What is a pap smear? And when should I get one?
A pap smear is a routine screening test where a clinician uses a small brush to gather cells from the cervix (starting at age 21 and every 3 years thereafter if the result is normal). To do this, the clinician first places a speculum (looks kind of like a duck beak) in the vagina (which is a canal) to create some space that lets the clinician reach the cervix (the lower part of the uterus). This sample is sent to a laboratory to be examined to look for any kind of abnormal changes in the cells. The exam is slightly uncomfortable and can cause feelings of pressure or cramping.
What is an abnormal pap smear?
An abnormal pap smear is a lot more common than you might think. Sometimes bleeding, recent pressure on the cervix from sex, semen (cum) or common vaginal infections can cause cervical cells to appear abnormal. Other times, cervical cell changes are due to a sexually transmitted infection known as Human Papilloma Virus (HPV). More about HPV below.
So why are abnormal cells such a big deal?
Abnormal cells on the cervix can lead to cervical cancer if not monitored and/or treated. However, that doesn’t mean an abnormal pap will lead to cervical cancer. That’s because it takes a long time for abnormal cells to turn into cancer. I mean, a really long time with plenty of time for treatment. Cervical cancer is treatable! So as long as you are getting routine paps, even if the result is abnormal, there is a very low risk of cervix cancer.
What happens if I get an abnormal pap?
Usually, a clinician will simply want to repeat the test in 6 months. This is because the immune system will generally clear the abnormal cells. In less common situations, a clinician may want to do a colposcopy.
90% of abnormal PAP smears will get better on their own.
What is a colposcopy?
A colposcopy is a more specific test to examine abnormal cells of the cervix. A colposcopy uses a large microscope (called a coloposcope) that allows the clinician to look at the cervix more closely. Your clinician may put acetic acid (vinegar) on your cervix in order to see the abnormal areas on the cervix more easily. The clinician may take a small biopsy (a tiny sample of cervical cells) to send to the lab for examination.
What is HPV?
HPV (human papilloma virus) is spread by skin to skin contact. There are over 100 types of HPV viruses; about 40 of those types can cause genital infections and are sexually transmitted. Some strains can cause genital warts and others can cause cell changes on the cervix. About 14 types can, in rare cases, lead to cervical cancer. Over 80% of men and women get infected with HPV one or more times in their life. But as I mentioned above, usually the immune system clears the virus and a person may not ever know they even had it.
The best way to protect yourself from HPV is abstinence or condom use. It’s important to acknowledge that because condoms do not cover all of the genital skin, transmission is still possible. But because condoms prevent skin to skin contact with the cervix, they do protect against the strains that can cause cervical cell changes which is way awesome!
In happiness and health,
Shawna Pattison & Mei-Lani
Reviewed by Andrea Raider, NP & Debby Davidson, NP