To Your Health

Q. I recently had my annual physical, and my pap smear was abnormal. My doctor will do another test in six weeks, but I am a little worried. Does this mean I have cancer?

A. A positive pap smear (Papanicolaou test) is not the same as a diagnosis of cancer, but it does indicate some irregularity of cells of the cervix (cervical dysplasia). This is a pre-cancerous condition, and if it persists your physician will probably do a surgical procedure to remove the questionable cells. If your physician is waiting for a second test, you probably had a "Class II" test result. Class III, IV or V test results usually incite immediate intervention. By the way, most physicians prefer a newer, more descriptive classification method, the Bethesda method, using Groups 1-6 to replace Classes I-V.

The Pap test is one of the most successful early cancer detection tests ever developed, finding about 90% of cervical cancers. Deaths from cervical cancer are now about half what they were in the past and would probably drop to zero if more women would have the test as often as recommended. Presently about 40% do not.

A very high-dose folic acid supplement may normalize your next test and should be continued for a few weeks even if the next test is normal. The usual folic acid supplement is 0.4 to 0.8 mg per day, but you would need to use much more, 10 mg per day, for the next month. This may lead to some breast tenderness, but after a month you can reduce to 4 mg of folic acid per day, which should be comfortable.

Cigarette smoking increases the risk of cervical dysplasia and also increases the tendency of Class II dysplasia to progress to the more severe Class III or IV. There are many other advantages to stopping smoking. Also avoid risky sexual behavior since a higher number of different sexual partners increases the risk of cervical dysplasia. Women who eat generous amounts of vegetables and fruits, especially the colorful ones like beets, carrots, tomatoes, winter squash, etc., have reduced risk of cervical dysplasia.

An abnormal Pap test may be your motivation to take better care of yourself. Everything you do to improve the test result will profit you in many other ways.

Q. I am a 23-year-old male homosexual, very careful about choosing only partners who are HIV-negative, but I have heard that frequent ejaculation depletes men of certain nutrients. Is there any truth to this?

A. There is no doubt that semen contains nutrients that are lost by ejaculation, although there are still questions about the significance of these losses. Assuming four ejaculations per week, insignificant amounts of most vitamins and minerals are released. There are two glaring exceptions to this presumption: about half a milligram (mg) each of zinc and copper is lost in each discharge, which represents about 4% of our average daily zinc intake and about 25% of copper intake.

Even though zinc loss is considerably less than that of copper, zinc deficiency has by far the greater influence on immune status, and this rate of decrease is considered worrisome. Furthermore, when we change the assumption of four ejaculations per week to 20 per week (not unheard of among homosexual men), the potential for serious depletion of these nutrients becomes obvious. For practicing homosexual men, maintaining a vigilant immune system is an extremely high priority.

The role of copper deficiency in immune status cannot be discounted, but serum copper levels are not lower in homosexual men. As a pro-inflammatory mineral, less copper could conceivably be an advantage. Serum zinc levels, however, continually decline in practicing homosexual men, and it may also be significant that many symptoms of AIDS (susceptibility to infection, kidney, liver, and intestinal problems) are also zinc deficiency symptoms.

Three other nutrients have high losses in semen: vitamin C, magnesium, and selenium. All the other nutrients are present, but in very small amounts. Deficiency of any of the three nutrients mentioned above will impair immune function, and with 20 ejaculations per week, deficiency would be very likely.

It seems that a broad-spectrum multivitamin/mineral supplement especially generous in zinc would be obligatory to practicing homosexual men in order to preserve a fully functional immune system.