What to Expect at Pap Smear

Pap Smears: What to Expect and Why You Need One

I don’t remember my first pap smear. I’ve had so many over the years they sort of run together. Several years ago I had my routine pap smear. A day or two later- I received a cryptic phone call from my family doctor to call her back about my tests results. I thought- what results? I was so used to not hearing anything after a pap test that I didn’t even realize what she was talking about at first.
 
When I phoned back, she said: You have some abnormal cells on your pap smear.  The most likely cause is HPV, would you like me to run the DNA test to be sure? And of course, I did the test. The results came back as she expected- I had HPV, which had resulted in high-grade cervical dysplasia, or abnormal cells on the cervix, that can lead to cervical cancer. The high grade is the closest you get without having cancer.
 
Of course- I was freaked out beyond belief. How had this happened to me? What would be done about it? For several years I had regular paps and a procedure known as colposcopy to keep an eye on those pesky cells. Thankfully- natural treatments come to the rescue and this isn’t a concern for me anymore.
 
Because of this experience- I wholeheartedly agree that women should receive regular pap smears.
 
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What is a PAP Smear?

 

A Pap smear, also called a Pap test, is a procedure to test for cervical cancer in women. A Pap smear involves collecting cells from your cervix — the lower, narrow end of your uterus that’s at the top of your vagina.

There are two versions of this test- liquid and non-liquid, or conventional versions. The liquid-based test is the newest around and seems to be more accurate. You can see by looking at the picture below from the ThinPrep Pap Test website how much easier it is to see various components with the liquid.
 
pap test liquid
 
 


Why Do We Need a Pap Smear?
 

 
A Pap test is done to look for changes in the cells of the cervix. Finding these changes and treating them when needed will greatly lower your chance of getting cervical cancer. The Pap smear test was developed by and named after Dr. George Papanicolaou for the purpose of early identification of cervical cancer. Soon after its introduction, the Pap smear proved effective at detecting precancerous lesions, which represent early — and still very treatable — indicators of cervical cancer risk.
 

How Often Should You Get a Pap Smear? 

 
This all depends on your age (and reproductive history), but generally women aged:
 
21-29 – every 3 yrs
30-64 – every 5 yrs if PAPs are normal
65+ – no more paps!
 

Preparing for a PAP Smear

 

f you have had problems with pelvic exams in the past or have experienced rape or sexual abuse, talk to your doctor about your concerns or fears before the exam.

No other special preparations are needed before having a Pap test. For your own comfort, you may want to empty your bladder before the exam.

 
Tell your doctor whether you have had an abnormal pap test in the past.
 
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What to Expect at a PAP Smear 

 
 
You will feel more comfortable during your Pap test if you are relaxed. Breathing deeply may help. Holding your breath or tensing your muscles will increase your discomfort. You may feel some discomfort when the speculum is inserted, especially if your vagina is irritated, tender, or narrow. You may also feel pulling or pressure when the sample of cervical cells is being collected.
 
The Pap smear is an easy and reliable test to perform and the procedure takes only minutes to perform. So if this is your first Pap smear and pelvic exam, relax, here is the procedure, step by step.
 
First, you will be asked to disrobe from the waist down and put on a hospital gown or sheet over your body. The clinician will ask you to sit at the edge of an exam table. Then, when instructed, you place your feet in the stirrup-style foot rests and lie back on the table (like the women in labor depicted on TV or movies). The doctor will ask you to separate your thighs and stay calm so the muscles are relaxed. The more relaxed and dropped apart your legs remain, the more comfortable you will be and the quicker the procedure will go. (If you wiggle your toes it is a great way to reduce tension in the legs, groin, or buttocks.)
 
With a gloved hand the examiner will touch the exterior of the vulva to separate the labia (vagina lips) and take a look to make sure it’s all normal. To widen the opening of your vagina a speculum, which is similar to a tampon applicator with a handle, is then gently inserted into vagina. There are different sizes and styles of speculums used for different women. The speculum allows the clinician to view the vaginal walls and the cervix. The cervix is located high up in the vagina. It resembles a mini bagel projecting into the vagina.
 
When the speculum is in place, the clinician will collect a sample of tissue from the exterior of the cervix (ectocervix) with a tool described as a spatula, then another from the cervical canal to the womb (endocervix) with a brush like instrument called a cytobrush. This process may cause some discomfort in women, especially if you are close to your period or are experiencing a vaginal infection.
 
The speculum is then removed; at this point the doctor usually performs a quick bimanual examination, where she or he feels the uterus and ovaries as is possible with their skillful hands — placing two fingers of one hand within the vagina and the other hand on the lower belly. Then your doctor will press gently to feel what cannot be seen.
 
The Pap sample is sent to a pathology lab for the technician to review the cells under a microscope, checking for normal and abnormal features. An HPV DNA analysis can in addition be done at that time if requested. Because I had abnormal cells, I opted for this DNA test to confirm HPV.
 
Be sure to take charge of your own body and collect your results, whether they are normal or not. Having copies of medical tests is very handy for following your health and diagnosing problems (if there are any!).

Comments

  1. Annah

    Today it was my first time for a check up ,it was little bit sore but everything went well.I think woman must go for this test.

    1. Glad to hear everything went well! You are so right- with the prevalence of reproductive/vaginal problems, these tests are a must!

    1. Hey Tonya,

      That is a question I can’t answer for sure. Some women may experience discomfort as a virgin, some may not. Just as some women who are sexually active will experience discomfort, and some will not.

      The important thing is to relax and know that any discomfort is only temporary, and in the name of your good health!

    2. Elaine

      Im getting married in a couple of weeks and i am planing to have a baby, would it be helpfull if i do papsmear before planning to have a baby? And does it affect if we do make love after papsmear?
      Thank u

      1. It may be beneficial to have one before trying to get pregnant to check for infections or other abnormalities. Care after the pap smear will be discussed by your doctor.

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