Iowa Health Book: Obstetrics & Gynecology
Throughout our lives, we have many choices to make. These choices affect our family, friends, employers, and last but not least, ourselves. The choices we make today affect the choices we'll have to make in the future. Health care choices such as diet, exercise, health habits, and physical exams may be among our most important decisions. Our health is one of our most valuable assets, yet too often we neglect our physical needs or develop habits that may do us harm.
Yearly Checkup
A smart choice that we can make to ensure good health is to have a yearly Pap smear. A Pap smear is a simple test that does not involve much time or discomfort. The Pap smear will detect potential problems of the cervix (opening of the uterus) or vagina (birth canal) early so they can be diagnosed and treated. Another good reason to have a yearly Pap is because your doctor will also do a breast exam, blood pressure check, pelvic exam and listen to your heart and lungs. Other tests may be done based on your needs and health history.
It's a good feeling knowing you're healthy and that you are doing your part to stay that way.
Who Should Have a Pap Smear?
Pap smears of the cervix are recommended every year as soon as a woman is sexually active; otherwise, every year starting from ages 18-21.
If a woman has had her uterus removed, Pap smears of the vagina should be done regularly as recommended by her doctor.
A common myth is that women should not have a Pap smear until after they have had intercourse. The exam does not in any way harm or alter the female organs.
How is a Pap Smear Done?
Some women find the Pap smear and pelvic exam embarrassing, but it should be seen strictly as a necessary medical process and not as a procedure to embarrass you. It is the only way to examine you internally and to take a Pap smear.
For the exam, you will be asked to lie on you back on the exam table, bend you knees and put your feet on the foot rests. The doctor will want you to let you legs rest out to the sides. The important word at this point is RELAX. Concentrate on letting your muscles go soft and take slow, easy breaths in through your nose and out through your mouth. The more relaxed you are the more comfortable the exam will be. A speculum is gently inserted into the vagina, then opened to allow the examiner to see your cervix. When the cervix is in good view a sampling of cells is taken from the cervix or vaginal wall by gently scraping a wooden spatula and soft brush on your cervix. You may feel a pressure feeling and maybe a small cramp. The cells are placed onto a glass slide and sent to the laboratory to be examined.
What Does a Pap Smear Tell Us?
A Pap smear gives us information about the cells of the cervix or vagina. An abnormal Pap smear means that changes in the cells have been found. These changes can be referred to as "warning cells" (cells that can later become cancer cells.) This is why it is important to have regular Pap smears and to treat any abnormalities at an early stage.
Some abnormal Pap smears are due to infections of the cervix or vagina. Many abnormal Pap smears caused by infection will return to normal once the infection is treated.
It is not possible to remove every cell of the cervix with a Pap smear. Therefore, cells that are taken for the Pap smear can be normal and the cells remaining on the cervix may be abnormal. This does not happen often, but it is possible . This is another reason to have Pap smears regularly.
What Will Happen if Your Pap Smear is Not Normal?
The doctor will notify you in one to two weeks by phone or letter if your Pap smear is abnormal and to discuss recommendations for follow-up and treatment.
Further testing may be needed. Colposcopy, an office procedure, may be used to help the doctor view the cervix with a microscope to look for infection or any abnormal cells on the cervix or vaginal wall. This would help him/her to see signs of infection or any abnormal cells. If an area on the cervix doesn't look normal, the doctor may want to take a biopsy (sample cells) for further testing.
Who is At Greater Risk for Abnormal Paps?
Women
What are the Warning Signs of Cancer?
Remember that these are just warning signs which may or may not indicate cancer. If you notice any of the symptoms listed above, it is important for you to see your doctor to find out the cause and to receive treatment.
It is also important to realize that often there are no warning signs. Because of this, it is important to have regular Pap smears.
Most women with abnormal Pap results can look forward to a normal Pap smear in the future with appropriate treatment and follow-up.
Planning for your Pap Smear
You can help your doctor do the very best exam by having the following information available:
These facts help the doctor and the specialist looking at your cells to decide if your Pap smear is normal or not.
If you are having your period at the time of the exam, it is best not to have a Pap done that day. You should also avoid douching or using vaginal cream for at least 24 hours before having a Pap smear.
In summary, there are many good reasons to make the choice to have a Pap smear:
Think of your yearly physical as an important way of taking care of yourself. You're worth it.
Written by:
Sharla Taylor, R.N.
Lois Mulholland, R.N.
Vicki Guzman, R.N.
OB-Gyn Clinic
Approved by:
Susan Johnson, M.D.
Deborah Turner, M.D.
September, 1988