Cervical Dysplasia: Stages, Causes, Symptoms, Pregnancy, Treatment, Prognosis, Prevention

The cervix is the narrow opening of the uterus (womb) situated between the rectum and the bladder. Cervical dysplasia is a precancerous disorder in which the cells on the cervix grow abnormally. The term dysplasia is defined as an abnormal growth of cells under a microscopic view. The degree of this abnormal growth can be tested under tissue biopsy and is classified into three stages:

• Mild
• Moderate
• Severe.

Cervical dysplasia can be measured using Pap smear, which is a tool to measure the normal or abnormal cell growth on the cervix.

A precancerous disorder of abnormal growth of cells on the surface of the cervix caused by the Human Papillomavirus (HPV) is called cervical dysplasia. HPV is a virus causing sexually transmitted disorder.

Cervical dysplasia affects women of any age, especially between 25 to 30 years. In U.S, the number of women infected with cervical dysplasia lies between 250,000 to one million.

Cervical dysplasia may get critical and result into cervical cancer if it is not treated properly. Cervical cancer occurs when the abnormal cell growth get deeper into the tissues. Women above age 40 have a higher risk of cervical cancer.

There are no significant signs or symptoms, through which cervical dysplasia can be diagnosed. However, it is associated with other symptoms like:

• Irregular bleeding
• Genital warts
• Atypical vaginal discharge
• Bleeding post menopause
• Pain in lower back
• Prolonged menstruation
• Pain during intercourse
• Spotting post intercourse.

These symptoms need to be diagnosed carefully as it may be due to other conditions.

The stages of cervical dysplasia are divided into three, based on its severity:

• Mild Stage of Cervical Dysplasia- This type of cervical dysplasia is the primary stage, in which 70% cases get cured unaided.
• Moderate Stage of Cervical Dysplasia- The cervical dysplasia of moderate stage is more severe and requires treatment and proper care. This may develop into cancer.
• Severe Stage of Cervical Dysplasia- The cervical dysplasia at severe stage is more advanced and shows the signs of precancerous cells.

The women suffering from cervical dysplasia at a milder stage have higher chances of getting pregnant. There is no direct relation between the occurrence of cervical dysplasia and pregnancy. However, if the number of occurrences is higher the chances of conceiving are lower. However, if a woman with cervical dysplasia becomes pregnant, the doctor would take extra care and routine check-ups are required. Having cervical dysplasia can increase the chances of pre-term delivery. Yet, one can have a normal pregnancy without causing any harm to the baby.

Pap smear is a useful tool to measure the abnormal cell growth and detecting cervical dysplasia. However, 2% of women who have a positive result suffer from cervical dysplasia.

Almost all cases of cervical dysplasia get cured if they are managed and treated properly. Improper treatment may lead to cervical cancer. Women even after getting cured, have a higher risk of recurrence. The number of cervical cancer patients has reduced significantly with timely screening and treatment of cervical dysplasia.

The human papilloma virus (HPV) which is sexually transmitted causes cervical dysplasia. There are various types of HPV, out of which some lead to cervical dysplasia or cancer. It is seen among women of age of 25-35 years.

The causes of cervical dysplasia are not identified. However, there are a certain factors which increase the risk of getting the chances of cervical cancer. These factors are discussed below.

The factors that increase the chances of cervical cancer are:

• Smoking– exposure to smoke
• Genital warts
• HPV-Human Papillomavirus infection can cause cervical dysplasia
• Having sex before 18 years of age
• Multiple sexual partners can be a cause for Cervical Dysplasia
• Having a baby at 16 years of age or below
• Patients taking immunosuppression drugs
• Immunodeficiency disorders
• Patients with organ transplant
• Patients with HIV
• Low levels of vitamin B9 in red blood cells
• The vulnerability of diethylstilbestrol (DES), used between 1938-1971 for a sustained pregnancy
• Regular intake of contraceptive pills.

The diagnosis of cervical dysplasia can be done with the help of following tests:

• Pap smear-This test is used to identify the abnormal cell growth and its degree. Cervical dysplasia identified using this test is known as SIL- Squamous intraepithelial lesion. Squamous intraepithelial lesion can further be classified into:
  • LSIL- Low grade squamous intraepithelial lesion
  • HSIL- High grade squamous intraepithelial lesion
  • Malignant- Cancerous
  • AGUs-Abnormal Glandular cells
• Biopsy-This test is used to find if there are signs of the disorder. Cervical dysplasia assessed using biopsy on the cervix is termed as CIN- Cervical intraepithelial neoplasia. These are classified into three stages:
  • CIN- I – Mild cervical cancer
  • CIN- II – Moderate cervical cancer
  • CIN- III – Severe cervical cancer

The types of biopsy that can be used to measure the cervical dysplasia are:

• Cone biopsy
• Direct biopsy- colposcopy
• LEEP excision- Administered after colposcopy

• HPV DNA Test –It is a test to measure the HPV- Human papillomavirus, which are highly risky to cause cervical cancer. This test can be administered on:
  • Any women who have a negative Pap smear test result
  • Women over age 30 as a screening test.

The treatment for cervical dysplasia includes the following:

• Medications to Treat Cervical Dysplasia- Allopathic treatment can be given to treat mild cervical dysplasia by reducing the abnormal cell growth. The effect of medication in the treatment of Cervical Dysplasia can be tested regularly using Pap smears test.
• Surgery for Cervical Dysplasia- In case of severe cervical dysplasia, various types of surgeries can be done to remove the infection. These include:
  • Cryosurgery- This type of surgery diminishes the cells by freezing them. The cervical cells can be destroyed using trichloroacetic acid. This solution would burn the cervical cells.
  • Conization- It is a process with the help of which the cone-shaped piece of the cervix is removed. It is highly effective in minimizing HPV infection.
  • Laser surgery- This would help in destroying the cells with the help of a laser.
  • LEEP Procedure for Cervical Dysplasia- LOOP Electrosurgical Excision Procedure destroys the cervical cells using electrical charge with the help of the small loop.
• Exercises- Exercises help in eliminating stress and boosting the immune system. Yoga is also helpful in exceeding the functions in lower body.
• Psychotherapy- Emotional problems have a direct correlation with the cervical dysplasia. Hence, psychotherapy would help in reducing stress.
• Detoxification therapies- This includes sweating, fasting to detoxify the bodies which are prone to smoking, drugs or unhealthy eating.

The following should be kept in mind:

• Food that Should be Avoided in Cervical Dysplasia- Caffeine, alcohol, sugar and fried food, meat and dairy products.
• Food that Should be Consumed in Cervical Dysplasia – Fresh fruits, grains, nuts, yellow and green leafy vegetables and legumes.

The following precautions can help prevent cervical dysplasia:

• Women should avoid risky sexual behaviors
• Avoid smoking
• Avoid contraceptive pills
• Regular Pap test and other gynecological tests should be done to monitor recurrence.

Besides these precautions, a vaccine to treat HPV type 16 helps reducing the chances of cervical dysplasia.

Cervical dysplasia is a precancerous disorder, if untreated would lead to cervical cancer. Proper medication and treatment would help in curing cervical dysplasia. However, education and awareness would avoid getting infected.