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January 2007     View PDF     En español

Gynecological problems

Gynecological (GYN) problems occur in all women. They’re also some of the most common complications experienced by women living with HIV. GYN problems can be more serious and difficult to treat in women with weak immune systems.

GYN problems range from irregular periods to vaginal yeast infections that just won’t go away. More serious complications can include cancers or painful warts on the vagina, labia (vaginal lips) and anal area (around your butthole).

Many women to not experience symptoms related to GYN problems and the problems can remain undetected. Left untreated, they can further weaken the immune system. Therefore, regular exams to detect problems are crucial, even when you’re feeling well and even when you don’t have symptoms. Detection and treatment are critical steps to prevent a GYN condition from getting out of control.

GYN screening for women with HIV

Pap smear
This screening test can save your life. It can find the earliest signs of cervical cancer. It’s recommended that women get Pap tests done at least once every three years, starting about three years after they start to have sexual intercourse, but no later than age 21.

Women, especially those living with HIV, should talk with their doctors about when and how often they should get a Pap test done. Your doctor may recommend more regular tests based upon your health and risk factors.

The Pap smear checks for changes in the cells of your cervix. It may detect inflammation, abnormal cells, or cervical cancer.

Your doctor will use a special tool to swab a sample of cells from the cervix. The sample will be tested for abnormalities. The process may be uncomfortable but usually doesn’t hurt.

Colposcopy
This test examines your vagina, vulva, and cervix with an instru­ment called a colposcope. This test can be uncomfortable though it generally isn’t painful. Sometimes, due to how the cells look, your doctor may also choose to do a biopsy, which can be painful.

Biopsy
This test removes a small piece of the cervical tissue that will be tested for abnormal cells. This may sometimes accompany a colposcopy and can hurt.

Problem periods
Changes in periods are common in all women, but they may be especially common in HIV-positive women with lower CD4+ cell counts. These changes may include irregular, heavier or lighter periods, painful periods, or the end of menstrual bleeding altogether.

Tracking your periods from month to month is a good idea. (See the Tracking charts [PDF only].) Let your doctor know if you have any changes in your periods. It’s important to determine why your period has changed.

GYN problems? Here are some common clues …

• Unusual or smelly vaginal discharge
• Cramping
• Irregular periods
• Genital warts
• Pain and itching around the vagina
• Pain during sex
• Burning or pain when urinating

Don’t forget your breasts!
Three tests are used to screen for cancer. Mammograms (breast x-rays) are recommended every 1–2 years for women over 40. Clinical breast exams done by a health expert are recommended every three years for women 20–39. Breast self-exams can be done regularly to check for changes in breast tissue. Report any changes to your health care provider.

Keep track of your body!
Track your periods, hemoglobin (red blood cell) count, body weight, viral load and CD4+ cell counts.

For more information on GYN conditions, read Project Inform’s publication, Gynecological Conditions and HIV Disease.

Tracking Charts

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Working with your Doctor