Low-grade CIN1 for 3 years - docs want to do loop diathermy

Hi all,

Since 2020 I’ve had numerous colposcopy appointments, all showing minor CIN1. They are now wanting to do loop diathermy. They say that even though it’s CIN1, I’ve had it for a while.

Calling out to those experienced: What’s your advice?

I’m an otherwise healthy and fit 30 y.o. with my only downfall being I haven’t been that great at consistent sleep. I really don’t want to do the treatment because I have trauma from past medical procedures that weren’t successful/had bad side-effects. I want to have kids and give birth preferably naturally in the next few years. I am happy to do whatever it takes if I can fight it myself (including sleep better).

This is my history:

  • 2020 Extremely minor abnormalities and possibly HPV infection only
  • 2021 Mild CIN 1 change, HPV changes only
  • 2022 Low grade CIN1, HPV detected with borderline changes

Hi @starbloom

It is usually recommended to treat CIN1 after it has persisted for a couple of years or so, but in my opinion i think a LOOP is abit of a OTT treatment when changes are so low and the other treatment options should be considered… some countries may not be able to offer other treatments so this may be why a LOOP has been offered, but have you asked them about the less extensive treatments like laser therapy, cold coagulation or cryotherapy? LOOPS are usually the prefered treatment method for abnormalities as the can analyse the sample in the lab afterwards instead of just destroying the cells like the other treatments do, the other methods are just as succesfull at removing them

There more info about the other treatments here: https://www.jostrust.org.uk/information/cervical-cancer/treatments/other-treatments-for-cervical-cell-changes

Or since the changes are still very low, there is still the option to monitor the changes like you have been and treat the cells if they do ever progress to a higher grade xx

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Thank you so much. I would love to explore the other treatments and thank you for the links sent. Is there one you’d recommend over the others?

My doc sort of dismissed them saying they weren’t as effective/wouldn’t be as effective if by chance my infection turned out to be deeper. Even if they weren’t as effective/didn’t provide a sample, I’d rather do anything with less side effects. I will ask them again and press them for those treatments. My hesitancy is that they may not be very good at the alternative treatments, seeing as they seem to mainly just do LOOP.

I would look at trying papilocare or Deflagyn gels prescribed in Europe for 6 months first.

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I’ve got my hands on Papilocare now. Did it work for you based on experience?

Hi all, i had a lletz for mild changes (smear in jan 22 shows low grade, but more recent smears have returned inadeuqtae results). The colposcopist said this was guidance when persistent. My concerns are that she said its advised because i have a type 3 cervix (transformation zone tucked into the cervical canal) so now driving myself crazy that something more developed or sinister is hiding there. Fingers crossed for quick (ish) results. Hope you are doing well @starbloom , what treatment route did you go for in the end? Xx

That sounds like overtreatment. The standard protocol for CIN1 is still watchful waiting. If you want to do a treatment, I would explore cryotherapy.

The reason doctors prefer to do a LLETZ is because they get a tissue sample to look at under a microscope and check for clear margins.

CIN1 is, by definition, only in the top layer. So I’m not sure why they’re talking about it “hiding” in lower layers. Sometimes CIN “skips” up the endocervix, but anything worse than CIN1 probably would have been discovered during colposcopy/biopsies.

Cryotherapy is still an effective treatment for persistent CIN1, though it’s fallen out of favor in recent decades. Watchful waiting doesn’t work for every woman (I also have persistent CIN1) and I’m also more open to cryotherapy than a LLETZ; it’s something I’ve been looking into. It’s not without side effects but somehow it seems less invasive.

Ive not had a biopsy before, so gone straight from inadequate smears to lletz. I suppose they dont know that it is CIN1 on that basis. Probably didnt go for a punch biopsy as there wasnt a specific area to target, instead they want a broader view/testing of the transformation zone that they cant visualise. Still waiting for results, cant wait for it to be over. X

Just had my results this morning and thankfully all clear, no abnormal cells found. Feel like i can breathe again xx

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