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Pap smears: abnormal results and what they actually mean

By Alyssa Horowitz

So you went to your doctor and had a routine Pap test. Your doctor then follows up telling you that it came back “abnormal.”


Just being labeled “abnormal” is enough to cause panic. But before you let this set off any alarms, let’s take a closer look at what the Pap test even is.

Named after Dr. Papanicolaou, this test screens for HPV and cervical cancer and can identify any suspicious or funky looking cells on your cervix. Your doctor will scrape off cells from your cervix and examine them under a microscope looking for any changes in size, shape, and color most likely caused by HPV.

Although some abnormal pap smears are caused by inflammation, which can be caused by anything that irritates your cervix (soap, condom, IUD…), the most significant changes are caused by one culprit - the human papillomavirus.

HPV is incredibly common, affecting 85% of women at some point in their lives. 

It is also the primary cause of cervical cancer.

Yeah. More than 90% of cervical cancers are caused by the virus. But, here's the thing...

HPV is not a cancer sentence. 

It’s far from it. There are more than 200 types of HPV and the majority of them are “low-risk,” responsible for feet and genital warts. There are only few “high-risk” strains responsible for cervical cancer and in most cases, the virus clears on its own in 1-2 years.

This is because with a strong immune system, and healthy lifestyle habits (not smoking, eating your greens and exercising) your body can fight the virus. However, in a small-percentage of cases, HPV persists, and progresses into cancer slowly over time. That’s why early detection saves lives. The earlier you can catch these morphing cells, the earlier you can get rid of them.

Let’s break down your abnormal pap results- and what you can do to help protect yourself 

Case A: Normal Pap- Wonderful! This means your cervix is healthy, and the cells appear “normal”. Even if you might have HPV, there is no need to take action since your immune system is strong and is fighting the virus.

Your doctor will most likely follow-up with regular checkups.

Case B: ASC-US – Now it starts to get a little complicated with medical terminology. Bear with me.

All this means is that there are some funky looking cells, but the lab is not sure why. It can be the result of inflammation from previous infections or something as simple as using a different type of condom than what you’re used to. Oftentimes, this result indicates an HPV infection. Depending on your age and risk factors, you doctor will either send you for a biopsy to see how severe these changes are or will simply keep a closer eye on your cervix.

Case C: LSIL (Low Grade Squamous Intraepithelial Lesion) aka CIN 1 – Sounds intimidating, right? But oftentimes, it's nothing much to worry about. This result means that there’s a current HPV infection...but it’s low grade.

Your doctor might want to do a biopsy to investigate the severity of these cells (especially if you're over 30), but for the most part, an overwhelming majority of women clear the infection before it progresses.

Case D:HSIL (High Grade Intraepithelial Lesion) aka CIN 2/3 – This is a red flag, and signals more serious “precancerous” changes. You likely do not have cancer now, but without treatment you are at risk for developing cervical cancer. The next step, for women of any age, is a biopsy. Then, depending on the results, your doctor will recommend treatment.

If your results ever come back abnormal, chances are you're going to be absolutely fine. If there are precancerous cells, it typically takes years to progress into cancerous ones. That doesn't mean you should delay visiting your doc; but by going to follow-up appointments, having the right procedures done and being proactive about your lifestyle, you can treat any problems early and take control of your health.

(Conventionally, HPV can be treated by surgical procedures. You can also help your body fight the virus by boosting your immune system through diet and lifestyle support.)

Here are some key tips to help your immune system stay strong when you find out that you have HPV:

Eat plenty of fruits and vegetables – especially those rich in vitamin A and carotenoids. A study in the journal Cancer Epidemiology, Biomarkers and Prevention found that women who consumed large amounts of vegetables were less likely to have persistent HPV.

Eat a rainbow of fruits and vegetables daily to get your essential vitamins and minerals will keep your immune system strong.

Supplement with herbs - Herbs can help to fight HPV and are not only effective against HPV but almost all types of viruses can benefit from herbal remedies. There are many herbal remedies for HPV, including Astragalus, Green Tea Extract and Reishi Mushroom. Rather than buying them individually you can also purchase the HPV herbal supplements Papillex, that packs 10 researched HPV-herbs together in a single capsule.

Drink Green Tea. There is a growing body of evidence that suggests the active ingredients in Green Tea, ECGC may halt the development of HPV warts and cervical lesions. Try replacing your afternoon coffee with a cup of green tea or matcha tea.

Quit smoking. Smoking is horrible to your health in countless ways; there really is no bodily system or vital organ that goes unscathed by this habit. What’s more, according to a study published in the journal Cancer Causes and Control, smoking doubles the risk of HPV progressing into cervical cancer.

Women should know that long-term use of oral contraceptives has been connected to an increased risk of developing cervical cancer. The Institute for Research on Cancer found that women who have the HPV virus and have used oral contraceptives for five years are nearly four times as likely to develop cervical cancer. The good news is that the risk decreases once women go off of the pill.

Lastly...I'm just gonna leave this right here. #AllAdventurousWomenDo

Guest Post by Alyssa Horowitz (BSc Biochemistry, ND candidate). Keep up with her here!

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