While it requires some medical intervention, CIN doesn’t usually cause symptoms. There are complications that can occur, though, if these noncancerous cells go undetected and are left with the opportunity to multiply or mutate (change). This is why getting routine Pap smears is such an important part of preventive healthcare. Only a Pap smear can see the signs of CIN.
Signs and Symptoms
CIN is usually thought of as asymptomatic (without symptoms). However, there is an association between CIN and bleeding after penetrative sex (known as postcoital bleeding, or PCB).
A 2019 limited-sample study conducted in Israel suggests that bleeding after sex may be a sign of the following:
Infection such as HPV (human papillomavirus) infection CINCervical cancer
Diagnosis was through colposcopy, a simple procedure used to examine the cervix.
Signs of CIN From a Pap Smear
Your Pap smear, or Pap test, results will determine whether or not you have cell abnormalities or lesions on your cervix known as squamous intraepithelial lesions, or SILs. In many cases, these lesions will clear away on their own as your body’s natural defenses destroy them. Other times, the cells may have spread already so further medical intervention may be necessary.
The cell sample findings from your Pap smear are categorized based on how far they have spread across your outer cervical lining, known as intraepithelial tissue, and based on your risk factors for human papillomavirus or HPV (the sexually transmitted infection that causes CIN) or cervical cancer.
The signs will be categorized as follows:
Low-grade SIL (LSIL)High-grade SIL (HSIL)Possibility of cancerAtypical glandular cells (AGUS)
Another way of categorizing CIN based on the same information collected from your Pap is by numbered grades (1–3) rather than scaled grades (low–high). Your doctor may use terms from either categorization method, so if you’re not sure what they’re referring to, simply ask for some clarification.
The three grade levels include:
Low-grade neoplasia (CIN 1) involves about one-third of the thickness of the epithelium. CIN 2 refers to abnormal changes in about one-third to two-thirds of the epithelial layer. CIN 3 (the most severe form) affects more than two-thirds of the epithelium.
Complications
Most of the time there are no complications associated with CIN since it doesn’t often progress to cervical cancer. Your immune system may fight the infection and make it resolve. If for some reason it doesn’t, you can rest assured that there are many intervention strategies and treatments to fight it.
Common options to reduce complications include removing the cells or destroying them so healthy cells can replace them. These treatments can even be used in later disease stages, in which the diseased cells have spread.
People with weakened immune systems (including those with human immunodeficiency virus (HIV) and AIDS are at greater risk of experiencing complications because they may be less able to fight off HPV. They may also be more likely to develop health problems from HPV.
The Centers for Disease Control and Prevention (CDC) estimates 91% of cervical cancer cases are linked to a type of HPV. There are more than 80 types of human papillomavirus and about 30 of these can infect the cervix. HPV types 16 and 18 are most often linked to cervical cancer.
When to See a Doctor
If you experience postcoital bleeding, whether it’s once in a while or all the time after engaging in penetrative sexual activity, see your doctor to begin the process of getting an accurate diagnosis.
You should also be have regular Pap tests. Here’s what the National Cancer Institute’s 2020 Guidelines recommend based on your age group.
A Word From Verywell
Chances are you’re not going to notice any signs or symptoms of CIN. This is why it’s important to get tested in accordance with the guidelines listed above. This way, if you ever do have CIN, your healthcare provider can catch it in its early stages and determine next steps.
Remember, if you have questions, you can always contact your healthcare provider or women’s clinic to discuss whether or not it’s time for you to get a Pap or HPV test.
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