Annual Well Woman Exams

Comprehensive Medical Review, Annual Pap Smear

A Pap smear is a test that checks for changes in the cells of your cervix. The cervix is the lower part of the uterus that opens into the vagina. You may also hear a Pap smear referred to as a Pap test or a cervical smear. Pap smears are recommended yearly at age 21. Screening for sexually transmitted diseases (such as gonorrhea, chlamydia, trichomonas, and herpes) is recommended whenever sexual activity begins with a new partner. A pap smear tests for cervical dysplasia, a term used to describe a change in the cells of the cervix. A Pap smear can detect this condition. The abnormal cells can develop into cancer if the dysplasia is not treated. The Pap smear may also detect viral infections of the cervix, such as genital warts and herpes. It may detect vaginal infections such as yeast infections or trichomonas. Sometimes the Pap smear can give information about your hormones, especially progesterone and estrogen.

How often should I have a Pap Smear?

Most women should get a Pap smear at least every year. Your health care provider will recommend how often you should be tested based on your risk factors for cervical cancer. Risk factors that place you at an increased risk for cervical cancer include:
  • You have had an abnormal Pap smear in the past.
  • You began to have sexual intercourse at an early age.
  • You have a history of many sexual partners.
  • You or your sexual partner has or has had genital wart (HPV) virus infection.
  • You have had vulvar or vaginal cancer.
  • Your sexual partner’s previous partner had cervical cancer or abnormal cervical cells.
  • Your sexual partner has or had cancer of the penis.
  • You smoke cigarettes
  • Your mother took the hormone diethylstilbestrol (DES) when she was pregnant with you.
  • Your immune system is weakened, for example, because you are taking immunosuppressive drugs due to a transplant or if you have AIDS
Your health care provider may not recommend continuing Pap smears beyond age 65 as a screen for cervical cancer if previous Pap smears were consistently normal. However, an annual exam continues to be important for other health reasons, including early detection of possible breast and vulvar cancer.

How do I prepare for a Pap smear?

Do not douche or use vaginal creams during the 2 days before the test. Do not have sexual intercourse within 24 hours of the Pap smear because it can cause inaccurate test results.

What happens during the procedure?

A Pap smear takes only a few seconds and is performed as part of a routine pelvic examination. You lie on your back with your knees bent and your feet apart. The health care provider inserts a speculum into the vagina. The speculum is a tool that holds open the walls of the vagina. Your provider uses a special swab, brush, or wooden stick to scrape off some cells from the cervix. The cells are sent to a laboratory to be viewed under a microscope.

What happens after the procedure?

If the cells look normal, no treatment is necessary. The Pap test may show that you have an infection. Your health care provider may treat you for the infection and suggest that you have another Pap test in several months. If the cells look abnormal, more tests may be necessary. Discuss with your provider when you should return for a follow-up exam. A Pap test is not 100 % accurate. You may want to talk to your provider about the results if you have any concerns.

What are the benefits of the procedure?

Pap smears can detect precancerous conditions. If these conditions are discovered, there is a good chance that simple treatment will prevent the development of cancer. Pap smears are also useful for detecting some types of cervical or vaginal infections.

What happens if I have an abnormal Pap smear result?

Many abnormal Pap smears are the result of a sexually transmitted disease called Human Papilloma Virus (HPV), which is the same virus that causes genital warts. While it is difficult to fully eradicate the virus, it is important to evaluate and treat all abnormal Pap smears for prevention and early detection of cervical cancer. If you have an abnormal Pap result, we may recommend a colposcopy to take a closer look at the cervix. Biopsies may or may not be taken. Depending on these results, we may recommend treatment such as cryotherapy (freezing), laser vaporization, or LEEP (loop excision).