First of all, I am the parent of 3 daughters. HPV scares me.

Let me tell you my story.

I oldest daughter turned 17 in July '06. She met a boy. He is 21. They started having sex in August ' 06. She was a virgin prior to this relationship. She was his 4th sexual relationship.

Before they started having sex, he went to the health department and was tested for "everything". He was told he was fine.

In December '06, my daughter went to have a pap test because the boy had moved in October and they had broke up. Her father and I wanted to have her checked out for any STD's


All her tests came back fine including all her blood work. The nurse practioner said she does not have any STD's

Should we wait 6 months and have all the blood work redone. How quick can a test determine HIV?

Her pap came back abnormal. The nurse practioner said it could be because she had a yeast infection. She recommended that my daughter have a scope and biopsy done. When the biopsy came back abnormal, she recommended that she have the LEEP procedure done.

Now, I had been asking all along does she have a STD. "NO, she said."

Finally, after alot of internet research, I call again. Are the abnormal test results because of HPV? "Could be, is she sexually active?", she said.

Third phone call. What exactly was her pap test result? "Low grade Squamous-HPV", she said. Biopsy? "Moderate Dysplasia," she said.

Why was I not notified all along? Do they know what type of HPV she has?
(They never even told my daughter, and I was present for every office visit.)

Now all my questions that my doctor can't seem to answer.

Can HPV progress this fast in 6 months? (Remember, she only had sex for 3 months and none since.)

Is this result, because her body is still just reacting to the virus?

Is this fast progression because she is fighting more than one type of HPV at the same time?

Does only have the high risk cell changing type or could she also have the low risk gentital wart kind?
Wouldn't the doctor be able to tell this early?

Wouldn't the pap test have identified which type she has?

Is the LEEP procedure absolutely necessary at this time?

Can her body suppress this virus in time? She is 17 and only been having sex for 6 months. (She had sex with him in August, September and October, but none since.)

She swears she used a condom each and everytime. However, if he masturbated and then touched her, would that have spread the virus?

Will folic acid help? How much?
(The doctor has not even mentioned this. I read about it on the internet.)


We currently have an appointment with a second doctor for a second opinion.


Thankyou for all your help.

Yes some forms of hpv can progress pretty quickly unfortunately - it's terrific that your daughter's medical providers are on the ball with this and being fairly aggressive about it even if they have been seemingly oblivious to the whole hpv part of it all. With moderate dysplasia - the LEEP is probably a good idea. Better to be too aggressive than to sit back and let it have more time to do what it wants to do at her age. If you want to know if indeed she has hpv and if so what type - they can do a hpv dna test before they do the LEEP. a regular pap test doesn't check for hpv. The thin prep brand pap tests do - they report back if high risk hpv is found or not. I'm guessing your daughter had a regular pap test since there seems not to be any idea of if she definitely has hpv or not. Did they explain the LEEP to you both? Basically they look for any suspicious areas on her cervix and then remove them. They take as little tissue as possible in order to preserve her future fertility.

As far as std's - it was pretty close to the 3 month mark for her testing - negative results should be accurate for hiv. was she also tested for herpes? The reason I ask is that most clinics don't test routinely for herpes so it's always a good idea to make sure she was. There is a terrific list on ashastd.org of what std's to get tested for.

Unfortunately condoms are not always used properly and they aren't 100% protection for either herpes or hpv. A recent study did show that if the condom was put on from the time the pants come off it reduced the chances of transmitting hpv significantly - the odds of protection go much lower if you wait until actual penetration to apply the condom. Most people do a lot of "fooling around" naked before the condom goes on so yes indeed you can still get herpes or hpv even if you use a condom everytime ( and even if you are still technically a virgin too even ). Since this would be a type of herpes that in a male wouldn't present with any symptoms - chances are good that her bf had no idea he even had it. There isn't a commercially available test for hpv in males at this time.

You can check out www.pubmed.gov for the latest info on follic acid and hpv infections. Also you can check out www.clinicaltrials.gov to see if any hpv research is going on near you that your daughter might be interested in participating in. There are some terrific studies going on right now that might be worthwhile to check out. most of them are in phase 3 testing which is the safest stage.

I'm really glad you are there with your daughter for all this So many times on the boards daughters are afraid of what their parents would think of them so they try to handle this all on their own. Kudos for you for being there for her and helping her with all this

betsy

Hello supportive parent,

Let me echo what Betsy says in that it's wonderful you are in fact taking a non-judgemental approach where your daughter's emotional and physical well-being is your prime concern. That will mean a great deal to her, no doubt.

You've received excellent information in Betsy's responses, so I'll keep my remarks brief (well, "brief" for me!).

The necessity of treatment, and even the specific therapy used, is determined by factors such as the size, distribution, location, and number of lesions confirmed on colposcopy/biopsy. Even moderate dysplasia can self-resolve, although treatment is common with these lesions. The risk of progression to cancer is not great, especially given your daughter's age and the fact she is following her health care provider's advice.

Many health care providers, like their patients, are confused about HPV and not sure how to discuss it. Sometimes there's a reluctance to bring up anything related to STIs, while other times there is simply a lack of awareness about the virus and the kinds of questions patients might have. Still others are in harried clinics where such discussions are often trumped by too much to do in one day. Regardless, the lack of info is frustrating, and a scenario people bring to us very often.

