Why You Need A Pap Smear, When To Get It & What To Expect
For women, pap smears are a medical essential. And while the idea (and at times the process) of a pap smear can be uncomfortable, regular screenings can be life-saving. In fact, it’s estimated that if women maintained regular OBGYN checks and pap smear exams, 83% of cervical cancer cases could be prevented, which is monumental.
And yet despite their grave importance, there remains a great deal of confusion surrounding the test. Many women aren’t sure how often they need to receive a pap smear or what age they should start screenings.
To help clarify and educate, we got in touch with two of the world’s top OBGYNs: Rebecca Booth, M.D Gynecologist, Co-Founder of VENeffect Anti-Aging Skin Care, and Mary Jane Minkin, Professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at the Yale University School of Medicine. We asked Dr. Minkin and Dr. Booth all those important (and awkward) questions, so you don’t have to! Here’s everything you need to know about pap smears.
What is a Pap Smear?
A pap smear is a test used to detect potentially precancerous and cancerous cells in the cervix. Dr. Booth begins by explaining, “A pap smear is simply a collection of cells from the cervix or vagina that is stained in a special way (designed by the creator of the stain used: Dr. Papanicolaou) to demonstrate the architecture of the cells to rule out cancerous or precancerous changes.” It’s also important to be aware that the pap smear doesn’t prevent cancer but helps with early diagnosis and treatment.
Dr. Booth continues to clarify that among healthcare professionals, “It’s now usually called a “screening cytology” test depending on what site is being tested (the cervix, vagina, skin surrounding the vagina and sometimes the anus and other sites)” with “many women casually referring to their annual gynecologic exam as a “pap test.”
Testing for HPV (Human Papilloma Virus) is, according to Dr. Booth “Often performed with the cytology test and may eventually replace cytology in the future making the word “Pap,” less relevant.”
What’s The Process of a Pap Smear Examination?
You’ll be happy to know that the “The screening process is simple and quick,” says Dr. Booth – it’ll take approximately 15 minutes. She continues to explain, “Your caregiver will talk with you and explain the process. She will begin the exam after first examining other areas such as your heart, lungs, and your breasts.” You will be asked to remove your clothes from the waist down. Then “She will ask you to lie on an exam table and a smooth device called a speculum is used to open the vagina. It slides in much like a tampon and gives a clear view of the cervix and upper vagina” Says Dr. Booth.
During this process, cells are gently scraped away from the cervix. These cells are later tested and examined for abnormal growth. You will often receive a phone call with your results three days to two weeks after your test with the results.
You do not need to do anything before the appointment. Dr. Booth says, “Do not douche (gynecologists don’t recommend this anyway)” and “it’s not necessary to shave.” However, after the exam “You may have a little spotting after the exam so it is wise to have a panty shield on hand just in case… But the doctor can give you a pad,” says Dr. Booth.
Is it Painful?
As with most medical exams, everyone’s experience is different; some women find the process painful while others have had no pain at all. The most important thing to remember is you can ask your OBGYN to stop at any time: it’s your body and therefore, you are in control.
Dr. Minkin confirms, “The process can be a bit uncomfortable but if someone is sexually active, it should be OK.” Adding that if her patients do find it particularly uncomfortable, “Warming the speculum up and putting some warm water on it” can help.
Dr. Booth likens the experience to tampon application; “Much like a woman’s first attempt at inserting a tampon, the process is more awkward than painful. Most women find it completely tolerable, and some women experience no discomfort, while others find the screening very uncomfortable… Even painful. Most women’s health experts can make the experience more pleasant by reassuring a woman about her body and answering questions that most women would not ask a primary care physician.”
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Can I Have a Pap Smear if I’m on My Period?
Dr. Minkin notes that while “It’s ideal to do the pap without a period, if you’re just spotting, it shouldn’t be a problem.” However, “If your period is very heavy your caregiver may opt to do the cytology test at another time, but most of the time it can be performed while you are on your period,” explains Dr. Booth.
When do I Need to Have My First Pap Smear?
This is probably the most debated fact regarding pap smears. In fact, many countries have different rules and regulations regarding pap smears. For example, in the UK, women receive a letter recommending to book for a pap smear at the age of 25.
Dr. Minkin explains that in the USA, “The current recommendation is age 21. Now that doesn’t mean that if a woman is sexually active, we wouldn’t screen her for things like STIs but we don’t, in general, do paps before age 21.”
Dr. Booth warns, “The Pap test should not be confused with the annual gynecologic exam. It is best to begin (gynecologic) exams when a woman is sexually active and continue yearly.” As for the pap smear “The latest recommendations suggest starting cervical cytology screening at age 21. Women aged 21 to 29 years should have a pap test alone every 3 years (HPV testing is not recommended in this age group).” Then, “Women aged 30 to 65 years should have a Pap test and an HPV test (“co-testing”) every 5 years.”
If I’m Not Sexually Active, Do I Still Need to Get a Pap Smear?
Cervical cancer is, in most cases, caused by a sexually transmitted infection called human papillomavirus (HPV). Therefore, if you have not had sexual intercourse, the likelihood of you having cervical cancer, and needing a pap smear, are lower.
For this reason, Dr. Minkin confirms “If a woman has never been sexually active, that is a discussion she should have with her gynecological caregiver and they can come up with a decision based on shared decision making.”
The same rule does not apply for a woman who is no longer sexually active but has had sex in the past. Dr. Minkin provides an example “Say a woman had sex when she was 19 but is now 21 and isn’t currently sexually active – she should do a pap.”
On a final note, we totally understand that a visit to an OBGYN amid the COVID crisis may have been put on hold over the past few months. However, it is still important to have regular checks. Therefore, wherever possible we’d recommend visiting an OBGYN that’s not in a doctor’s office or hospital that’s caring for COVID patients, to ensure your safety. And of course, wearing a mask and gloves at all times during the visit.
If you’re worried about an appointment to an OBGYN, check out 9 things your gyno wants you to know.