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Abnormal Pap Smear

Abnormal Pap Smear

Also indexed as: Cervical Dysplasia, Cervical Smear Test

Illustration

A routine cervical smear test is a must for most women. If you are sexually active, then caring for your cervix is especially important. According to research or other evidence, the following self-care steps may be helpful:

What you need to know

  • Check out folic acid
  • Ask your doctor if taking 10 mg a day can help reverse severe cervical dysplasia
  • Fill up on fruits and veggies
  • Help keep your cervix healthy by getting the nutrients you need from fruits and vegetables, especially tomatoes and dark yellow or orange vegetables, such as carrots and squash
  • Practice safe sex
  • Reduce your risk for cervical dysplasia by postponing sexual activity until you’re older, limiting sexual partners, and using barrier methods of contraception
  • Steer clear of cigarette smoke
  • Kick the habit and avoid secondhand smoke to reduce the risk of severe dysplasia
  • Plan a follow-up
  • If your pap smear detects an abnormality, see your healthcare provider for a repeat exam to determine whether additional tests or treatments are needed

These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading the full abnormal pap smear article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and lifestyle changes that may be helpful.

About abnormal pap smear

Sexually active teenagers and women 20 to 65 years old are advised to have periodic Pap smears, where a small amount of tissue is swabbed from the cervix and examined for evidence of precancerous or cancerous changes. A pap smear is considered abnormal when abnormal cervical cells are found. Cervical dysplasia is a term used to describe abnormal cervical cells taken during the pap smear. Cervical dysplasia is usually graded according to its severity, which can range from mild inflammation to precancerous changes to localized cancer.

If an abnormality is detected early, the doctor can prescribe effective treatment before the problem becomes more serious. Cervical cancer is a common, sometimes fatal disease. It is now known that human papilloma virus (HPV), also the cause of genital warts, is the major cause of cervical dysplasia.

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Product ratings for a Pap smear

Science Ratings Nutritional Supplements Herbs
3Stars

Folic acid (for women using oral contraceptives)

 
2Stars  

Green tea extracts (poly E or (-)-epigallocatechin-3-gallate)

1Star

Selenium

Vitamin A

Vitamin E

Echinacea, goldenseal, marshmallow, myrrh, usnea, yarrow (suppository; in various combinations)

3Stars Reliable and relatively consistent scientific data showing a substantial health benefit.
2Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
1Star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support and/or minimal health benefit.
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What are the symptoms?

There are no symptoms of cervical dysplasia until the disease has progressed into advanced cancer. Therefore, it is crucial that sexually active women, or women over age 20, have yearly Pap smears until the age of 65. Women who experience bleeding between menstrual periods, bleeding after intercourse, abnormal vaginal discharge, abdominal pain or swelling, urinary symptoms, or pelvic pain should be evaluated by a healthcare provider, even if it is not the regular time for a Pap test.

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Dietary changes that may be helpful

Most dietary studies have found that women consuming high amounts of nutrients from fruits and vegetables have less risk of cervical dysplasia.1 2 Protective effects may be especially strong from diets high in dark yellow/orange vegetables (carrots, winter squash, etc.)3 and tomatoes.4 5

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Lifestyle changes that may be helpful

Cigarette smoking increases the risk of cervical dysplasia,6 7 8 and increases the likelihood that mild forms of dysplasia will progress to more severe forms.9 10 Quitting smoking and avoiding exposure to secondhand smoke are essential for this and many other health reasons.

Certain sexual behaviors are consistently associated with cervical dysplasia, such as becoming sexually active at an early age and having multiple sexual partners.11 12 Avoiding these behaviors may reduce the risk of cervical dysplasia. For those who are sexually active, using barrier methods of contraception, such as a condom or diaphragm, is associated with reduced risk of cervical dysplasia.13 14 15

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Other therapies

If the Pap smear is normal, no further tests are necessary until the next yearly Pap test. If the cells collected on the Pap smear are abnormal, a repeat test and a pelvic exam where the doctor looks at the cervix with a special magnifying lens (colposcope) may be recommended. Sometimes a small piece of tissue is removed from the cervix (biopsy) and examined under a microscope to see if there are any precancerous changes or cancer present. If these additional tests find an early stage of cervical cancer, it is either treated by removing the affected portion of the cervix (cone biopsy) or by removing the entire cervix and uterus (abdominal hysterectomy).

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Vitamins that may be helpful

Large amounts of folic acid—10 mg per day—have been shown to improve the abnormal Pap smears of women who are taking birth control pills.16 Folic acid does not improve the Pap smears of women who are not taking oral contraceptives.17 18 High blood levels of folate (the food form of folic acid) have been linked to protection against the development of cervical dysplasia but these levels may only be a marker for eating more fruit and vegetables.19 20

Women with cervical dysplasia may have lower blood levels of beta-carotene and vitamin E21 22 compared to healthy women. Low levels of selenium23 and low dietary intake of vitamin C24 25 have also been observed in women with cervical dysplasia. Women with a low intake of vitamin A have an increased risk of cervical dysplasia.26 However, there is little research on the use of vitamin A as a treatment for cervical dysplasia.

In a double-blind trial, when women with cervical abnormalities were given either 500 mg of vitamin C or 50,000 IU beta-carotene per day for two years, no significant evidence of improvement was seen in either group, and those assigned to both supplements experienced a statistically insignificant worsening of their condition.27 Given that the apparent association between these supplements and deterioration of the condition of the cervix appears to have been due to chance, there is currently no sound evidence supporting the use of vitamin C or beta-carotene supplements for women with cervical dysplasia.

Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.

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Herbs that may be helpful

In a preliminary study, women with cervical dysplasia were randomly assigned to receive either (1) 200 mg per day of (-)-epigallocatechin-3-gallate (a flavonoid found in green tea), (2) 200 mg per day of poly E (a green tea extract), or (3) no treatment (control group) for 8 to 12 weeks. Approximately two-thirds of the women receiving (-)-epigallocatechin-3-gallate or poly E had an improvement in their Pap smear, compared with only 10% of the women in the control group.28

Several other herbs have been used as part of an approach for women with mild cervical dysplasia, including myrrh, echinacea, usnea, goldenseal, marshmallow, and yarrow.29 These herbs are used for their antiviral actions as well as to stimulate tissue healing; they are generally administered in a suppository preparation. No clinical trials have proven their effectiveness in treating cervical dysplasia. A doctor should be consulted to discuss the use and availability of these herbs.

Are there any side effects or interactions?
Refer to the individual herb for information about any side effects or interactions.

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References
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