For the ladies...pap tests

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Veteran Member

Date Joined Jan 2003
Total Posts : 1928
   Posted 6/24/2008 4:01 AM (GMT -7)   
I can't remember if I ever posted this information. So if this is a repeat, my apologies.

I thought I should give a heads up to the women on the board about pap tests. I'm not trying to incite a riot or fear, but just some info. For those who are on meds that affect the immune system (6MP, imuran, methotrexate, prednisone) and know that you are positive for HPV, make sure you go in for your annual pap smear if you don't. The reason for my post is that there's a risk for those who are on these meds to develop cervical dysplasia which can lead to cervical cancer. Normally our immune systems do a decent job fighting off the HPV so it doesn't do a lot of damage, but when we mess with our immune system then it can start to lose that battle.

My personal experience was never really having abnormal paps until late last year. Then all of a sudden I had severe dysplasia due to HPV. I had a colposcopy but it came back, so I had to have a LEEP. I discussed this with my GI doc and my gynecologist, who concurred that the Methotrexate could be causing the HPV to take over and thus the dysplasia. My GI took me off MTX so I'm only on Humira now. My argument was I'd rather have some crohn's than risk the dysplasia going over to cancer since it was pretty aggressive. After the LEEP, no dysplasia was seen on my follow up pap 4 months later. Now I have to go in every 6 months to be monitored, which is fine with me. I figure I can get to know my gynecologist as well as my GI doc tongue

During this I also emailed a GI doc who specializes in women's issues and has some published research on this topic. Her opinion was to lose the MTX and any steroids, but that the TNF drug (I'm on Humira) was safe.

This PSA was brought to you by the letter C and the number 8. scool
"Only the meek get pinched...the bold survive."

Regular Member

Date Joined Dec 2007
Total Posts : 298
   Posted 6/24/2008 6:29 AM (GMT -7)   
Thanks for posting. I read in the past that women with IBD on the immunosuppressants have more abnormal pap smears. I'm not on anything right now, but I've been getting the ladies' check-up annually since I was 19 or 20...It's not the most pleasant thing, but I didn't think it was optional.

Could you send me the name of the GI doc you contacted?
July 2007 Drug-Induced Liver Injury
January 2008 Crohn's Ileitis
Currently trying...
Enteral Nutrition, Omega-3 (Flax Oil and Fish Oil), VSL#3, Vitamin E

Regular Member

Date Joined Jun 2008
Total Posts : 167
   Posted 6/24/2008 8:55 AM (GMT -7)   
That is interesting. Good info to know.

I am positive for HPV and have been going for regular colposcomies for a few years. I had mild dysplasia that never changed so I have had nothing other than regular biopsies done.

Now after having a major crohn's flare my GI brought my case to a national GI thing and all were agreed that I could safely use Imuran. He also talked in legnth to my Gyno and he agreed that I should be fine as well.
So I started the Imuran 4 weeks ago. I go for another colposcomy next week so we shall see how that goes.

Dx with Crohn's in 1997 after 5 years of worsening symptoms.
Resection a few months after dx after 1 month on TPN and IV steroids.
Also have severe asthma.

Tried: Pentasa, Cholestyramine

Presently taking: 3.2 grams Asacol, 150 Imuran (just started June 08), down to 20mg predisone, probiotics. For asthma I take Advair 500, singulair, arieus

Veteran Member

Date Joined May 2005
Total Posts : 4219
   Posted 6/24/2008 1:02 PM (GMT -7)   
It is so unfair that an STD can be so devastating to women and do practically nothing to men.
26 Year old married female law student (last year!!). Diagnosed w/ CD 4 years ago, IBS for over 10 years before that, which was probably the CD. I am sort of lactose intollerant too but can handle anything cultured and do well w/ lactose pills and lactaid. For crohns I am currently on Pentasa 4 pills/4x day and hysociamine prn. I also have bad acid reflux and have been on PPI's since age 13. I have been through prilosec, prevacid, and nexium. Currently I am on Protonix in the morning and Zantac at night. I also take a birth control pill to allow some fun in my life.

Veteran Member

Date Joined May 2003
Total Posts : 9448
   Posted 6/24/2008 2:18 PM (GMT -7)   
BetaGirl!!! So GREAT to see you post!!! (((hugs))) Thanks for the headsup too.
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.

