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.
Three special tests are done during colposcopy: acetic acid wash, use of
color filters, and sampling (biopsy) of tissues of the cervix.
Acetic acid wash
After the cervix is studied with the colposcope, the cervix is washed with a chemical called acetic acid, which is diluted 3% to 5%. The acetic acid washes away mucus and allows abnormal areas to be seen more easily with the colposcope. Moreover, the acetic acid stains the abnormal areas white. The areas that stain white after the acetic acid wash are called
"acetowhite lesions." Sometimes, however, normal areas can also stain white, but these areas have vague or faint borders. In contrast, significant abnormalities, such as genital warts, pre-cancers (dysplasia), and cancers, generally produce acetowhite areas with distinct and clear boundaries.
Sometimes staining with a dilute iodine solution (known as Lugol's solution or Schiller's solution) is also performed to further examine for abnormalities. Normal cells will generally take up the iodine stain (and turn brown) in a uniform manner, whereas severe precancers and cancerous areas will not.
Use of color filters
Another aspect of colposcopy involves the use of color filters. The filters
help the physician examine tiny blood vessels (capillaries) in the area of the
squamocolumnar junction. Blue or green filtered light can cause abnormal
capillaries to become more obvious, usually inside an acetowhite area.
Normal capillaries are slender and spaced out evenly.
In contrast, abnormal capillaries can appear as red spots (thickened
capillaries seen on end) or can produce a pattern resembling hexagonal floor
tiles. The worse the cervical disease, the thicker and more widely spaced
out are the capillaries. The abnormal capillary pattern ranges from mild, as with pre-cancer (dysplasia), to
severe, as with established cancer. Thus, when cancer eventually develops,
capillaries take on odd shapes, like punctuation marks.
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.
Menopause is the time in a woman's life when menstrual periods permanently stop, also called the “change of life." Menopause symptoms include hot flashes, night sweats, irregular vaginal bleeding, vaginal dryness, painful intercourse, urinary incontinence, weight gain, and emotional symptoms such as mood swings. Treatment of menopausal symptoms varies, and should be discussed with your physician.
Cervical dysplasia is a condition in which the cells of the inner lining of the cervix have precancerous changes. There are two types of cervical dysplasia; 1) squamous intraepithelial lesion, and 2) cervical intraepithelial neoplasia. Cervical dysplasia is caused by infection of the cervix with HPV (human papillomavirus). There are various diagnostic measures for cervical dysplasia. Treatment generally depends upon the progression of the dysplasia, mild, moderate, or severe.
Human papillomavirus (HPV) infection is the most common sexually transmitted infection in the U.S. HPV is primarily transmitted by sexual contact. While some people develop warts in the genital region after infection, others experience no symptoms. Though genital warts can be removed, there is no cure for HPV infection. There is a vaccine to prevent infection from four common HPV types.
Vaginal cancer is fairly uncommon. There are two types of vaginal cancer: squamous cell carcinoma and adenocarcinoma. Risk factors include being 60 or older, exposure to DES while in the womb, HPV infection, and having a history of abnormal cervical cells. Painful intercourse, pelvic pain, vaginal lumps, and abnormal vaginal bleeding or discharge are all symptoms of vaginal cancer. Treatment depends upon the stage of the vaginal cancer and may involve surgery, radiation therapy, chemotherapy, and the use of radiosensitizers.
Sexual health information including birth control, impotence, herpes, sexually transmitted diseases, staying healthy, women's sexual health concerns, and men's sexual health concerns. Learn about the most common sexual conditions affecting men and women.
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