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.
Most women with low grade (mild) dysplasia (LGSIL, CIN1) (when the diagnosis is confirmed and all abnormal areas have been visualized), will undergo spontaneous regression of the mild dysplasia without treatment. Therefore, monitoring without specific treatment is often indicated in this group. Treatment is appropriate for women with high-grade cervical dysplasia.
Treatments for cervical dysplasia fall into two general categories:
destruction (ablation) of the abnormal area and removal (resection). Both types
of treatment are equally effective. Generally, destruction (ablation) procedures
are used for milder dysplasia and removal (resection) is recommended for more
severe dysplasia or cancer.
The destruction (ablation) procedures are carbon dioxide
laser photoablation and cryocautery. The removal (resection) procedures are loop
electrosurgical excision procedure (LEEP), cold knife conization, and
hysterectomy. Treatment
for dysplasia or cancer is not usually done at the time of the initial
colposcopy, since the treatment depends on the analysis of the biopsies done
during colposcopy.
Carbon dioxide laser photoablation
This procedure, which is also known as CO2 laser, uses an invisible beam of
infrared light to essentially vaporize the abnormal area. A local anesthetic is given to
numb the area prior to the laser treatment. A substantial amount of clear
vaginal discharge and spotting of blood can occur for a few weeks after the
procedure. The complication rate of this procedure is very low, about 1%.
The most common complications are narrowing (stenosis) of the cervical opening
and delayed bleeding. Disadvantages of this treatment include that this
procedure does not allow sampling of the abnormal area and is not satisfactory
for treating cervical cancer. It is useful, however, for milder dysplasia.
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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