Veteran Member

Date Joined Nov 2003
Total Posts : 7314
   Posted 6/24/2008 6:04 PM (GMT -7)   
I also had cervical dysplasia, but mine wasn't as aggressive and was only stage 2. Back then, there was the possibility of testing for HPV, but my Doc and I decided that it wasn't worth it. In all liklihood I would test positive and there wasn't a treatment anyway, so why spend the money on the test? I had the dysplasia removed by laser and did my 3 month and then 6 month followups. All of my subsequent PAPs were normal.

The interesting thing is that all of that happened many years before I was Dx and immunosuppressed. Now that I'm on all these meds, I make certain to get my annual exam. Since I've been there and done that, I'm not feeling like having a repeat.

Thanks to the letter C and number 8!
Keah a.k.a. Wormy
 God helps those who help themselves.
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Veteran Member

Date Joined Mar 2006
Total Posts : 1354
   Posted 6/24/2008 7:01 PM (GMT -7)   
I too had an abnormal pap smear - stage three - last year and had the LEEP procedure only three weeks before my bowel resection.
I had never had an abnormal pap smear prior to this and gyno agreed it was due to MTX and pred. I have had a follow up pap smear and colposcopy six months later ( biopsies done but all clear) and am due again in August for my next six monthly.
I was quite shocked for this to have happened, when I think of being immuno suppressed I thought of other viruses not a "female type" one to be susceptible to. Quite naive really.
Betagirl its great that you have brought this to the female forum readers attention.
Take care

Veteran Member

Date Joined Jan 2003
Total Posts : 1928
   Posted 6/25/2008 5:45 AM (GMT -7)   
What's shaking C2? Still causing trouble over there?

Thanks for those who added their info. It was certainly something I'd never heard of/thought about.
"Only the meek get pinched...the bold survive."

Regular Member

Date Joined Oct 2006
Total Posts : 367
   Posted 6/25/2008 7:05 AM (GMT -7)   
Personally, I think it's an ibd thing. I think different meds can speed the process of dysplasia, but I think we gals w/IBD need to stay on top of paps no matter what meds we are taking. I have never been on steroids, IM, or TNFs and I've had abnormal paps for the three years--dx'ed with CD 6 years ago.

Veteran Member

Date Joined Mar 2007
Total Posts : 1642
   Posted 6/25/2008 7:08 AM (GMT -7)   
thanks for the info! I need to get my pap, it has been a couple years. I am switching to Humira too...


Karen (Karendee)

Diagnosed w/ Crohn’s Disease  March 2007 On 150mg Azathioprine (generic Imuran), Pentasa, & Entocort (take zofran for nausea now)

Diagnosed w/  Fibromyalgia May 2007 also on Soma

Also on Prilosec 2x a day for reflux.


Veteran Member

Date Joined Jan 2006
Total Posts : 3143
   Posted 6/25/2008 7:12 AM (GMT -7)   
Beta....missed your input here!  No riot incited, I just appreciate the info.  I have decided against starting Imuran.6MP.humira.  I always appreciate additional information I can use to explain to my GI doc what I am weighing when I make these decisions.  I just feel like I am doing really well and do not need these potential new issues
ps C is for cookie that's good enough for me, C is for cookie that's good enough to eat (over age 40 and no kids, but I still remember cookie's song!)
Dx'd '90 (emergency rupture), symptoms ignored long before that, '03 fistulas and bad flagyl reactions, B12 weekly, Pentasa [until I surrender to the bigger meds]
I'm riding on the escalator of life....

Veteran Member

Date Joined Jan 2003
Total Posts : 1928
   Posted 6/26/2008 5:13 AM (GMT -7)   
Good point Yogi.

Habs - good to see you and that you're doing well. The cookie monster rocks. Did you happen to see him on the Colbert Report the other night? (If you watch the Colbert Report that is)
"Only the meek get pinched...the bold survive."

Regular Member

Date Joined Mar 2008
Total Posts : 274
   Posted 6/26/2008 7:34 AM (GMT -7)   
I had one abnormal pap since I was diagnosed. My Dr recommended I get the Gardasil vaccination so I did and I have been clear ever since. :O) And I know there is controversy out there about it but it was my own choice.
Jenn 26/female
Ulcerative PANCOLITIS diagnosed 2004
Asacol 3 pills once/day
Daily Vitamin for Women and Folic Acid
Currently in a flare since March 6 !!!!!!!!!!!!!!!!!!!!!!!

Veteran Member

Date Joined Jan 2003
Total Posts : 1928
   Posted 6/26/2008 7:43 AM (GMT -7)   
Yeah, I forgot about the vaccine. Thanks for mentioning that. I'm too old to get it unfortunately. I wonder why they cut it off at 26....
"Only the meek get pinched...the bold survive."

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