The medical world is full of many conditions, procedures, and treatment plans. While some of these are complicated life-saving techniques, others are preventative measures taken to avoid disease altogether.
A Pap Smear is one of the latter procedures. Throughout their lives, people with vaginas should get this test done regularly to ensure vaginal and cervical health, and to avoid serious disease.
What Is a Pap Smear And How Is It Done?
A Pap smear is a medical procedure developed by George Nicholas Papanicolaou, and is a procedure to test for cervical cancer. The cervix is the opening of the uterus and is located at the back of the vaginal canal (technically considered the top of the vagina). A Pap smear takes a sample of cells from the cervix and tests them for abnormalities or strange growth. These are the first signs of cervical cancer.
To retrieve the sample, a primary care doctor or gynecologist will insert a speculum into the vagina. This device opens the vaginal canal enough for the doctor to see the cervix and swab it with a long-stemmed cotton swab.
Why Are Pap Smears Necessary?
Cervical cancer is a serious disease. It can be difficult to treat and can be incredibly painful. However, the sooner it is discovered, the simpler it is to treat. Pap smears detect abnormal cervical cells. These are the first signs of cervical cancer. Detecting the cells in this early stage can significantly increase survival and recovery rates.
When Should A Woman Get A Pap Smear?
Pap smears are recommended beginning at age 21. From ages 21-29, individuals with cervixes should get a Pap smear every three years. This frequency helps to catch cancerous cell growth, but is not too frequent to be invasive.
From age 30 onward, the individual will be tested for HPV during their Pap smear. By doing this, they can reduce the frequency from every three years to every five years.
In some cases, individuals with cervixes who are 65 and older can stop getting regular Pap smears. This only occurs if they have never had an irregular Pap smear, they’ve kept up with their Pap smear schedule in recent decades, and their doctor recommends it based on their unique makeup.
It should be noted that Pap smears will often occur more frequently if irregular cells are found. These tests are used as part of a comprehensive care plan, and to track any healing that may occur.
How Long Does a Pap Smear Test Take?
Pap smears are incredibly fast procedures. They occur during a regular doctor’s appointment, and there is no recovery time afterward. Generally speaking, a Pap smear takes about 2-5 minutes. If it is scheduled as a part of an overall checkup or physical, the appointment may take longer. However, the actual time needed to obtain a sample is only a few minutes.
Remember, the actual procedure is just to get a sample of cervical cells. While a doctor may be able to tell if something is wildly wrong simply by sight, the cells need to be sent to a lab to get results. This result can take up to a week or two, no matter what the result. Wait time should not be an indication of results, and patients are encouraged to refrain from panicking if their results take longer than anticipated.
Is It Painful to Get a Pap Smear?
Many patients are curious about what to expect when getting a Pap smear, especially in reference to potential pain. Pap smears are generally not painful procedures. However, it is necessary to understand that they can be uncomfortable. Depending on the physiology of the vagina, there can be pressure when the speculum is inserted into the vagina. Similarly, the cervix is not commonly directly touched, so the sensation can be new or uncomfortable, especially the first few times.
Overall, it is rather normal to expect strange sensations over pain for a first Pap smear. They should not hurt and have nothing to worry about. In fact, they can prevent you from a lot of pain and suffering down the line.
Preparing for a Pap Smear
A Pap smear is not like a surgery or extensive procedure, so very little preparation is needed for an appointment. However, there are a few small changes that the patient should implement in the days leading up to the Pap smear.
- Refraining from sexual activity for 48 hours beforehand
- Refraining from inserting anything into the vagina, including menstrual cups, tampons, douches, sex toys, etc.
- Avoiding powders and perfumes in the genital area
It is also not a good idea to schedule a Pap smear during menstruation. Large amounts of blood can alter the test results, leading to false negatives and other harmful missteps. If a patient gets their period in the days leading up to the exam, they should call their doctor’s office and ask what should be done. Some doctors will not perform a Pap smear on a person who is menstruating, as the risk of skewed test results is too high.
Does a Pap Smear Test for STIs?
Pap smears do not test for sexually transmitted infections. Their only purpose is to detect abnormal cervical cells for cervical cancer.
If a patient would like to get an STI test, they must inform their doctor. The method is generally the same for an STI test, the doctor simply needs to have a separate test ready. The swab is just as fast and efficient for STIs.
Pap Smear Results
After a Pap smear is finished, the patient will get their results within the next few weeks. It is important to know what the results mean, though a doctor will often explain if the situation warrants it.
A normal Pap smear result means that no abnormalities were found at the time of the sample. The cells of the cervix seem to be normal, and the patient can come back in their scheduled number of years for their next test.
