Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Are there symptoms or signs of cervical dysplasia?
Typically, cervical dysplasia does not produce any signs
or symptoms. So regular screening is important for early diagnosis and treatment.
How is cervical dysplasia diagnosed?
Screening for cervical dysplasia
Cervical dysplasia and cervical cancer generally only
develop over a period of years, so regular screening is essential to detect and treat early
precancerous changes and prevent cervical cancer. Traditionally, the
Papanicolaou test (Pap test or Pap smear) has been the screening method of choice. To perform the
Pap smear, the health care practitioner removes a swab or brush sample of cells
from the outside of the cervix during a pelvic examination
using a speculum in the vagina for visualization. The cells are smeared onto a
glass slide, stained, and observed under the microscope for any evidence of
dysplasia or cancer.
Newer, liquid-based systems to screen samples of cervical cells are also
available and are effective screening tools for detection of dysplasia. The
samples for this test are removed as for the conventional Pap smear, but the
sample is collected in a vial of liquid that is later used to prepare a
microscope slide for examination as with the Pap smear.
Further testing
For women whose initial screening result is unclear or abnormal, other
diagnostic tests are used:
Colposcopy is a gynecological procedure that illuminates and magnifies the
vulva, vaginal walls, and uterine cervix in order to detect and examine
abnormalities of these structures. A
colposcope is a microscope that resembles a
pair of binoculars. The instrument has a range of magnification lenses. It also
has color filters that allow the physician to detect tiny abnormal blood vessels
on the cervix. The colposcope is used to examine the vaginal walls and cervix
through the vaginal opening. Colposcopy is a safe procedure with no
complications other than mild vaginal spotting of blood.
Biopsies are tissue samples obtained for examination under the microscope A
biopsy may be taken of suspicious areas seen during colposcopy.
HPV testing to detect whether or not HPV infection with a "high-risk" HPV
type is present may be recommended for some women. This may be particularly
useful if the results from regular screening tests are ambiguous, such as
results suggesting atypicalsquamous cells of uncertain significance or ASC-US
(see below). Because of the number of women infected with HPV in general and
because the infection can be temporary and short-lived, regular screening of all
women for HPV infection is not thought to be useful and is not routinely performed
in the U.S.
Sexually transmitted diseases, or STDs,
are infections that are transmitted during any type of sexual exposure,
including intercourse (vaginal or anal), oral sex, and the sharing of sexual
devices, such as vibrators. Women can contract all of the STDs, but may have no symptoms, or have different symptoms than men do.
Cervical cancer is cancer of the entrance to the womb (uterus). Regular pelvic exams and Pap testing can detect precancerous changes in the cervix. Precancerous changes in the cervix may be treated with cryosurgery, cauterization, or laser surgery. The most common symptom of cancer of the cervix is abnormal bleeding.
Sexually transmitted diseases, or STDs, are infections that are transmitted during any
type of sexual exposure, including intercourse (vaginal or anal), oral sex, and
the sharing of sexual devices, such as vibrators. Although treatment exists for many STDs, others currently are
usually incurable, such as those caused by HIV, HPV, hepatitis B and C, and HHV-8.
There are a number of different methods of birth control to include: barrier methods, IUDs, hormonal methods, natural methods, and surgical sterilization. Birth control methods can be reversible or permanent. In simple terms, all methods of birth control are based on either preventing a man's sperm from reaching and entering a woman's egg (fertilization) or preventing the fertilized egg from implanting in the woman's uterus (her womb) and starting to grow.
When you are pregnant, many sexually transmitted diseases (STDs) can be especially harmful to you and your baby. These STDs include herpes, HIV/AIDS, genital warts (HPV), hepatitis B, chlamydia, syphilis, gonorrhea, and trichomoniasis. Symptoms include bumps, sores, warts, swelling, itching, or redness in the genital region. Treatment of STDs while pregnant depends on how far along you are in the pregnancy and the progression of the infection.
Disease prevention in women includes screening tests that are a basic part of prevention medicine. All screening tests
are commonly available through your general doctor. Some specialized tests may be available elsewhere.
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