Cervical Dysplasia: It’s the diagnosis many women carry yet none want to talk about. It’s mentally, physically, and emotionally exhausting. It’s a time when the body needs extra support and loving care, yet many are too embarrassed to search for help. So what does one do when they receive this diagnosis? First, let’s go over some basics.
Let’s Look At Some Statistics:1
- The most common results of an abnormal PAP smear typically portray low-grade inflammatory changes that usually resolve on their own without the need of any intervention.
- It is estimated that about 1 million CIN classification changes are diagnosed each year within the U.S.
- CIN 2 has a self-resolution rate of 40% in females under the age of 25 and a 90% resolution rate in adolescent women.
- Higher-grade changes are more often found in women between the ages of 25-35 years old, and invasive cancer is commonly diagnosed after they reach the age of 40.
- The lifetime risk of developing an HPV infection in sexually active people in the U.S. is around 80%.
- There are over 100 different strains of HPV and each strain has a different capability to cause cellular changes. The most common strains associated with high-grade changes are HPV 16 & 18. Strains 6 & 11 are most commonly associated with low-grade cellular changes. It can take more than 10 years after the onset of HPV to detect high-grade cellular changes.
- 50% of new infections are cleared in 6-18 months, and 80-90% will resolve within 2-5 years. Transient infections are common in young women. 90% of women who have HPV will have a persistent infection without cellular changes.
What Are The Risk Factors For HPV Abnormal Cell Progression?
HPV is able to cause cellular changes because it integrates its DNA into our cellular DNA, activating cell growth while suppressing our immune response.2 An HPV infection alone is typically not sufficient enough to cause cellular changes; it needs a combination of risk factors that put enough strain on the body to make the cervix tissue susceptible to the infection.3 These include:
- Compromised immune system from a preexisting condition
- Poor Diet
- Nutritional Deficiencies
- Genetic Predisposition
Cervical dysplasia is strongly correlated with the virus HPV, or human papillomavirus, that turns healthy cervical cells into abnormal, precancerous cells. There are 13 strains of high risk HPV: HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68. In the beginning stages the abnormal cells are not yet considered cancerous and may resolve on their own, yet if left untreated they have the potential of progressing to cervical cancer.5 Your doctor, whether a gynecologist or naturopathic doctor, screens for cervical dysplasia with the PAP smear.
In determining a diagnosis for cervical dysplasia, there is a spectrum of change that begins in the cervix with inflammatory markers. Tissue change is measured using two different systems: the PAP smear and then if needed a biopsy. The PAP smear was developed as a screening test. Once a marker is noticed on a PAP result, a biopsy, or colposcopy, is typically taken of the tissue in order to develop a more accurate picture of the abnormal cells and their progression. Atypical squamous cells, or LSIL, are indicative of a low-grade amount of chance on the PAP while HSIL is indicative of a high amount of change within the cell on the PAP. When the tissue is biopsied, histologically the results range from normal cells to CIN 1 through 3, as pre-cancerous lesions. CIN 1 is a lower grade change, while CIN 3 is a higher grade of change6.
Management options and natural medicine
If the degree of change is CIN I or lower, you may be told to watch and wait and repeat the PAP in 6 months depending on your risk factors and past medical history. If the degree of change is CIN 2-3, immediate treatment is recommended and women are often recommended to have the LEEP procedure or cold knife cone. In both procedures, the abnormal tissue is being cut out and removed. For moderate to severe cervical dysplasia (CIN II & III), studies show that escharotic treatments of high-grade cervical changes with satisfactory tissue biopsies hold promise as an effective and low-risk alternative therapy to a LEEP and other excisional procedures. Instead of having a LEEP procedure, the escharotic treatment is available as an alternate therapy if the changes to the cervix are only located on the face of the cervix. In some situations, the cells are too progressed and a LEEP procedure is necessary6.
What is an Escharotic Treatment?
An escharotic treatment is a series of in-office treatments that paint an escharotic mixture of sanguinaria and zinc chloride onto the cervix. This mixture causes burning of the cervical cells to remove the abnormal tissue. It has less side effects and is less invasive compared to other ablative treatment. Following the in-office procedure, at-home treatments of vaginal suppositories that use botanicals and vitamins to remove the dysplastic tissue and support cervical healing7.
Regardless of whether you are harboring a diagnosis of HPV, cervical dysplasia, or CIN, know that there is hope in finding relief through integrative treatments.
Dr. Abercrombie is a California Licensed Doctor of Naturopathic Medicine. While she maintains a general practice, she specializes in women’s health, fertility, PMS, cervical dysplasia, auto-immune disease, thyroid conditions, adrenal dysfunction, mood balance, gastrointestinal disorders, and pediatrics. Dr. Abercrombie understands illness as a disruption of physiology and normal function of the body. She strives to identify and remove barriers to healing while supporting the innate ability of the body to heal; empowering her patients with their personal health. She received her doctorate from the National College of Natural Medicine in Portland, Oregon. She completed a year gynecology specialized internship with Dr. Kimberly Windstar-Hamlin, ND, which emphasized women’s health concerns, cervical dysplasia, as well as infertility, thyroid disorders, and autoimmune diseases. Dr. Abercrombie is an active member of the American Association of Naturopathic Physicians, the California Naturopathic Doctors Association, the American College for Advancement in Medicine, and the Endocrinology Association of Naturopathic Physicians.
- “Human Papillomavirus.”Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 26 Mar. 2015. Web. 15 Apr. 2015. <http://www.cdc.gov/hpv/>.
- Madkan, V, Cook-Norris, R, Steadman, M, Arora, A, Mendoza, N, Tyring, S. The oncogenic potential of human papillomaviruses: a review on the role of host genetics and environmental cofactors.National Center for Biotechnology Information. 2007. Available at: http://www.ncbi.nlm.nih.gov/pubmed/17553059. Accessed April 15, 2015.
- Rieck, G, Fiander, A. The effect of lifestyle factors on gynaecological cancer.National Center for Biotechnology Information. 2006. Available at: http://www.ncbi.nlm.nih.gov/pubmed/16543119. Accessed April 15, 2015.
- Tolstrup, J, Munk, C, Thomsen, B, et al. The role of smoking an alcohol intake in the development of high-grade squamous intraepithelial lesions among high-risk HPV-positive women.National Center for Biotechnology Information. 2006. Available at: http://www.ncbi.nlm.nih.gov/pubmed/16929418. Accessed April 15, 2015.
- Montero, J, Larkin, J, Toney, J, Haley, J. Examining the complex relationship of Human Papillomavirus to cervical dysplasia and carcinoma.Medscape Log In. 1999. Available at: http://www.medscape.com/viewarticle/719250_1. Accessed April 15, 2015.
- Massad, LS, Einstein, MH, Huh, WK, et al. 2012 Updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors.Obstetrics & Gynecology. 2013;121(4):829-846. doi:10.1097/AOG.0b013e3182883a34.
- Jellinek, N, Maloney, ME. Escharotic and other botanical agents for the treatment of skin cancer: A review. 2005. Available at: http://www.jaad.org/article/s0190-9622%2805%2901429-5/abstract. Accessed April 15, 2015.