Colposcopy - HPV, no abnormal cells

Hello all,

So my very first smear test 12/13 years ago came back as showing borderline abnormal cells. Had another smear 6 months later which came back normal. Had yearly smears after that which all gave normal results.

Anyway, for the past few years now, since the new smear test system has been in place, I’ve continued having yearly smears with a result of HPV found, but my cells don’t show any abnormality. Yesterday, I received this year’s results again, HPV found, normal cells, but I’ve had a referral for a colposcopy. I’m not really concerned, I just have a few questions and wondered if anyone else has had this?

Firstly, I have been suffering with genital warts for the past 6 years. Well, one, that doesn’t seem to go even though I’ve had it frozen several times. Do smear tests pick up the genital wart HPV strain? Or do they only report the strains that could cause cervical cancer?

Also, as my very first test showed abnormal cells (before they reported HPV), does that mean I’ve had HPV for a very long time without it clearing? If my colposcopy comes back clear, will I continue to have yearly smears, and will I have repeat colposcopies to check my cervix in the future?

I do often spot after sex, even sometimes when I pass stools, so don’t know if there is something going on, guess I’ll find out soon enough.

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Hi Emma
I just wanted to write incase no one else does . I dint have the same experience as you , I also did yearly smears and sometimes in late 2019 ( bad itching and discharge symptoms and bleeding after sx ) my smear was abnormal and so 2020 I went for second opinion, it was still abnormal hpv hsil and was booked for lletz under GA which was done end of March this year, no clear margin later but gyno assured me the burning might have cleared it so past 6 months later for the test of cure ( cervical biopsy and Endocervical curettage ) came back normal thank God .
So I think for you , you are right to not be worried coz at the end of the day it’s abnormal cells that needs treatment.
I have researched this for you

  1. Low-risk HPV strains, such as HPV 6 and 11 , cause about 90% of genital warts, which rarely develop into cancer. These growths can look like bumps.
    1. Imiquimod (Aldara, Zyclara). This cream appears to boost your immune system’s ability to fight genital warts.
      I hope I am of help .
      Let me know how you are doing

Thank you for your response @JaneG. Good to hear you’ve got the all clear!

I don’t really know what to expect from the colposcopy, or whether they’ll find anything. My letter said that some people with normal smears can still have cell changes, so will have to wait and see what comes back from mine.

I have tried genital wart cream before (the GUM clinic gives warticon). Unfortunately, it’s always made my warts worse, seeming to irritate them rather than make them go away. I’ll have to have another trip down the GUM clinic soon for another go at freezing :unamused:

I wondered if cervical smears picked up the wart strain, as last year when I had my smear, I told the nurse I had a wart and she said that could be why I keep showing HPV in my smears. But then I thought the smear only reported high-risk HPV, so this has left me a bit confused.

Hello Emmal87 I believe that the NHS when they check for HPV they don’t tell you the type but you can do a private test from superdrug and find out the type. Only an idea hope you get the answers to all this soon
Take care. Good luck :+1:t3:

Had my colposcopy today, had three biopsies taken (that was very unpleasant, feeling it!). Now I have the dreaded wait to find out if there is anything untoward. She said she wasn’t concerned, that it simply looked “viral” which seems like an odd statement to make, considering HPV is viral…

I asked about the HPV strains they test for and the Colposcopist said that they don’t actually check the strain, just whether you have HPV or not, so genital warts strain would come back as HPV positive in a smear. She did mention cold sores as well, which is incorrect, that’s HSV :expressionless:

Indeed, your colposcopist seems not to know one virus from another!! I think safe to say you can’t go by any comments a the time, but you’ll need to wait for the outcome of the biopsies. Not very a very nice procedure, is it! X

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Hi there.

I too had a colposcopy after 3 smears said I tested positive for HPV but no abnormal cells seen. I believe they test for the high risk HPV.

After colposcopy said mine looked viral the biopsies came back Cin2/3. I had lletz to remove the cells which was completely painless for me. They only remove then and there if its obvious that you have an abnormality so the fact that it didn’t look bad should give you comfort.

If you do need treatment then please don’t worry. I worried about it and built it up in my mind and it was less uncomfortable than the biopsies.

