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Cervical Dysplasia


Description

Cervical dysplasia is a term used to describe the appearance of abnormal cells on the surface of the cervix, the lowest part of the uterus.

Mild dysplasia is the most common form, and up to 70% of these cases regress on their own (i.e., the cervical tissue returns to normal without treatment). Left untreated, dysplasia sometimes progresses to an early form of cancer known as cervical carcinoma in situ, and eventually to invasive cervical cancer.



Causes

Several risk factors have been linked to dysplasia including multiple sexual partners, early onset of sexual activity, cigarette smoking, and sexually transmitted diseases, especially human papillomavirus (HPV) and HIV infection.

Eighty to ninety percent of women with cervical dysplasia have an HPV infection. Human papillomavirus (HPV) is a group of more than 80 different viral strains. About one-third are sexually transmitted, and some types cause genital warts. HPV infects about 25 million people in the United States, and most of the viral strains are harmless.

Most HPV infections resolve within 6 months and many women develop immunity. Untreated HPV can result in recurrent and persistent cervical dysplasia and many experts believe that HPV is the main cause for changes in cervical cells that result in dysplasia.

Risk factors: Smoking

Nicotine and cotinine, chemicals produced from tobacco, have been found in the cervical cells of women who smoke. Men who smoke also excrete these chemicals in their semen, which comes in contact with the cervix during sexual intercourse. Tobacco chemicals may cause alterations in the cells that lead to dysplasia.

High-risk sexual behavior

Having multiple sex partners, having sex with a man who has had multiple sex partners, and engaging in sexual intercourse before the age of 18 are linked to cervical dysplasia. Women in these categories have a greater chance of being infected with HPV or HIV, especially if they do not use a barrier contraceptive such as a condom. These infections put them at higher risk for developing cervical dysplasia.

DES Exposure

Between 1938 and 1971, approximately 5 million pregnant women were prescribed diethylstilbestrol (DES), a synthetic estrogen thought to help prevent miscarriage. Its use was discontinued when researchers found it to be ineffective and dangerous. The daughters of women who took DES have a higher risk for developing rare cancer of the vagina or cervix, called clear cell adenocarcinoma, and abnormalities of the cervix, vagina, and uterus.

Poor Nutrition

There is growing evidence that certain vitamins, such as folic acid, play a role in cervical health. A poor diet may also cause the immune system to weaken, decreasing the body's ability to fight viruses such as HPV.

Oral Contraceptives

Some research shows that women who use oral contraceptives may be at a higher risk for developing cervical dysplasia. However, it is not clear if the risk is directly attributable to the contraceptives themselves. One reason may be that oral contraceptives interfere with folic acid metabolism in the cells around the cervix, and folic acid may help prevent or improve cervical dysplasia. Another reason may be that women using this method of birth control may have increased exposure to sexually transmitted diseases, compared to those who rely on a barrier method such as a condom.

Coffee

Coffee is a known phytoestrogen that exacerbates Cervical Dysplasia. Since it is a phytoestrogen, decaffeinated coffee may still be able to act as an estrogen. Coffee has been also shown to increase estradiol levels in women provoking cervical dysplasia.



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