Why Annual Pap Smears Are History But Routine Ob
An ob-gyn explains current guidelines for cervical cancer screening and routine checkups.
In the recent past, women were advised to visit their ob-gyn every year for a Pap test, as well as a pelvic exam and breast exam. The Pap test, also called a Pap smear, is a screening test for cervical cancer.
Fast forward to today, and our advice has changed. Women should still visit their ob-gyn each year, and Ill outline why thats so important below. But we no longer advise women to have an annual Pap test. A big reason for the change: We now better understand the way cervical cancer develops over timewe know it takes many years to developso weve expanded the time between screenings.
We also now have two screening options to detect cervical cancer, the Pap test and the HPV test. With both tests, cells are taken from the cervix and tested. The Pap test looks for abnormal cells that may develop into cancerous cells over time. The HPV test looks for the strains of HPV that are most likely to cause cancer.
Heres a quick summary of ACOG guidelines for cervical cancer screening :
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What Causes Bleeding After A Pap Smear
There are several things that may increase the chance of bleeding or cramping after a pap smear. To put your mind at ease, it is helpful to know about these various factors to better identify the source of your discomfort or symptoms. Hormonal contraception, such as birth control pills, elevates your hormone levels and causes your cervix to become more sensitive, making bleeding more likely. Vaginal infections, such as STIs, STDs, and yeast infections, can create tenderness in the cervix and may cause bleeding after a pap smear as well.
Bleeding should end within a few hours if the cause of it is from the cervical scrape itself, and over the following two days, light spotting may persist. Unless your doctor conducted the pap smears during your period and you are currently menstruating, bleeding after a pap smear for a week is not normal. If you experience bleeding, we recommend avoiding tampons and vaginal penetration for three days after the test to allow the area to heal. If you have pap smears during your period or a pap smear on the last day of your period, you may want to use a pad or sanitary napkin instead of tampons as the area will be very sensitive.
What Are The Risks For A Pap Test
Tell your healthcare provider if you are allergic to or sensitive to latex.
Tell your healthcare provider if you are pregnant or think you might be.
There may be other risks based on your condition. Be sure to discuss anyconcerns with your healthcare provider before the procedure.
Certain things may interfere with a Pap test including:
Use of things, such as vaginal creams, jellies, medicines, or spermicidal foams, for 2 to 3 days before the Pap test, as these substances may alter the pH of the cells or hide abnormal cells
Douching for 2 to 3 days before a Pap test as douching can wash away surface cells
Sex within 24 hours before the test may cause inflammation of the tissue
Certain medicines, such as tetracycline
Who Performs My Pap Test
A gynecologist typically performs a Pap test. A gynecologist is a medical doctor who specializes in treating diseases of a womans reproductive organs. Sometimes other health care providers perform Pap tests. This may include primary care doctors, physician assistants, or nurse practitioners. If the person performing the test is a man, a female assistant or nurse may also be in the room.
If the results of the Pap test show cervical cancer, your health care provider will refer you to a gynecologist or an oncologist. An oncologist is a doctor who specializes in treating cancer.
Getting A Pap Smear With A Light Period Or Spotting
If you have your period, its more likely that youll be able to go through with your Pap test if you are experiencing light bleeding or spotting. This small amount of blood is less likely to affect the results of the test. However, the best time to have a Pap test done is about two weeks after the start of your last period.
When women experience abnormal menstrual cycles or spotting, it could indicate a medical issue. This is not the time to worry about how accurate the Pap test will be if youre on your period. Regardless of where you are in your cycle, call your primary care provider or gynecologist for an examination. When there are changes in your menstrual cycle or symptoms that you cant explain, seek medical advice. Your doctor can determine whats causing the changes and either prescribe medication or recommend treatment that will be more effective if diagnosed early.
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How To Prepare For A Pap Smear
The results of your pap smear can be affected by different variables, so its important that you prepare before attending your appointment. Youll want to make sure that you avoid sexual intercourse two to three days before the test. In order to prevent abnormal cells from washing away, you should also avoid using certain products for two to three days. These include:
- Vaginal creams or powders
If You Are Older Than 65
Your doctor may tell you that you dont need to be screened anymore if
- You have had normal screening test results for several years, or
- You have had your cervix removed as part of a total hysterectomy for non-cancerous conditions, like fibroids.
You should not schedule your test for a time when you are having your period. If you are going to have a test in the next two days
- You should not use a tampon.
- You should not have sex.
- You should not use a birth control foam, cream, or jelly.
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So Can You Get A Pap Smear While On Your Period
There are three main factors to consider when determining whether or not you need to reschedule your pap smear if youre on your period.