Take care x

Nope, not nice at all! The second biopsy was particularly painful, had cramping and twinges all afternoon. But it’s a small price to pay for the sake of health. The colposcopist and nurses were lovely, they do make you feel reassured, but as you say, just have to wait for the results to know for sure.

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@Jordo sounds similar to me. I took my neighbour in at the beginning of the week for her to have. LLETZ on CIN2, she said the same thing, that the biopsy was worse. I think it’s just the waiting that’s the worst to be honest!

It is but the worst case scenario is that you have to have lletz to remove the cells. I promise you it isn’t bad. 20 minutes. Think of it like a filling at the dentist!!:see_no_evil:

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So, as promised, I had my results today, exactly 4 weeks to the day of my colposcopy.

Good thing they now check for HPV as well as cell abnormalities, as my smears have been showing no abnormal cells, yet the colposcopy result is showing CIN2.

The letter mentions cold coagulation treatment. I would have expected LLETZ for CIN2.

Has anyone had cold coagulation before? Why would it be offered instead of LLETZ?

I’m counting down to my first colposcopy on 26th January. My letter said borderline abnormal cells. I’m thinking it could be anything or nothing they find as I’m reading a few who have different results to their smear and wondered if that’s the usual case and if borderline means they don’t know what they’ve found or if it means they know they have found mild or CIN1. I have positive HPV but the letter doesn’t say a strain but I am presuming a high risk one. The letter also does not say how long I will be there as an outpatient.

Forgot to add, I have the Mirena coil in for many years and had it put back in at the same time as my screening in October 2021. I am having spotting after sex but put this down to my coil. I had my coil taken out in June and my periods were regular and light and considering I always used to have heavy ones I was surprised. I have read that this may have to be removed if they do treatment. I will just have to wait and see but I would rather have the most effective treatment as I have real bad health anxiety and self harm. However this whole experience is helping my depression bizarrely because I am glad to be being investigated now and dreading the appointment much less than when I initially got the letter.

Yeah, I guess I wasn’t really expecting my result. I just don’t know how I have CIN2 and yet smears have not detected any abnormalities for many years, only the HPV. I’m not too phased to be honest, I’ll get it treated and hopefully job’s a good’un!

I think what’s thrown me is that I don’t know anything about cold coagulation, as everyone seems to talk about LLETZ treatment. I like to be as informed as possible, and felt pretty clued up as to what to expect with LLETZ but now I don’t know what to expect again, and why I’m having this treatment. I’ll just have to have a good chat with the Colposcopist at my appointment.

When I had my colposcopy, I asked about the strains and she said that they don’t actually test which strain you have, just whether HPV is present. So if you had HPV from genital warts for instance, which is considered low risk, your smear will still say HPV positive. Also, they won’t probably state a duration on your appointment letter, as it depends what they see. Sometimes they offer treatment there and then so you may be there for an hour or so. My neighbour’s LLETZ treatment was just over an hour, but she was having a long chat with the Gynaecologist beforehand. My colposcopy took 15 minutes.

I had the mirena coil last year, but had it removed after 6 months. It was causing me pain and discomfort, especially during sex, maybe my cervix is sensitive? I did read that cold coagulation is offered to people with cervixes that have thin skin that bleeds easily, so perhaps that’s the case with mine? Who knows, I’ll find out soon enough.

Good luck with your appointment @HEH0 , it’s not the most pleasant experience but at least you’re getting investigated and any problems can be sorted :slight_smile:

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Hello I thought cold coagulation was offered to women with CIN2 not CIN3. Young and probably still wanted children as it is less aggressive on the cervix.(Not that you can’t have kids after Lletz.)
Probably if you were offered one is because you fall into some of this category as I am quite sure they don’t offer it if the CIN is more severe. Take care and good luck with your treatment

Thanks @Hop1 :slight_smile: Yeah perhaps that’s what it is, as I’m 34. My neighbour had LLETZ treatment at the same clinic for CIN2 but she is nearly 60. With the LLETZ, they send the tissue off for further investigation, but I guess that doesn’t happen with cold coagulation as they burn the cells? So they clearly aren’t concerned that there is anything else more sinister going on.

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