Abnormal Pap: What It Means + What You Can Do
While no one likes getting a Pap, the only thing worse than the exam is receiving an abnormal result. An abnormal pap can be anxiety-inducing but you don’t need to panic, you just need to know what to do next.
A Pap test is looking for cervical dysplasia, which occurs when abnormal cells grow on the surface of your cervix (the entry to your uterus). The good news is that most abnormalities found on Pap exams will self-correct over time, and with the regular screening guidelines many abnormalities are found early and are treatable if they don’t clear on their own.
So let’s break down a few of the abnormal results that can show up, so you know exactly what’s going on and what you can do about it.
Atypical Squamous Cells of Unknown Significance (ASCUS)
What this actually means
This is the most common abnormal finding and means that the squamous cells (which line the outer cervix) are mildly atypical in their appearance, but not so different that they are considered precancerous.
Next steps
If you are under 30 years old HPV testing is often not recommended. Instead it’s recommended that a second Pap be performed in 6 months. If you’re over the age of 30 HPV testing is recommended. If you test positive for HPV you’ll be sent for a colposcopy as this is a sign that we need to take your abnormal Pap results more seriously and better understand what changes are taking place. If HPV testing is negative, rest assured it’s unlikely that your ASCUS results are signalling a precancerous change, so you will be seen for a second Pap in 6 months.
Low-Grade Squamous Intraepithelial Lesion (LSIL)
What this actually means
This signals that there are some early, precancerous changes showing up in the cells that line your outer cervix and is very often associated with an HPV infection. Low-grade means that these abnormal changes are not severe but they are significant enough for us to respond more seriously.
Next steps
The good news is that most of these abnormalities go away on their own (especially in younger women), however in about 10% of cases these changes will progress to cancer if left untreated. So you will have a colposcopy, which looks at the tissue of your cervix up close, and be scheduled for a follow-up Pap in 6 months.
High-Grade Squamous Intraepithelial Lesion (HSIL)
What this actually means
This tells us that more significant changes have shown up in the cells lining your cervix. In about 20% of cases these changes will progress to cancer if left untreated, and in a very small percentage of women these changes may have already progressed to cancer.
Next steps
Our bodies have an amazing ability to recover from abnormalities, even in the presence of more serious changes, cervical dysplasia can be successfully treated in almost all women. You will be sent straight in for a colposcopy and will likely need treatment to remove these abnormal cells, but catching these changes early makes all the difference. You will also need more frequent Pap testing over the coming years to make sure that once treated, your cervix cells return to a healthy state.
Atypical Squamous Cells of Unknown Significance cannot rule out High-Grade Squamous Intraepithelial Lesion (ASC-H) + Low-Grade Squamous Intraepithelial Lesion cannot rule out High-Grade Squamous Intraepithelial Lesion (LSIL-H)
What this actually means
These wordy, somewhat unclear findings mean that the results are showing abnormal cell changes to the tissue lining your cervix, which raises concern for the presence of higher grade (more significant) changes, but are not consistent enough to be designated as HSIL.
Next steps
Your provider may recommend a colposcopy to further examine your cervical cells, or you will be brought in for a repeat Pap in 3 months to retest your cervical cells. No matter what your results show, once you’ve been treated you will continue with more frequent Pap testing (every 6 months) until you’ve had 2 tests that show no abnormalities. Once this has happened, you can return to your regular 3 year Pap schedule.
Atypical Glandular Cells + Atypical Endocervical Cells + Atypical Endometrial Cells
What this actually means
This tells us that cells from inside the cervical canal or uterus, have an abnormal appearance. The risk of these atypical cells reflecting a precancerous change can be as high as 11%, with a 1% risk of cervical cancer and 3% risk of endometrial (uterine) cancer, so this signals a change that we want to take seriously.
Next steps
You will be sent straight in for a colposcopy to better see these abnormal cells. If your medical history or family history signals a higher risk of uterine cancer, a pelvic ultrasound and biopsy of the uterine lining (endometrium) may also be done. Based on the results, treatment options will be discussed and once completed, you’ll be brought in for more regular Pap exams until you’ve had 2 clear Pap exams in a row.
Natural Treatment Options
Cervical dysplasia is most often caused by HPV, a virus so common it’s estimated that over ¾ of us have been exposed to it. However, while most of us will be exposed to this virus, not all of us will carry it. Some people’s immune systems are able to clear the virus from the body without any additional intervention or treatment. They may never know they even had it!
Conventionally your options are to watch and wait, or investigate further with more in-depth testing of your cervical tissue. For many women, sitting and waiting for things to clear up can feel disempowering and frustrating.
In naturopathic medicine there are so many effective ways to treat cervical dysplasia, alongside conventional medical care. It’s often a matter of focusing on the fundamentals around what causes cervical dysplasia and what we know about how healthy cells grow. This often means a 3-6 month treatment protocol that includes vitamins, herbs, and vaginal suppositories that will help your body clear the viral infection (even if you haven’t been tested for HPV, the odds of infection are high enough that we will treat anyway) and boost your immune system function. After that we move to a maintenance plan that helps prevent a recurrence by ensuring we address the reasons why you were more susceptible to the viral infection in the first place.
Next Steps
Want more support? Naturopathic medical treatment is not about over-complicating your life, but empowering you to make smart, safe choices that you feel good about. I want your treatments to not only be tailored to your specific Pap results and needs, but to have as many positive effects on your health as possible.
If you want to learn more about how Naturopathic Medicine can help support abnormal PAP results, check out our Hormone Health and Cancer Care pages for more information.
Ready to make a change?
When it comes to your health, it’s important to be your own advocate AND have a doctor that will advocate for you. If you are in search of more direct and personalized ways to treat your abnormal Pap findings don’t be afraid to reach out and ask. I can help.
In support of your health,
Dr. Hayhlee Clarence, ND