Receiving the diagnosis of cervical dysplasia can be mentally, emotionally, and physically challenging. Whetheror not you have CIN 1, 2, or 3, your body needs extra support, nourishment, and loving care. Because eachperson has a unique body, there is no one treatment for everybody. Each treatment is individualy designed based upon the degree of change in the cells, your overall health, and the type of treatment that you want to pursue.
Treatments range from the escharotic treatment, specially formulated vaginal suppositories, integrative care for those who need more invasive procedures such as the LEEP, clinical nutrition, lifesytle modification, vitamins, herbs, hydrotherapy, homeopathy, body work, and flower essences. Dr. Abercrombie’s goal is to address your predisposition, support your body’s innate ability to heal and to throw off the HPV infection, support your vaginal ecology and immunity, support healthy replication of cells, and if needed remove the cells that are changed with treatments that cause the least amount of scarring.
What is cervical dysplasia?
- Cervical dysplasia is when the cells on the cervix change and become abnormal. There is a spectrum of change that begins with inflammatory changes and that extends to the CIN classification of dysplasia and then carcinoma.
- Tissue change is measured using two different systems, the PAP smear, which was developed as a screening test, and biopsies of the tissue that are used to get a more accurate picture of the cells following an abnormal PAP smear. Some of the terminology that you hear in association with abnormal PAP smear includes atypical squamous cells, LSIL which is a low grade amount of change, and HSIL which is a high amount of change. When the tissue is biopsied, an LSIL lesion will typically correlate with CIN-1 classification which is considered a low grade lesion, and an HSIL lesion will correlate with CIN 2 and CIN 3 classifications which are considered as high grade lesions. Histologically, the CIN classifications define the degree of cellular change to describe premalignant changes.
How common is this?
- Fortunately, the most common abnormal results of a PAP smear are the low-grade inflammatory changes which will likely resolve on their own without any intervention. About 1 million CIN classification changes are diagnosed each year within the U.S. It is estimated that 4% of PAP screenings result in CIN 1 and 5% of screenings result in CIN 2 & 3. About 500,000 cases of CIN 2 & 3 dx/yr in the US, of which 50-60% are caused by HPV strains 16 & 18.
- CIN 2 has a self-resolution rate of 40% in females under the age of 25, and 90% in adolescent women.
- The higher grade changes are more commonly found in women between 25-35 years old, and invasive cancer is commonly diagnosed after the age of 40.
What causes the cervical changes?
- There is a strong correlation between the human papilloma virus, also known as HPV, causing the cellular changes seen with cervical dysplasia. The lifetime risk of HPV infection in sexually active people in the US is 80-85%. Most HPV infections are transient where over 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.
- There are over 100 different strains of HPV, each strain has a different capability to cause changes. The most common strains that are associated with high grade cellular changes are HPV 16 & 18. Strains 6 & 11 are associated with causing low grade cellular changes. It can take more than 10 years after the onset of the HPV infection for high grade cellular changes to be detected.
- HPV is able to cause cellular changes because it integrates its DNA into our cellular DNA that activates cell growth and suppresses our immune response and programed cell death. But an HPV infection alone is usually not sufficient enough to cause the cellular changes; it needs a combination of risk factors that put enough stress on the body to make the cervix tissue susceptible to the infection.
What are the risk factors associated with increasing HPV’s ability to cause cervical changes?
- Smoking: Smoking is one of the most significant & modifiable risk factors for cervical dysplasia & the potential development of cervical cancer. The breakdown of nicotine, cotinine, or NNK become concentrated in cervical mucous that increases the duration of an HPV infection and decreases the ability of the body to clear the infection. They may also cause their own cellular changes, and can decrease the local immunity. This creates an impaired ecosystem.
- Any condition that suppresses the immune system which allows the HPV to hang out longer in the area.
- Sexually transmitted diseases such as herpes simplex virus and chlamydia are a risk factor purely due a potential HPV exposure, and can be a causal factor itself by decreasing the local immune system and protective factors, allowing persistence of the HPV virus.
What are the usual treatments?
- Depending on the extent of cellular change, treatment varies between watching and waiting to see if the body clears the infection, therapies that remove the tissue through cryotherapy, use of lasers, or surgical removal of the tissue through procedures such as the LEEP and cold knife cone.
How does a Naturopathic Doctor treat Cervical Dysplasia?
The goal of treating cervical dysplasia is to support the body’s innate ability to throw off the HPV infection, to create a healthy vaginal ecosystem that supports a healthy local immune system, and to support the health of the cervical cells to reverse and prevent cellular changes. Some women are candidates for the escharotic treatment, a therapy that removes the abnormal cells using a series of botanicals and minerals. While escharotic treatments still cause scarring, they can cause less scarring than other treatments that destroy the tissue. Studies are showing that escharotic treatments of high-grade cervical changes with satisfactory tissue biopsies hold promise as an effective and low-risk alternative therapy to LEEP and other excisional procedures.
Dr. Abercrombie will work with you to design your unique treatment plan that fits your specific needs. She will spend the time to educate you and to make sure that you understand all of your options. Even if you are not a candidate for the escharotic treatment, if you have already had a LEEP procedure, if you have low grad inflammatory changes, or if you just want to maintain healthy cervical tissue, there is much that you can do through nutrition, lifestyle modification, detoxes that rev up the body, homeopathy, flower essences, stress management, and vaginal suppositories to support and nurture the health of your cervix.
Some of the treatments commonly used to heal the tissue and support the body’s innate ability to prevent HPV changes include vaginal suppositories that contain botanicals that are anti-viral in nature, that decrease local inflammation, and that support the healing of the local tissue. Usually a series of supplements are designed uniquely for the woman to help increase the health of the cervical tissue by supporting the immune system, helping the body to process your hormones correctly, promote detoxification, decrease inflammation, decrease the stress on the body so that it can function at a higher level, support normal cell growth and division, and help your body fight HPV.
Naturopathic visits also delve into nutrition and lifestyle modification. There are specific dietary measures for treating cervical dysplasia such as cleaning out preservatives, additives, and other chemicals and consuming a diet rich in colorful fruits and vegetables that will provide the body with the right vitamins, minerals, and flavonoids that support the terrain of the body, support innate defense mechanisms from HPV infections, and prevent cancer as many studies are showing. Many of these factors that contribute to the progression of dysplasia, such as nutrient deficiencies, can be reversed, which will aid in regression of the lesions.
Some basic treatments that Dr. Abercrombie will help you create can support the body during this time of change and include:
- Mental/emotional outlook: create a strong support network and manage the emotions that arise.
- Detoxification: gentle detoxification that uses nutrients and botanicals to support the liver’s conversion phase 1 and phase 2 pathways to promote its ability to process estrogen and its resultant metabolites.
- Support creating a regular physical exercise routine that will help elimination of toxins and hormone metabolites through stimulating routes of elimination such as breathing, sweating, and regular bowel movements.
- Stress management: Chronic stress is known to decrease the immune system, and specifically sIgA, a particular antibody in the immune system. Because sIgA is a local immune defense on the mucous membranes, local immunity is challenged when stress decreases sIgA. Managing stress can encompass a variety of treatments that range from emotional work, journaling, exercise, breathing exercises, body work, sleep therapy, and nutraceutical supplementation.