HPV, the Test and the Testiness

First off, if you have had HPV or will get HPV, most reading this post will clear the HPV virus with your own immune system. Second of all, apparently testiness is a legal term too, but since this is a medical discussion between us, so no legal terms defined here! Official approval for an HPV test as a cervical screen did not come until March 2009 with the introduction of Cervista. HPV testing, and what to do about it, when, what test, how often, will I have coverage for it, should I get my partner tested, should I tell my partner I got this test result back, all bring a variety of answers from the Gynos on the street, as well as in their offices!

But knowledge may be power, so getting the test is often the first best step to answering these questions with your own Gyno. The Cervista test can be used two ways. It can be used as the individualized 16/18 test, or the general screening test for any of 14 different HR HPV types. As a general screening test it performs better than other tests in the past as it also tests for HPV 66 which was not available previously. So next time you go to the gyno, find out if you had the 13 test or the 14 test (and stay tuned better tests may be in the pipeline). The most respected source physicians look for in terms of guidelines regarding pap tests the American Society for Colposcopy and Cervical Pathology reminds women in their clinical update on the topic that only 1/2 of all cases of moderate dysplasia are due to the HPV types 16 and 18 (see reference below). So if you just had a slightly abnormal pap (ASCUS) you need the full screen not just a test for 16 and 18. There are also lots of other ways you shouldn't use the test: after a sexual assault, in basic STD testing, or if you are trying to decide whether to get a vaccination, to name a few. And even the proper way to use the test is a bit of a flummox right now as the last comprehensive guidelines (2006) came out before this test was approved. So therein lies part of the testiness of this test. And a shout out to the women who participated in this valuable research from the Women's Health Practice Clinical Research branch of those trials. The Cervista test was developed by Third Wave Technologies.

Smith JS, Lindsay L, Hoots B, et al. Human papillomavirus type distribution in invasive cervical cancerand high-grade cervical lesions: a meta-analysis update. Int J Cancer 2007;121(3):621-32.

Passing Your Uterine Lining, Menstrual Period Norms

Decidual Cast Periods can be fairly easy, passing some tissue at a time, or off can come the whole lining in one piece called a decidual cast. Generally the lining of the uterus is only 6-8 mm thick at the time of the menstrual period, and it is shed gradually, a few cells at a time. The decidual cast is when the entire lining passes spontaneously. It's not uncommon, but it usually both uncomfortable, and alarming to some. But us women are designed to have some sort of periods Or Not? We have to pass tissue each month. Or Not? Are they good for us? Or Not? Do we want them? Or Not? Is this something that is individual? Or Not? It's a complex topic that I will be discussing a lot over my time in this blog. So lets start with basics: How much do we bleed and what are we loosing, and just what was this that the patient passed? And another basic: track your periods, and the Women's Health Practice site http://www.womenshealthpractice.com/media/pdf/menstrual_chart.pdf you

Endocervial polyps

2 cm Endometrial Polyp After Removal Polyps in the cervix are almost never cancerous, but can bleed or get infected and should be removed. The are not directly related to an endometrial or uterine polyp (which is a precancerous condition), but your gyno may want to make sure these two conditions do not co-exist.

Irregular Periods can Be the Sign of Other Medical Conditions

Heavy menstrual Bleeding Menstrual Period Norms The menstrual period's normal physiologic function to shed the lining and then prepare the lining for a pregnancy. Thus a sample of the lining under the microsope looks like it has glands within tissue. It’s hard to know if this is a heavy period, or one that is really so heavy that you need treatment without really checking completely with your gyno! Experts have used a number of definitions to determine if the period you are having is too heavy. Your perception is important. The actual amount of blood lost is important, but that can be determined by collecting each pad and weighing them before and after blood collection. So gynos have struggled with how to determine the formal definition of heavy bleeding. A basic check up, and a basic blood count, is not going to really make your version of heavy periods fit the typical “FDA” approved definition because that is defined by the exact amount of blood lost, which is los

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