What Is a Pap Smear?
What Is the Difference Between a Pap Smear and a Well Woman’s Visit?
In a well woman exam, the provider will review your medical history, surgical history, medications, and allergies. They will also conduct a physical exam which will include a bimanual exam (checking the size of the uterus and ovaries). We perform a pap smear during the physical exam if it is warranted.
When Should a Woman Get Her First Pap Smear?
A women will start getting pap smears at the age of 21. The age of first sexual intercourse experience does not matter. From age 21 to 29, the screening should be performed every 3 years if normal. From age 30 to 65, screening is every 5 years with HPV contesting or every 3 years with a pap smear alone, if normal. This interval may change based on personal history.
How Is a Pap Test Done?
For the pap test, a gynecologist will insert a lubricated speculum into the vagina and will visualize the cervix. With a broom, we collect cells using a circular motion around the cervical opening. This takes only a few seconds. After we collect the specimen, the speculum is closed and taken out of the vagina.
Pap Smear Side Effects
Usually there are no side effects to a pap smear. If any, there may spotting and mild cramping after the pap smear.
How to Prepare for Your Pap Smear
In preparation for the test, patients should relax as much as possible. Usually, patients experience no pain with a pap smear. The most patients will feel is pressure.
Pap Smear Results
Pap smear results may take up to 2 weeks to complete. Once the results are sent to the office, a provider will review the results and they will be reported to the patient.
Abnormal Pap Test
Types of Abnormal Pap Test Results
The most common abnormal results in pap tests are:
- Normal Pap but, HPV Positive: There are no cellular changes on the cervix, but the patient has been exposed to the HPV virus.
- ASC-US: These cells don’t appear completely normal, but doctors are uncertain about what the cell changes mean. The changes may be related to an HPV infection but they can be caused by other factors.
- ASC-H: These cells don’t appear completely normal and these lesions may be at higher risk of having cancer. The meaning of the cellular changes is unknown. At times a biopsy is necessary.
- Low-Grade Squamous Intraepithelial Lesions (LSIL): Mild abnormalities caused by the HPV virus. These are early changes in size and shape of the cells. Typically, we perform a biopsy to look at the cells more closely.
- High-Grade Squamous Intraepithelial Lesions (HSIL): More severe abnormalities caused by the HPV virus that may progress into cancer if untreated. When examined under a microscope, the cells are further classified into CIN-2, CIN-2/3, or CIN-3 based on severity.