Fredericksburg, Virginia OBGYNNo one goes to their gynecologist wanting to get a routine pap smear or pelvic exam. However, in the course of the past several decades, pap smears have been known to save lives as it screens for cervical cancer. The most important thing for women to remember is to get their pap smears and pelvic exams at least yearly to screen for abnormal cells on the cervix or even in the vagina. Women must also know that even if they have had a hysterectomy and/or the cervix removed, they must still go for their yearly exam; sometimes, abnormal cells that could be potentially pre-cancerous or cancerous can be “picked up” on the pap smear from the cervix and/or vagina. And, that could save a woman’s life, if it is detected early.

Usually pap smears are performed yearly and if they are “normal”, then the woman can continue with yearly Pap smears and pelvic exams. If the Pap smear is “abnormal”, then the woman must follow her physician’s advice for maintaining good gynecologic health. Often times, this means more frequent pap smears every 3-6 months for 2 to 3 years.

Many patients panic when they get results back that are considered “abnormal.” Some patients will actually shy away from medical intervention as they are in denial mode. Women must realize that when it comes to early detection for most medical issues, especially a pap smear, it can be life-saving as well as problem solving. Except for numerous visits to the gynecologist, it is not too much of an issue to get evaluated and treated.

In regards to abnormal pap smears, they can occur for different reasons. Some of the more common ones are outlined below:

  • Vaginal Yeast Infection
  • Bacterial Infection of the Vagina
  • Sexually Transmitted Infections (Chlamydia, Gonorrhea, Trichomonas)
  • Human Papilloma Virus (HPV)****Most Common
  • Close to Menses (“picks up” menstrual cells from shedding during or near the menses)
  • Cancer (Uterine, Cervical, Vaginal)

The most common reason for abnormal pap smears in women who are or have been sexually active is due to HPV. It is known as the virus that causes abnormal pap cells, genital warts, post-coital bleeding, and/or cervical cancer. Thankfully, due to the sensitivity of the liquid based pap smear, most gynecologists are able to diagnose abnormal cells early and thus have patients follow a strict protocol in order to avoid cervical and/or vaginal cancer, if they test for positive HPV.

If you have an abnormal pap smear, you must make a follow up appointment to discuss the proposed treatment plan with your gynecologist. This will most likely include repeat pap smears in short intervals for the course of 2 to 3 years, colposcopy (a microscopic view with possible biopsies of the cervix and/or vagina, and/or removal of the diseased tissue with a LEEP (loop electrosurgical excision procedure) or cone biopsy. It is also important to note that normal pap smears do not mean that a woman has not been exposed to HPV as it may take up to 30 years before it starts to shed. In other words, HPV may lay dormant in the body for a very long time, before it is detected.

In our practice, at The Women’s Health and Surgery Center, both Drs. Thott and Shorter encourage patients to make appointments to discuss in detail their (the patient’s) particular issues on their abnormal pap smear results. And, together both the physician and patient will formulate a treatment plan effective for maintaining and/or gaining a healthier patient. If you have any questions about your gynecologic care, please feel free to make an appointment with one of the friendly doctors at The Women’s Health and Surgery Center.

Submitted by:
Lia D. Shorter, MD
Women’s Health and Surgery Center