Pap tests don't actually determine the type of HPV one has, as they alone don't check directly for the virus, but they can indicate the presence of lesions that are strongly suggestive of "high risk" HPV types; then, the colpo/biopsy is done to confirm. Actual HPV DNA testing, which is specific and direct for the virus, is most often reserved with young women to sort out unclear Pap results. The health care provider may not feel it's necessary to do one now, after the colpo/biopsy. but ask them if you have questions.

Wow - if this is brevity on my part, imagine how I am when I decide to be long-winded! Thanks for posting and come again anytime you have questions.

All the best,
Fredo

_________________
ASHA Moderator

Let me first say Thank you for being my lifeline 2 1/2 years ago when my oldest daughter was diagnosed with high-risk hpv.

Now, let me add a positive message on this board that sometimes seems to be lacking hope. There is hope when it comes to HPV.

The past 2 1/2 years has been a time of education, patience and prayer, but we have finally gotten a diagnosis of normal pap test and normal colposcopy.

I have read messages from people asking similar questions to the ones I asked several years ago.

Let me answer with prior and post experience:


1. Don't be afraid to get a 2nd or 3rd opinion regarding treatment of HPV.

My daughter's 1st doctor wanted to perform a LEEP procedure on her without waiting to see if her body could "fight" this newly acquired infection. This doctor was too busy to communicate with us directly.
We never saw her and my daughter's 1st Colposcopy and biopsy was performed by her assistant. When we asked for her records for a second opinion, the doctor made us sign a paper stating that she was refusing to treat my daughter forever. We took her records to another doctor who reviewed my daughter's records, and she told us some of the
tests that was performed on my daughter was not necessary. She also agreed that my daughter's infection was new and possibly could clear on its own. If we were willing to come for Pap Tests every 3 months and Colposcopies every 6 months, she was willing to watch and wait. No LEEP procedure unless the lesion worsen.

2. Always go over your medical bill and ask questions. Call your insurance company if necessary. They know what the billing codes stand for.

My daughter's first doctor ordered a High Risk and Low Risk HPV test on my daughter during her first Physical. This test was $600.00. This test is not to be used as a screening process on someone under the age of 30.
This test is only done by a lab if a pap test is abnormal. The lab also performed this test when my daughter's pap test was abnormal. I was billed for the HPV test twice. Once by the doctor and once by the lab company. I argued with the doctor, and she dropped this additional $600.00 charge from my bill. I did pay the lab company for their HPV test because it was medically necessary.

3. Educate yourself about HPV.

I read all the information I could about HPV from reliable sites. I could then ask intelligent questions concerning my daughter's treatment. The first doctor only wanted to perform LEEPS. Our 2nd and consequently 3rd doctor understood that HPV can possibly clear in 2 years especially in young and healthy patients. (We had to find a 3rd doctor when the 2nd doctor moved her practice to another state.)

4. Being cheap is not the best way to go when making medical decisions.

A LEEP would have been quicker and less expensive than 2 1/2 years of repeat office visits, pap tests and colposcopies. My daughter's latest colposcopy and biopsy in in Jan. '09 Doctor $540.00 Lab $250.00

However, she is now 19 1/2 and had a normal Pap Test in July '08
and a normal Colposcopy/Biopsy in Jan. '09. All this without having a LEEP performed and her cervix compromised.

5. Sometimes a change in lifestyle is necessary.

My daughter realized that sex is not worth dying for or losing her feritility over. She has abstained from sex for the past 2 1/2 years. She is going to college and waiting for the right man instead of waiting with the wrong one.

Also, she no longer takes birth control pills because she is abstaining. There are reports that birth control pills depletes the body of folic acid which the body needs to "fight" HPV.


6. Sometimes alternative medicine has a place.

Also, there are reports that eating healthy, not smoking and taking vitamins, especially folic acid, helps the body "fight" HPV. She takes her vitamins every night.


7. Get your HPV Vaccination!

I wish I had known and gotten her this shot before she became sexually active. It might have prevented the strain of HPV that she contracted. (We do not know what type strain she has because the cost of the test is pointless because the treatment is always the same when it comes to high-risk HPV.)

My daughter got her HPV shots from the health department for free because she was a full-time college student.

8. Learn from your mistakes.

My daughter recently did a powerpoint presentation on HPV for her college communications class. She passed out pamplets from the local health department to everyone in the class including the male students. High Risk HPV might not affect males the same as females, but they do help spread HPV.


Thank you,
Supportive Parent

that she contracted. We do not what strain or strains she contracted because the cost of the test would be pointless because the treatment for High-Risk HPV is always the same regardless of the strain.

My daughter received her HPV vaccinations for free from the Health Department because she was a full-time student.

Thank you,
Supportive Parent

Supportive Parent,

I just wanted to say 'thank you' for coming back to the boards to post an update about your daughter. It's not often that people remember to check back and report on their outcomes, so thanks for taking the time! Glad to hear that your daughter is doing well.

I'm glad that you're doing well, Supportive. I, too, wish that I had gotten the HPV vaccine as soon as it came out....actually, looking at your first post I got HPV about the same time your daughter did, in 2007---I had started the series then, but I contracted HPV from my current bf (still together, though, quite happy) before I finished the series. I'm hoping that I'm at least protected from the oncogenic/cancer strains.

I think we need to put a "happy" thread in here somewhere and sticky it to the top It's good to see the positive as well, since it's the norm to see the unhappy aspects of HPV most of the time here.