First is the heaviness of your menstrual flow. If youre in the middle of a very heavy cycle, it could affect the accuracy of the sample taken when sent in for testing. If youre experiencing light spotting, testing accuracy should be less of a concern.
Second is your comfort level with being seen while on your period. Your pap smear can always be rescheduled, so theres no need to put yourself in an uncomfortable position by rushing to get it done while menstruating.
The final thing to consider is your providers preference. When in doubt, call your doctors office and ask what they recommend you do. They may ask you questions about your flow or symptoms to gauge how necessary it is for you to come in that day. You should be prepared to reschedule if thats what they recommend. I always tell my patients that the worst that could happen is we get an invalid test result and you need to schedule a repeat pap smear.
What Did The Biopsy Show
- If biopsy shows the cells are normal, another Pap smear and sometimes another colposcopy are done just to make sure.
- If biopsy shows mild changes , most health care providers do not treat. Treatment will not cure wart virus.
- If biopsy shows high grade changes , treatment should be done.
- If biopsy shows cancer, a cone or other surgery should be done.
- If colposcopydoes not give a diagnosis and the Pap smear shows high grade changes, a conization may be done.
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Track Your Period For Scheduling
If possible, women should try to schedule the pap smear 10-14 days after having a period. Depending on the heaviness of bleeding, menstruation may or may not interfere with detecting abnormal cells. If a woman is uncertain about whether or not to reschedule a pap smear based on menstrual cycle, experts advise consulting with the healthcare provider individually. Some physicians prefer to avoid performing pap smears during menstruation altogether, while others will advise based on the heaviness of bleeding.
Additionally, if a pap smear is scheduled close to a womans period, experts recommend avoiding tampons 2-3 days prior to the pap test. Tampons are another item that can wash away abnormal cells. While it might be more comfortable to use tampons, its not worth throwing off the results of the pap smear.
How Is The Pap Smear Test Performed
Pap smears can be a bit uncomfortable, but it is quite a quick and fast procedure. During the procedure, your doctor will tell you to lie on your back on the examination bed or table. You can spread your legs and feet with the support of an instrument called stirrups.
Now, your doctor will scrape a small sample of cells from your cervix. To take the sample, your doctor may use an instrument called a spatula, or spatula with a brush, and a device called cytobrush- which is the combination of spatula & brush.
- You may feel slight push or irritation while your doctor tries to scrap the sample of cells.
- After scratching the cells from your cervix, your doctor will keep them in the sample box and preserve the same to be tested in the laboratory.
- After the test is complete, you may feel little discomfort or a kind of cramping. There can also be chances that you may have little bleeding. You can ask the doctor if you notice such complications immediately after the test.
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A Pap Smear Using A Thin Period Or Spot
If you are experiencing your period, it’s much more likely you’ll be able to pass through the Pap test if you’re experiencing slight bleeding or spots. The small amount of blood is not likely to influence the test results. The best timing to get the Pap test performed is around two weeks following the beginning in your period.
If women notice irregular periods or spots the spotting could signal an issue with your medical. This is not the right time to fret about how reliable the Pap test is when you’re experiencing your menstrual cycle. No matter where you are on your cycle, contact your primary care physician or gynecologist to have an exam. If there are any signs of changes to your cycles or symptoms that are difficult to describe, seek medical advice. Your doctor can identify what’s causing these changes and prescribe medications or suggest treatment that’ll be more effective when diagnosed in the early stages.
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What Happens After A Pap Test
You may rest for a few minutes after the procedure before going home.Scraping the cervix may cause a small amount of bleeding. You may want towear a sanitary pad for any spotting that may occur.
Tell your healthcare provider if you have any of the following:
Fever or chills
Severe abdominal pain
Pap test results usually take a few days. Ask your healthcare provider howyou will be hear back about the results.
Your healthcare provider may give you other instructions after theprocedure, based on your situation.
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Pap Test With Your Period It Depends
As for getting a Pap test on your period, there’s no reason you can’t have one, though it may not be ideal if you’re experiencing a particularly heavy flow. “A lot of blood might obscure some of the details of the cells, which may make it hard to read,” , FACOG, Clinical Professor of Obstetrics at the Yale University School of Medicine, told Health.
According to Dr. Brightman, “Pap tests are typically liquid-based cytology evaluations with the cervical cells placed in solution, and cervical cells can then be separated from the blood in the lab to allow for proper analysis.” But, again, if there’s too much blood in that sample, it may obscure results. Board-certified ob-gyn Dr. Angela Jones, formerly Astroglide’s resident sexual health advisor, agrees that a Pap test on your period is totally fine”as long as your period isn’t too heavy,” Dr. Jones told Health.