If a Pap smear comes back as abnormal, there are several factors that could be causing it.
- HPV, which is a condition that leads to cervical cancer
- Inflammation or cell changes
- Cancer or pre-cancer
- An infection, such as a yeast infection
- Changes in hormones, often found during pregnancy and menopause
If these do occur, the patient’s doctor will advise on the next steps.
Possible Next Steps
Abnormal Pap smear results can seem alarming, but they are not automatically a cause for panic or concern. In some cases, a doctor may decide that waiting a few months and getting another Pap smear is the best course of action. In some cases of inflammation, the situation clears on its own. The doctor may simply want to monitor the condition closely until she is assured that the patient is not at risk.
In other situations, a colposcopy is necessary. In this procedure, a doctor uses a small magnifying tool to examine the cervix, vulva, and vagina. A sample, or biopsy, may also be taken to send to the lab.
Patients should discuss their treatment plan with their doctor to determine what is best for their specific test results.
Are There Risks to Getting Pap Smears?
Technically there are risks to getting a Pap smear, just as there are risks to any medical procedure. However, among routine procedures, Pap smears are extremely safe.
The two main risks are:
- False positives
- False negatives
There is always the risk for these in any medical setting. However, Pap smears tend to be very accurate.
Can Pregnant Persons Get a Pap Smear?
Pap smears do not interfere with pregnancy. However, if a patient gets a Pap smear past 12 weeks of gestation, they may experience some increased pain. This is because the cervix begins to swell during pregnancy, making the swab site increasingly tender.
It is important to note that a normal Pap smear schedule is likely going to be altered during pregnancy. Pregnant individuals have their own set of tests and procedures that they must undergo to ensure that the baby is healthy. This may involve similar vaginal exams. The patient should communicate with their prenatal care provider and gynecologist, who can both advise them on what to do. They may simply suggest that the Pap smear be delayed until after the baby is born. However, they may suggest that keeping to a regular Pap smear schedule is preferable.
Are Pap Smears Necessary After a Hysterectomy?
Many individuals undergo hysterectomies and believe that they no longer need to get Pap smears. This is not necessarily the case. Cancer can still occur in the cervical area, even if the uterus and/or ovaries have been removed.
Many individuals who get hysterectomies do so because they have had cervical cancer or signs of untreatable cervical cancer. In these cases, a doctor will continue to check for abnormal cells to help to make sure that the cancer does not return.
Preventing Cervical Abnormalities
Cervical cancer is intimidating, but there are several ways to reduce one’s risk of getting the disease. Many of them involve protecting against HPV, which is a main cause of most cervical cancers.
Some ways to do this include:
- Get the HPV vaccine
- Use condoms during sexual intercourse to reduce risk
- Refrain from douching, which can wash out normal cells that would fight against disease
- Get HPV tests regularly
- Get Pap smears regularly
- Communicate with partners about STI status
Though this is not an exhaustive list of the ways individuals can protect themselves from HPV and cervical cancer, these steps can help reduce risk. The most important factor is getting regular Pap smears. Cervical abnormalities and cancer can occur for reasons outside of HPV, so regardless of one’s lifestyle, regular Pap smears are absolutely recommended.
Contact AZGYN for Expert Female Healthcare Services
Vaginal and cervical health can feel intimidating. Many women feel embarrassed or ashamed to discuss it. Here at AZGYN, we are here to create an accepting and judgment-free environment for individuals to get quality female healthcare services.
If you are concerned about an issue you are currently facing, feel free to contact us to see if we can help you with your health needs.
Founder and Medical Director of ARIZONA GYNECOLOGY CONSULTANTS
Dr. Kelly Roy is a specialist in surgical gynecology and advanced laparoscopy (and hysteroscopy). She is a long-time resident of Arizona and obtained her Bachelor of Science degree in Biomedical Engineering at Arizona State University before finishing her Doctorate of Medicine at the University of Arizona in 1997.
Dr. Roy completed her residency in Obstetrics and Gynecology at the then “Banner Good Samaritan Hospital” (now Banner University Medical Center), in Phoenix Arizona in 2001.
Well known for her teaching and surgical ability, she is on the faculty at the residency program at both Banner University Medical Center and Saint Joseph’s Hospital in central Phoenix and is a Clinical Assistant Professor of Medicine at the University of Arizona College of Medicine, Phoenix Campus. Dr. Roy has taught advanced surgical techniques to medical students, residents, fellows and colleagues for over 15 years.
Dr. Roy is also a consultant to the medical device industry and has participated in the design and clinical testing of many instruments and surgical devices available on the world-wide market today.