Patient: Ok, I had mirena placed in 2009. Since then I have not had a period. I went to the dr a year ago for weird bleeding. They said it was because I needed new mirena placed. I was also tested and it came back with high risk hpv, as well as abnormal squamous cells. I got a new mirena placed. My dr said that I shouldn’t worry because I’m young (24). I asked for a colposcopy, but he said no. After having the new mirena placed, I still continue to not have periods, however I do bleed after sex. It’s like the beginning of a period, but stops. What is your opinion?
Symptoms: Bleeding after sex, high risk hpv, abnormal squamous cells, weird discharge for the last 2 years
Doctor: Hello.thanks for contcting askthedoctor.comAt 24 , when you are sexuallt active and you have been diagnosed hsil and atypical squamous cell on pap smear ,then you must understand that these lesions are most likely hpv induced and are treated with LEEP procedure or conisation where the lesions are burnt or the part of cervix is cut and removed through electrosurgical techniques. But the disadvantage is the chances of preterm delivery in case the kady gets pregnant increases and cervical competence is compromised.Colposcopy can be offered and a directed biopsy should be taken of acetiwhite areas to rule malignancy in such high grade lesions. Follow up 6 monthly is an advise for low grade lesions and young women.So colposcopy is indicated in your case.Thirdly Mirena should cause amenorhoea so thats what has been achieved and cervical ectopy is a side effect in sexually active women.If the post coital bleeding is not stopped then you probably would have to consider electrosurgical techniques and avoid sex for few months.I hope i have answered your query in detail.wishing you good health.regards