Well Woman Exams

The Pap test, also called a Pap smear, checks for changes in the cells of your cervix. The cervix is the lower part of the uterus, that opens into the vagina. The Pap test can tell if you have an infection, abnormal, unhealthy, cervical cells, or cervical cancer.

A Pap test can save your life. It can find the earliest signs of cervical cancer. If caught early, the chance of curing cervical cancer is very high. Pap tests also can find infections and abnormal cervical cells that can turn into cancer cells. Treatment can prevent most cases of cervical cancer from developing. Getting regular Pap tests is the best thing you can do to prevent cervical cancer. In fact, regular Pap tests have led to a major decline in the number of cervical cancer cases and death.

It is important for all women to have Pap tests, along with pelvic exams, as part of their routine health care. You need a Pap test if you are 21 years or older.

It depends on your age and health history. Call to find out what is best for you. Most women can follow these guidelines:

  • Starting at age 21, have a Pap test every 2 years
  • If you are 30 years old and older and have had 3 normal Pap tests for 3 years in a row, call us so that we can develop spacing out your Pap test.
  • If you are over 65 years old, ask your doctor, we would advise stopping the Pap smear.

More frequent testing is recommended if:

  • Your immune system has weakened because of organ transplant, chemotherapy or steroid use.
  • Your mother was exposed to diethylstilbestrol (DES) while pregnant
  • You are HIV positive.Women who are HIV positive, the virus that causes AIDS, are at a higher risk of cervical cancer and other cervical diseases. The U.S Center for disease control and prevention recommends that all HIV -positive women get an initial Pap test and get re-tested 6 months later. If both Pap tests are normal, then these women can get yearly Pap tests in the future.

Women over the age of 65 who have had 3 normal Pap tests and in a row, have had no abnormal test results in the last 10 years and have been told by their doctors that they don’t need to be tested anymore, do not need regular Pap tests. Women who do not have a cervix are at a low risk for cervical cancer. These women should speak to their doctor before stopping regular Pap smear.

It depends on the type of hysterectomy you had and your health history. Women who have had a hysterectomy should talk with their doctor or call us. Usually during a hysterectomy, the cervix is removed with the uterus. This is called a total hysterectomy for reasons other than cancer may not need a regular Pap test. Women who have had a total hysterectomy because of abnormal cells or cancers should be tested yearly for vaginal cancer until they have had three normal test results. Women who have had their uterus removed but still have a cervix need regular Pap smear.

Aside from getting Pap tests, the best way to avoid cervical cancer is by steering clear of the human papillomavirus (HPV). An HPV is a major cause of cervical cancer. HPV infection is also one of the most common sexually transmitted infections. A woman boosts her chance of getting cervical cancer if she:

  • Starts having sex before age 18.
  • Has many sex partners
  • Has or has had an STD

Human Papillomaviruses are a group of more than 100 different viruses.

  • About 40 types of HPV are spread during sex
  • Some types of HPVs can cause cervical cancer when not treated
  • HPV infections are one of the most common sexually transmitted infections
  • About 75% of sexually transmitted infections are HPV infections
  • Most women with untreated HPV do not get cervical cancer
  • Some HPVs cause genital warts but these HPVs do not cause cervical cancer
  • Since HPV rarely shows symptoms, most people don’t know they have it

Most women never know they have HPV. It usually stays hidden and does not cause symptoms like warts. When HPV does not go away on it own, it can cause changes in the cells of the cervix. Pap test usually find these changes.

Many things can cause wrong test results by washing away or hiding abnormal cells of the cervix. So doctors suggest that for 2 days before the test you should avoid:

  • Douching
  • Using Tampons
  • Using vaginal creams, suppositories, and medicine
  • Using vaginal deodorant sprays or powder
  • Having sex

No. Doctors suggest you should schedule a Pap test when you do not have a period. The best time to be tested is 10-20 days after the first day of your last period.

Your doctor can do a Pap test during a pelvic exam. It is a simple and quick test. While you lie on an exam table, the doctor puts an instrument called a speculum into your vagina, opening it to see the cervix. She/he will then use a special stick or brush to take a few cells from inside and around the cervix. The cells are placed on a glass slide and sent to a lab for examination. While usually painless, a Pap test is uncomfortable for some women.

Usually it takes 3 weeks to get Pap test results. Most of the time, test results are normal. If the test shows that something might be wrong, your doctor will contact you to schedule more tests. There are many reasons for abnormal Pap test results. It usually does not mean you have cancer.

It is scary, to hear that your Pap test results are abnormal. But abnormal Pap test results usually do not mean you have cancer. Most often there is a small problem with the cervix. Some abnormal cells will turn into cancer. But most of the time these unhealthy cells will go away on their own. By treating these unhealthy cells, almost all cases of cervical cancer can be prevented.

There are many reasons for abnormal Pap results. If results of the Pap test are unclear or show a small change in the cells of the cervix, we will report it as abnormal. If the test finds more serious changes in the cells of the cervix, the doctor will suggest more powerful tests. Results of these tests will help your doctor decide on the best treatment. These include:

  • Colposcopy: The doctor uses a tool called colposcope to see the cells of the vagina and the cervix in detail.
  • Endocervical curettage: The doctor takes a sample of cells from the Endocervical canal with a small spoon-shaped tool called currette.
  • Biopsy: The doctor removes a small sample of the cervical tissue. The sample is sent to a lab to be studied under a microscope.

Pap tests are not always 100 percent correct. The false positive and the false negative results can happen. This can be upsetting and confusing. A false positive Pap test is when a woman is told she has abnormal cervical cells but the cells are really normal. A false negative Pap test is when a woman is told that her cells are normal but in fact there is a problem with the cervical cells that was missed. False negatives delay the discovery and the treatment of unhealthy cells of the cervix. But, having regular Pap tests boost your chances of finding any problems. If abnormal cells are missed at one time, they will probably be found on your next Pap test.