2:38 pm - 08/13/2018

LEEP/Cone biopsy and Nexplanon

Hi everyone! Glad to be here.
I will keep it short and simple. I have normal Pap smear results that are positive for hpv 16- this has been on and off for the past four years. The paps are always “normal” but because of the hpv 16 it always results in me getting a colposcopy. They were always negative until last year. Last year even though my Pap smear was normal- abnormal areas were seen on colposcopy and biopsied- turns out it was cin 1 and was told to just come back in a year. This year, same result- normal pap with +hpv 16. This time on colposcopy not one but two abnormal areas were seen and biopsied (as well as the cervical canal both times)
Anyway, since this is ongoing and may have progressed, I am aware that LEEP or even possibly cone biopsy may be in my future.
I currently use the Nexplanon as contraception and I love it. One of the main reasons I love it is I do not get a single period with it. I am having an irrational fear that I cannot use Nexplanon if I need a LEEP. The nurse practioner and several people at the office told me that it’s fine and has nothing to do with it- but I’m still
Scared because they aren’t the ones who would be doing the LEEP. One of the reasons this scares me is I’ve been reading online that the possibility of developing cervical stenosis may increase if you are on a progestin only method or not getting periods. I personally am not too worried about that as I don’t plan on having kids AND I plan on using Nexplanon until menopause if possible, but I am so nervous that someone’s going to suggest that Nexplanon is contraindicated in people needing leep or cone. Even though my own NP told me no I am still having these fears. Can anyone help!
archangelbeth 18th-Aug-2018 06:26 am (UTC)
Unfortunately, I don't have any experience with any of that -- which is why I hadn't commented anything sooner.

In the absence of much else... I'd go with your NP. From a quick websearch, it seems that increased risk of cervical stenosis is more from having multiple LEEPs -- that was the first hit that jumped out at me (site:gov is a good thing to add to web searches!), rather than anything about progestin-only contraceptives. (Heck, I found some IUD-insertion things for the hormonal IUDs that talk about how to insert despite cervical stenosis. So there's definitely not a "ohs noes, you can't use a hormonal contraceptive at all if there's cervical stenosis!" situation.)

Perhaps you could talk to the nurses about what symptoms you might get, if you did develop cervical stenosis? That way, you'd be able to know when you should go to the doctor, or what tests you might want to do regularly, to ease your mind.

And if you did have a doctor try to get you off Nexplanon, you might consider a hormonal IUD instead, as they are also prone to stop periods in many people. (But get the cervical anesthetic shot -- arrange with doctor at the initial appointment, as not all have taken the training for it. I've had insertions both ways, and my cervix was SO much happier when it was numbed up first.)

Good luck!
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