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A Pap smear is a routine screening test aimed at detecting cervical cancer or precancerous cells in the cervix, the lower part of the uterus. Typically recommended for individuals assigned female at birth, it's advised to undergo a Pap smear every 3-5 years, starting at age 21. While the thought of a Pap smear may induce some anxiety, rest assured that this straightforward procedure is easy to prepare for, swift, and usually only mildly uncomfortable. If you have any concerns or uncertainties, don't hesitate to discuss them with your healthcare provider!
Steps to a Successful Pap Smear
Ensuring a Smooth Pap Smear Experience
Choose a time for the test when you're not menstruating. Since menstrual bleeding can interfere with the accuracy of the test results, aim to schedule your Pap smear for a time when you're not expecting your period. Ideally, book the appointment at least 5 days after the end of your last period.
- If your period unexpectedly begins close to your scheduled test, don't panic—you may still be able to proceed with the Pap smear. Contact your doctor's office and explain the situation, and they'll advise you on whether to reschedule.
- If you have a regular menstrual cycle, consider using a calendar or a period tracking app (such as Clue or Period Tracker Lite) to monitor your cycle and predict the timing of your next period.
Avoid inserting anything into your vagina 48 hours before the test. Introducing foreign objects into your vagina may disrupt abnormal cervical cells, leading to inaccurate pap smear results. Refrain from engaging in vaginal intercourse and avoid using the following products in your vagina during the 2 days preceding the test:
- Douches
- Vaginal medications (such as creams or suppositories for yeast infections)
- Spermicidal foams, creams, or jellies
- Tampons
- Vaginal deodorants
Remember: Using douches or vaginal deodorants is generally discouraged as they can cause vaginal irritation and infections. Stick to washing the area around your vagina with mild soap and water instead.
Inquire whether you should empty your bladder before the test. Undergoing a pelvic exam and pap smear with a full bladder can be uncomfortable, so it's advisable to use the restroom beforehand. However, consult your healthcare provider to confirm. Depending on the purpose of your visit, they may request a urine sample for testing purposes instead of voiding directly into the toilet.
- For instance, your healthcare provider might require a urine sample if they need to screen for pregnancy, urinary tract infections, or sexually transmitted infections.
- Many healthcare providers prefer a urine sample prior to the examination, so it's wise to inquire in advance. If you arrive at the office with an insufficiently full bladder, you can request water to help fill it.
Inform your doctor about any medications you're currently taking. Certain medications, such as hormonal birth control pills, can impact pap smear results. Provide your doctor with a comprehensive list of all medications or supplements you're using to ensure accurate interpretation of your test results. Additionally, disclose the following information:
- Any history of abnormal pap test results
- Pregnancy or suspicion of pregnancy
- Allergies to medications or materials (such as latex)
- Any concerning symptoms you've been experiencing (such as vaginal bleeding, unusual discharge, skin rashes, or pelvic or vaginal pain)
Preparing for the Test
Remove clothing from the waist down. Following your medical history discussion, the nurse or doctor will provide you with a paper gown or sheet and ask you to remove your shoes, pants, and underwear. They will step out of the room or draw a curtain to allow you privacy while undressing. Once undressed, wear the gown or sheet to cover your front.
- On occasions, your doctor may perform a breast exam alongside the pap smear and pelvic exam. In such instances, they may request you to remove your top and bra as well.
- Your doctor or nurse will knock or call out to confirm if you're ready before re-entering the room.
Pro Tip: You can ask to have a chaperone present during the exam, such as a nurse or family member, for added support. Having someone else in the room can be reassuring if you're feeling anxious.
Position yourself on the examination table and place your feet in the stirrups. Climb onto the examination table and lie on your back, positioning your heels in the stirrups located at the table's end. Your doctor will instruct you to shift your buttocks down to the table's edge. Relax your legs and allow your knees to fall apart.
- Feeling nervous or embarrassed is completely normal and acceptable. Take deep breaths and try to relax as much as possible. This will help alleviate anxiety and facilitate the examination process.
