High risk hpv in scared menopausal lady needs help

[heidi4591]

Hi
Wrote you earlier about being high risk hpv positive/Feb. 2009 and having only 1 faithful sex partner Ever. I am 55 menopausal healthy nonsmoker .
Gyn records 2002/09
All normal Pap
Inflammation noted each time
Possible bv 2004 & it was stated that I refused treatment.If Dr. told me that I needed treatment I would not refuse; possible it was offered if I wanted it I am sure my understanding was that it was nothing to worry about.
Cytology reports/2004’05, “Request reflex hpv test” but it was not offered to me
Large cervical polyp -benign
No mention of my concern for mole like thing on labia
Had a series of  pc125 tests; 64/2004, 40/2004, 33/2005, 33/2006,and 33 /Jan. 2009, along with  transvaginal ultrasounds that showed small fibroids and 4 large ones.  My understanding was that I was fine.
I have hemorrhoids which I know that I have wiped front to back- just planted hpv back there. I have never had anal sex.

Im SCARED. Gyn  wants  repeat  pap in 6 months; she doesn’t like/use hpv test because thinks that it causes too much unnecessary fear/tests/political?  I understand this for younger women but I think that my circumstances require more caution.  
Pap tests not as good at finding adenocarcinoma because it can be higher up the cervix or deeper in the tissues?  My inflammations (indicate infection?/hpv?) interfere with the accuracy of Pap tests.  If  inflammation has been because of hpv then I have a very persistent lengthy infection which could be bad/cancer news for me?
?s
Is having sex/sperm keeping my viral load too high for my old tissues? Used condoms until my menopause.
Isn’t colposcopy needed?  Waiting 6 months-I'm sick with worry.
Can I get checked for anal, vulvar( very irritated), vaginal cancer? What kind of dr. tests anal cancer?
Do you think that my 7 years of inflammations have been hpv?
Should gyn biopsy my vulvar mole?  
Possiblity I don’t have precancer/ cancer?
Thank you

[H. Hunter Handsfield, M.D.]

Inflammation is very common on pap smears and usually not serious. Please carefullly re-read both my replies above and to your question in March.  Then follow the advice (in both replies) about talking to your gynecologist.

You came to the forum for reassurance -- twice.  I gave it -- twice.  Please accept it and move on, or at least don't argue with it.  Bad outcomes in situations like yours are almost unheard of, and you are not likely to be the exception to the rule.

I won't have any further comments.

[heidi4591]

My Paps were "normal".  Does inflammation make them abnormal?

I sure hope that you are right about me overreacting.  It just seems to me that something must be very wrong for a 55 year old menopausal lady to have hpv when I have only been sexually active with one man my entire life.  It must be a bad? #16 hpv?

[H. Hunter Handsfield, M.D.]

Welcome back to the STD forum.  Unfortunately, it really isn't the right place for the questions you ask.  STD specialists like Dr. Hook and I are experts in sexual transmission and prevention of genital HPV infections, but STD specialists do not manage patients with abnormal pap smears.  That's a gynecology issue.  Just about all the information I have (or that Dr. Hook would have) pertinent to your situation was answered in your other thread last month.  The questions you ask now are ones your gynecologist can answer much better than we can; she is the one to ask.  She probably has cared for literally hundreds of patients with issues essentially the same as yours.

I will say, however, that in general terms you are way overreacting to this situation.  There is nothing to be scared about, even in lower case; upper case SCARED is way beyond reason.  You have a garden-variety, everyday problem that rarely leads to serious outcomes, and from all you say, it seems you are in very good hands with your gynecologist.  Almost all cases of invasive cervical cancer, i.e. stages of the disease that seriously threaten health and life, occur in women who never have pap smears.  It usually takes several years for pre-cancerous cervical abnormalities to progress to that point.  Having a repeat pap every 6 months is essentially 100% assurance against a bad outcome.  To the extent I understand management of pap smear abnormalities, I agree there is no need to keep repeating tests for HPV; the pap test alone is sufficient.

Even though I haven't answered most of your specific questions, I hope this response helps settle your fears.  They really are unwarranted.  Please discuss them openly with your gynecologist.  One approach might be to print out this thread and discuss it with her.  I'll bet she agrees with everything I have said.

Good luck--  HHH, MD