Which Is Better: Normal Pap or Negative HPV Test?

The Danish Cancer society the MERMAID 2 project has been looking in to a woman's risk of pre-cancer or cancer of the cervix based on whether they have high risk (HR) or low risk (LR) HPV on a test. They also want to compare risks from women with normal pap vs women with negative HPV test. They found that negative HPV is a better predictor of having no cervical cancer in the next decade. Low risk HPV infection of the cervix has been shown to be associated with mild precancerous changes, but has never been shown to predict cancer or progression to carcinoma in situ or CIN III, the most advanced cervical pre-cancer. Thus the publications from the MERMAID 2 project and others have stopped endorsing testing for the low risk types of the HPV virus. Generally women getting a pap test have about a 1/100 risk for CIN III over the next decade. For women with Low Risk HPV there was only 1.7% risk vs 1.1%, over the 8 years of the study. So only about 1/2% difference in pick up of high grade disease; with many extra women being captured for testing who will never have serious risk. This is why these authors strongly urge not to est for low risk HPV. In contrary For women with high risk HPV on their pap, they have a risk of 17.4% of developing the CIN III or greater, or the high grade pre-cancer or greater (cancer itself), in the next decade. If patients had both the HR and LR they had only 15.9% chance of getting significant prec-cancer. This data on 35,000 women's pap smear fluid indicated that having a normal pap is not as reassuring as having a negative HPV test. So ask your gyno if you have had HPV testing, or if this testing may be right for you.

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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...

Post-Endometrial Ablation Syndrome

If you have had an endometrial ablation and have developed symptoms of pelvic pain you might have post endometrial ablation syndrome. What is post-endometrial ablation syndrome? It is a constellation of symptoms due to entrapped blood or tissue within a uterus that has previously undergone an endometrial ablation. We are able to diagnose this at Women's Health Practic e but occasionally other conditions are causing similar symptoms. Other complications of endometrial ablation include pregnancy, risks from pre-existing conditions such as a polyp or fibroid, an infection of the uterus, or a pregnancy. If you have had a tubal ligation then it is possible that the condition could be post-ablation tubal sterilization syndrome. The ablation procedure is designed to destroy all lining tissue, but in fact there is no way to confirm the completeness of the ablation. It is thought that either residual or regrowth of the tissue is producing the symptoms of post-endometrial ablation syndrom...

You Have an IUD: But a Positive Pregnancy Test

Fortunately IUD pregnancy failures are rare. But if you have an IUD for contraception, and you get a positive pregnancy test, you probably ask yourself, what next? Well, make your gyno appointment promptly, this is a condition that is not typically an emergency, but it can be and it’s not handled over the phone or on a blog, or through self diagnosis! That being said, some researchers from University of Texas Southwestern Medical Center in Dallas decided to look back at over 4100 women who had IUDs and of those 42 cases who became pregnant in their institution, over about a year period of time, to help understand what these women could expect when they got to their gyno and what actually happened to their pregnancies. Accurate pregnancy diagnosis, pelvic examination, and pelvic ultrasound were the cornerstones of the evaluations. They had very specific ways they looked at their ultrasound to prove there was no pregnancy in the fallopian tube, or partially in the fallopian tube...

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