Anticipate an external examination of your pelvic area and vulva. During most pap smears, your doctor will conduct a pelvic examination simultaneously. Typically, they will begin by palpating your abdominal and pelvic regions and visually inspecting your vulva and the external vaginal area for any abnormalities, such as rashes or redness.
- Your doctor should provide explanations throughout the examination and pap smear procedure. If you have any concerns or discomfort, don't hesitate to communicate with them.
- You'll feel the doctor's gloved hands examining the area surrounding your vagina. They may need to separate your vulvar labia (lips) to obtain a clearer view.
Permit your doctor to insert a lubricated speculum into your vagina. When ready to perform the pap smear, your doctor will insert a speculum—a plastic or metal instrument—into your vagina. This device enables the doctor to expand your vaginal walls, facilitating visualization of the cervix for swab collection. Although you may experience slight discomfort, try to breathe deeply and remain as relaxed as possible.
- Many medical offices provide warmers to heat the lubricant or speculum, enhancing comfort during the procedure.
- Once inserted, the doctor will gently open the speculum to widen your vaginal walls. You may hear a clicking sound and feel some pressure or discomfort, but it should not be painful. Inform your doctor if you experience any discomfort.
- If you feel anxious or uneasy, engage in conversation with the doctor or nurse or hum a tune to distract yourself.
Allow the doctor to swab your cervix for cell sampling. During the pap smear, your doctor will insert a long brush or cotton swab into your vagina through the speculum. Using this, they will gently brush your cervix, located at the base of your uterus deep inside your vagina. Depending on your cervix's sensitivity, you might feel a slight pinch or sting.
- The sampling process should only take a few seconds. Once completed, the doctor will remove the speculum, and you should feel much more comfortable afterward!
- After the exam, you may experience light spotting or bleeding, which is normal and should resolve within a day or two.
Prepare for an internal examination by your doctor's fingers. Following the pap smear, your doctor may use 1 or 2 fingers to examine the inside of your vagina while pressing down on your lower abdomen with their other hand. This helps them assess organ position and detect any abnormalities, such as lumps or masses in your pelvic region. Occasionally, they may also conduct a rectal examination.
- Your doctor will wear gloves and apply lubricant to their fingers for your comfort.
- After the examination, the doctor will step out, allowing you a few moments to dress. You can also use this time to clean up any excess lubricant.
Arranging Follow-Up Care
Inquire about the timeframe for receiving your test results. After the test, the doctor will send the cell sample to a lab for analysis. Typically, it takes 1-3 weeks to receive the results, although your doctor can provide a more precise estimate. Confirm whether they will inform you by phone or through an online medical portal.
- If you haven't received results within 3 weeks, contact your doctor's office for an update.
Schedule a follow-up appointment for abnormal results. While most pap smear results are normal, there are instances of 'abnormal' or 'unclear' results. Don't panic if this occurs! An abnormal result doesn't necessarily indicate a serious issue. Discuss scheduling further tests with your doctor during a follow-up appointment.
- In rare cases, abnormal pap smear cells may indicate cervical or uterine cancer. If your doctor suspects a significant problem, they may recommend additional tests such as a colonoscopy or biopsy.
- Alternatively, your doctor may advise waiting 6 months to a year before repeating the pap smear. If abnormalities persist or significant changes are observed, further testing may be recommended.
Discuss with your doctor the timing for your next pap smear. The frequency of pap smears depends on factors like age, medical history, and risk level for conditions such as cervical cancer or sexually transmitted infections. Collaborate with your doctor to determine the most suitable schedule for your routine pap smear and pelvic exam.
- Typically, doctors advise initiating pap smears at age 21, followed by testing every 3 years (or more frequently with abnormal results).
- After turning 30, the frequency can decrease to once every 5 years, unless abnormalities are detected.
- By age 65 to 70, pap smears can usually be discontinued if there have been 3 normal tests within the last decade.
Pointers
Precautions
- Pap smears may not be entirely accurate, potentially missing cancerous or abnormal cells. Therefore, regular pap smears are crucial. Fortunately, most cervical cancers progress slowly, allowing early detection and treatment even if the previous test was negative.
