Can medication affect your smear test

[Amanda89]

I recently had a smear test done, and received a letter on Friday informing me that there was mild changes and I've to be retested in 6 months time. Is it possible Infliximab or Azathioprine can affect you?

Also, it says in the leaflet I was provided that the HPV virus is protected by your immune system. but if my immune system is crap due to immunosuppressents, does this mean it's not doing its job?

 

[theOcean]

Did it state what the changes were? I had a smear test done recently and everything was fine, though I can look it up and doublecheck. Otherwise, Infliximab and Azathioprine do both affect your immune system so it may have made you prone to infection. (Though hopefully not.)

I think that would only be the case with HPV if you were too immunosuppressed, which happens to some people. But then they're usually getting sick constantly, so you would know if you were.

If you're concerned, Gardasil (HPV vaccine) does not use live virus so you could get it safely even while immunosuppressed.

 

[Jennifer]

I haven't heard of meds messing up the smear results but I know they can mess with your period and birth control so I don't think it's impossible. One thing to keep in mind with that test is to never have sex the day before. The test often comes back abnormal if you do. If you did engage in sexual activity then that's the likely culprit but if not then continue testing to make sure that everything is ok.

 

[Amanda89]

May have been the birth control I guess. Fingers crossed anyway! Nope, just said it was minor changes..not really much help eh?

 

[dreamintwilight]

I absolutely think medications can alter pap results. Ever since my dosage of azathioprine increased above 75mg (I'm now up to 125mg daily), I've had "atypical squamous cells of undetermined significance" results. Also known as ASCUS). The first time I received that result, I totally freaked out, thinking it meant I had HPV, but they tested for that and it came back negative for HPV. I've since received an ASCUS result 3 times in a row. After the first time, I was scheduled to come back in 6 months to have a repeat test. Since it was still the same, they scheduled me to have a colposcopy to take a biopsy. Thankfully, nothing cancerous or pre-cancerous was found. My doc said ASCUS results aren't of concern and usually just require yearly paps to make sure nothing changes. I think I read a while back someone on here said their gyno believed that it's possible for women with Crohn's to just have residual inflammation down there, which can cause an "atypical" result.

That said...I just moved and had to find a new doctor, who I saw last Wednesday. I feel like she doesn't have a whole lot of experience with patients who also have Crohn's and/or how medications affect women. I'm waiting to hear back about my pap results. I forgot to ask what her philosophy is when it comes to ASCUS results. Hopefully it will come back as only that (or normal would be even better!) and I won't have to come back in 6 months.

But yeah...all that to say, I'm totally a believer in our medications having an affect on our pap results. I hadn't had any issues prior to 2011 and had been on both Humira and azathioprine for over a year with normal results. Once I was moved up to 100 mg of azathioprine was when I started having the atypical results.

Let us know how things go in 6 months!

 

[dreamintwilight]

Well, just heard results back from my latest pap test. No surprise...ASCUS results again. So, looks like I'll be headed to my gyno around Christmastime. Rats!

Amanda89 - I guess you will have had your follow-up the month before mine, based on the date of your original post here. Let us know how things go. Hopefully you won't be like me and whatever slightly abnormal results you may have had will resolve on its own.

 

[Amanda89]

Hi Maria, unfortunately 2nd smear came back with changes again so I've been referred for Colposcopy!

 

[dreamintwilight]

Hey Amanda! Have you had your colpo done? How did it go?

I just got back from getting my pap smear redone and I asked me doc this time what happens if it comes back with the same results (ASCUS, but negative for HPV). She said I would have to get a colposcopy done. That didn't make me too happy, but I understood if maybe she wanted to double check and make sure things were okay. I asked her what happens if the colposcopy looks normal, then what, and she said I would have to have another pap in 6 months. So, I asked her, "So, I would just have to keep getting paps every 6 months if the same result happens?" And her response was "Well, we take it on a case by case basis." What the heck does that mean?? I feel like she totally forgot about my previous history (which I explained to her in June and brought my personal records with me, despite her not finding it important to make copies of) and is just going based off textbook procedures or something. I'd understand having to have paps annually, especially given the fact that I have a compromised immune system, but every 6 months seems excessive to me since I've also never tested positive for any high risk strains of HPV. Does anyone else have any experience/opinions on this?

It's really frustrating feeling like I have to start over again with this new doctor. I wish I felt like she was taking my previous history into account, but after I mentioned I had had a colpo done before and she asked me when that was, it made me realize she likely didn't remember any of my previous issues I had discussed with her. I really do not want to have to think about going somewhere else to get a 2nd opinion, but I suppose it may come to that if I feel like she's not listening to me. Maybe I should print out the literature online I've read about the current recommended guidelines healthy, normal women my age who get ASCUS paps but negative HPV results and show them to her. Everything I've read leads me to believe that as long as I'm HPV negative, I should be more likely to follow routine recommended guidelines for testing. That said, it does say that immunecompromised women shouldn't follow routine screening and may need to be monitored more frequently, but it doesn't specify what the recommended guidelines are for that special population. Oy. Every 6 months still sounds excessive to me. No clue if that would also include periodic colpos on top of that too. Rrrgh.

Sorry for totally hijacking this thread, but maybe someone else might find this info helpful if they ever find themselves in the same boat. :/

Here are the links I've looked at:

http://www.asccp.org/Portals/9/docs/ASCCP Updated Guidelines - 3.21.13.pdf
http://www.acog.org/~/media/Districts/District II/PDFs/USPSTF_Cervical_Ca_Screening_Guidelines.pdf
http://www.cancer.org/cancer/news/news/new-screening-guidelines-for-cervical-cancer