
not sexually transmitted
2. Bacterial Vaginosis
characterized by a fishy odor
caused by Gardnerella vaginalis
not sexually transmitted
3. Trichomoniasis
characterized by a fishy odor and copious greenish discharge
sexually transmitted infection
partner must be treated

Visit www.cdc.gov/std/ for more information.

Breakthrough bleeding is the most common side effect seen when women are placed on oral contraceptives, it can take up to 4 months for the pill to regulate your cycle. It is important to continue taking the pill at the same time every day. If abnormal bleeding persists, you should contact the office for evaluation and to possibly change pills.

If you miss one pill take two pills the next day and continue as normal. Break through bleeding may occur for a few weeks, it is important to continue taking your pills. If you miss two days in a row you may double up on subsequent days, but you must use a back up form of birth control (condoms or spermicides) for two weeks since you have lost the protection of the pills for that month. If you are on a progestin only pill (Micronor) the instructions are different—call your doctor. Since there are different formulations of oral contraceptives, refer to the package insert of your particular one for further instructions.

Emergency contraception or Plan B is available over the counter if you are 18yr or older. It requires a prescription if you are younger than 18yrs. It must be taken within 72hrs of unprotected intercourse, the earlier the better. It works by delaying ovulation or release of an egg. It does not cause abortion.

Any vaginal bleeding after you have had one full year without a period (menopause) should be reported to your physician and investigated.

Pain and fatigue are common following surgery. Pain should continue to improve as you move farther out from surgery. Your activity level should also increase after surgery—don't over do it. We recommend gradual increases, climbing the stairs is fine; heavy lifting should be avoided to help the body heal. Heavy lifting entails anything that you have to strain to pick up.