For the ladies...pap tests

I can't remember if I ever posted this information. So if this is a repeat, my apologies.

I thought I should give a heads up to the women on the board about pap tests. I'm not trying to incite a riot or fear, but just some info. For those who are on meds that affect the immune system (6MP, imuran, methotrexate, prednisone) and know that you are positive for HPV, make sure you go in for your annual pap smear if you don't. The reason for my post is that there's a risk for those who are on these meds to develop cervical dysplasia which can lead to cervical cancer. Normally our immune systems do a decent job fighting off the HPV so it doesn't do a lot of damage, but when we mess with our immune system then it can start to lose that battle.

My personal experience was never really having abnormal paps until late last year. Then all of a sudden I had severe dysplasia due to HPV. I had a colposcopy but it came back, so I had to have a LEEP. I discussed this with my GI doc and my gynecologist, who concurred that the Methotrexate could be causing the HPV to take over and thus the dysplasia. My GI took me off MTX so I'm only on Humira now. My argument was I'd rather have some crohn's than risk the dysplasia going over to cancer since it was pretty aggressive. After the LEEP, no dysplasia was seen on my follow up pap 4 months later. Now I have to go in every 6 months to be monitored, which is fine with me. I figure I can get to know my gynecologist as well as my GI doc

During this I also emailed a GI doc who specializes in women's issues and has some published research on this topic. Her opinion was to lose the MTX and any steroids, but that the TNF drug (I'm on Humira) was safe.

This PSA was brought to you by the letter C and the number 8.

That is interesting. Good info to know.

I am positive for HPV and have been going for regular colposcomies for a few years. I had mild dysplasia that never changed so I have had nothing other than regular biopsies done.

Now after having a major crohn's flare my GI brought my case to a national GI thing and all were agreed that I could safely use Imuran. He also talked in legnth to my Gyno and he agreed that I should be fine as well.
So I started the Imuran 4 weeks ago. I go for another colposcomy next week so we shall see how that goes.

Tanya

BetaGirl!!! So GREAT to see you post!!! (((hugs))) Thanks for the headsup too.

I too had an abnormal pap smear - stage three - last year and had the LEEP procedure only three weeks before my bowel resection.
I had never had an abnormal pap smear prior to this and gyno agreed it was due to MTX and pred. I have had a follow up pap smear and colposcopy six months later ( biopsies done but all clear) and am due again in August for my next six monthly.
I was quite shocked for this to have happened, when I think of being immuno suppressed I thought of other viruses not a "female type" one to be susceptible to. Quite naive really.
Betagirl its great that you have brought this to the female forum readers attention.
Take care
Joanne

Personally, I think it's an ibd thing. I think different meds can speed the process of dysplasia, but I think we gals w/IBD need to stay on top of paps no matter what meds we are taking. I have never been on steroids, IM, or TNFs and I've had abnormal paps for the three years--dx'ed with CD 6 years ago.

Beta....missed your input here!  No riot incited, I just appreciate the info.  I have decided against starting Imuran.6MP.humira.  I always appreciate additional information I can use to explain to my GI doc what I am weighing when I make these decisions.  I just feel like I am doing really well and do not need these potential new issues

ps C is for cookie that's good enough for me, C is for cookie that's good enough to eat (over age 40 and no kids, but I still remember cookie's song!)

I had one abnormal pap since I was diagnosed. My Dr recommended I get the Gardasil vaccination so I did and I have been clear ever since. :O) And I know there is controversy out there about it but it was my own choice.