Can A Pap Smear Detect Ovarian Cysts
No, a Pap test doesn’t detect ovarian cysts. However, a pelvic exam can detect a large ovarian cyst. During a pelvic exam, your healthcare provider feels your uterus and pelvis for lumps or masses. If a cyst is detected, they will likely order additional testing and discuss treatment options with you.
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When To Have Your Cervical Screening Test
If it has been two years or longer since your last Pap test, or you haven’t had one, then it’s time for your two-yearly Cervical Screening Test. Book an appointment with your doctor, nurse, community health or Aboriginal health worker. It may help to explain to the receptionist or nurse that the appointment is for a Cervical Screening Test as you may need a longer appointment.
The best time to have your Cervical Screening Test is when you are in the middle of your menstrual cycle. This is:
- a few days after your period has finished
- a week before your next period is due.
Within your 28-day menstrual cycle, this is days 9 to 20 of the cycle:
Days 17: Menstruation
Days 920: Best time for your Cervical Screening Test
Day 28: Day before your next period
You can have a Cervical Screening Test at any stage in your menstrual cycle. If you have booked an appointment for a Cervical Screening Test and then realised you will probably have your period, call your doctor or nurse to ask whether you should reschedule.
What if my period is irregular?
If your period is irregular, it can be difficult to predict the best time to have the test.
Dont worry – it is still possible to have your Cervical Screening Test at other times of the menstrual cycle, but the best chance of a satisfactory sample is mid-cycle.
What if I no longer have my period?
If you no longer have periods, any time is suitable for a Cervical Screening Test.
Why Do I Need A Pap And Hpv Test
A Pap test can save your life. It can find cervical cancer cells early. The chance of successful treatment of cervical cancer is very high if the disease is caught early. Pap tests can also find abnormal cervical cells before they become cancer . Removing these precancers prevents cervical cancer over 95% of the time.3
An HPV test can give your doctor more information about the cells from your cervix. For example, if the Pap test shows abnormal cervical cells, the HPV test can show whether you have a type of HPV that causes cervical cancer.
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You May Want To Reschedule Your Pap Smear If Youre On Your Period
Technically, you can get a Pap smear while on your period, but it may be better to reschedule to a time when you arent menstruating.
Depending on how heavy your flow is, it may affect the results of your screening. If your flow is lighter, it may not be an issue. Talk with your healthcare provider if youre on your period, and they can help you determine whats right for you.
Just due for a pelvic exam? Theres no reason to avoid it while on your period unless youre having the pelvic exam because youre having abnormal discharge or another concern.
P.S. Your period does not bother your healthcare provider.
How Long Do Smear Tests Take
Your whole visit should not take longer than about 15 minutes. “The actual test usually only lasts a couple of minutes but you can take some time to ask any questions you might have. If youre feeling nervous or know you have a condition which could make a smear test more difficult, you can book a double appointment, explains Eluned.
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Pap Smear Procedure: When And How To Perform It
Pap exam is used to diagnose cervical cancer for over 75 years. It is typically done during an annual OB-GYN examination. It is recommended that the Centers for Disease Control and Prevention advise all women who are sexually active to undergo a pelvic exam to rule out a variety of medical diseases such as cancer. This is particularly important for women who are over the age of 30 as they are at greater risk of developing cancer.
The majority of cases of cervical cancer result from HPV, also known as the Human Papillomavirus . It is a prevalent virus that can be passed via sexual contact and is considered an opportunistic sexually transmitted disease. Many women who are exposed to HPV don’t exhibit any symptoms. It may go unnoticed for quite a while before any signs become evident.
When you visit by your gynecologist doctor will conduct an examination of your pelvis and will collect the cells of your cervical. The specimen is sent to a lab to be tested. In general, this test only is required every couple of years unless you experience unusual signs and/or have an unusual result from laboratory testing. If you do you’ll need to see your doctor and you return to check the results and determine if further treatment is needed.
How To Prepare For Your Pap Smear
Read Time: Two Minutes
As a woman, your gynecologist will often recommend regular screening tests throughout your life, and one test most women have is a Pap test, or Pap smear.
Pap smears check for cervical cancer, which used to be one of the most common causes of cancer deaths in women in the US. However, because more women are now getting Pap tests, the death rate continues to drop.
According to the Centers for Disease Control and Prevention , the cancer death rate in 2000 was 2.8 per 100,000 women. That has fallen to 2.2 per 100,000 women as of 2019.
An estimated 14,100 new cases of invasive cervical cancer will be diagnosed in 2022 in the US, and about 4,820 women will die from cervical cancer, according to estimates from the American Cancer Society.
Jenny Pennycook, MD, FACOG, an OB/GYN with the Phelps Health Medical Group, shares tips on how to prepare for your next Pap smear.
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