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.
Pap smear analysis and reports are all based on a medical
terminology system called The Bethesda System that was developed at the National
Institutes of Health (NIH) in Bethesda, Maryland in 1988 and modified in 2001. The major
categories for abnormal Pap smears reported in the Bethesda Systems are as
follows:
ASC-US: This abbreviation stands for atypical squamous cells of undetermined
significance. The word "squamous" describes the thin, flat cells that lie on the
surface of the cervix. One of two choices are added at the end of ASC: ASC-US,
which means undetermined significance, or ASC-H, which means cannot exclude HSIL (see below).
LSIL: This abbreviation stands for low-grade squamous
intraepithelial lesion.
This means changes characteristic of mild dysplasia are observed in the cervical
cells.
HSIL: This abbreviation stands for high-grade squamous intraepithelial
lesion. And refers to the fact that cells with a severe degree of dysplasia are
seen.
Histologic analysis (cervical biopsies)
When precancerous changes are seen in tissue biopsies of
the cervix, the term cervical intraepithelial neoplasia (CIN) is used. "Intraepithelial" refers to
the fact that the abnormal cells are present within the lining, or epithelial,
tissue of the cervix. "Neoplasia" refers to the abnormal growth of cells.
CIN is classified according to the extent to which the abnormal, or
dysplastic, cells are seen in the cervical lining tissue:
CIN 1 refers to the presence of dysplasia confined to the basal third of the
cervical lining, or epithelium (formerly called mild dysplasia). This is
considered to be a low-grade lesion.
CIN 2 is considered to be a high-grade lesion. It refers to dysplastic
cellular changes confined to the basal two-thirds of the lining tissue (formerly
called moderate dysplasia).
CIN 3 is also a high grade lesion. It refers to precancerous changes in the
cells encompassing greater than two-thirds of the cervical lining thickness,
including full-thickness lesions that were formerly referred to as severe
dysplasia and carcinoma in situ.
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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