Dr. Keith Johansen: Cervical Health

This Mayo Clinic Medical Edge Weekend episode features Mayo Clinic physician, Dr. Keith Johansen.

Medical Edge Weekend 1-14-12


  1. Mari Elder
    Posted January 7, 2012 at 12:02 pm | Permalink

    I am in my 60s and I find the pap smear procedure so uncomfortable that I am putting off going for my next exam. Is there another way to “exam” this area, like with an ultrasound?

    • Tracy
      Posted January 17, 2012 at 1:32 pm | Permalink

      Dr. Johansen replies, “Find a provider that will listens to the question of discomfort and they can use narrower speculum lubricated lightly to not interfere with PAP test. Also the question if the pelvic exam is that uncomfortable she may wish to explore that issue with her provider. Also if paps were comfortable and not now, may have atrophic vaginitis from lack of estrogen. Can be treated easily with topical estrogen in the vagina with little risk for estrogen related side effects.”

  2. Jana
    Posted January 12, 2012 at 8:06 pm | Permalink

    My daughter received the first dose of the hpv vaccine, but since then I have done more research and am concerned that the risk/benefit ratio for this vaccine does not warrant continuing with the second and third doses. Considering she is only 11 and the vaccine only provides protection for 5 years against only 2 of at least 15 oncogenic hpv strains, is it alright to forgo the other two doses for now until more long-term safety data is available? I am pro-vaccine but this one is not so cut and dried…what are your thoughts? Thank-you!

    • Tracy
      Posted January 17, 2012 at 1:31 pm | Permalink

      Dr. Johansen replies, “The vaccine may work much longer than 5 years that information was from the 5 year followup that showed it to be effective now it is 6 years. It is very close to 100 % effective in preventing precancerous lesions. Of the two strains #16 and # 18 that it is effective against they cause at least 70% of the cervical cancers in females. A newer vaccine may be coming that has 9 viral types but the quadrivalent vaccine protects against 16 and 18 the oncogenic types and 6 & 11 the venereal wart virus and while they are not oncogenic they cause abnormal PAP and warts that are a bother and expense to treat. It seems very effective and I suspect as the followup in years goes on, so will the effective time period. Also if you prevent early infection it may protect the cervix as time goes on the cervix changes the rate at which cells change and the epithelium matures in older women it may be resistant to the infection.”

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