Are you trying to schedule your well-woman exam, but aren’t sure when the best time is to for a Pap smear? Well, don’t worry, because even though there are some better times for this test than others, the physicians at Aurora OB-GYN in San Antonio, TX can perform this exam any time and still achieve accurate results. Additionally, if it’s been a while since you’ve had one, it’s recommended that schedule your well-woman exam as soon as possible.
What Is the Best Time to Do a Pap Smear?
According to experts on cervical cancer, the ideal time to have a Pap smear done is at least five days following the last day of your menstrual period. Even though OB-GYN physicians can conduct this test when you are on your period, it is still better to reschedule for another date. However, if you are unable to find a date that works for your menstrual cycle, you should just keep your appointment and get your well-woman exam done anyway.
What Does a Pap Test Check For?
The Pap test has long been the most common test used to detect early changes in cells that could eventually evolve into cervical cancer. This test does not determine whether you have cervical cancer or not. Instead, it only tells the doctor that you have precancerous cells and that you may need to get a procedure called a colposcopy. This procedure will involve removing abnormal cells for a biopsy, which will indicate the grade of the cell changes.
For low-grade cell changes, your physician will likely take a wait-and-see approach as they are unlikely to develop into cancer. If you have moderate- to high-grade changes, your physician will provide your options, which may include surgery, as these changes are at higher risk of developing into cervical cancer. For high- to severe-grade changes, you may need to have the cervical tissue removed, but this again will be a discussion to have with your physician.
Pap tests can also be used to test for human Papillomavirus or HPV, which an infection that carries a risk of cervical cancer. HPV is usually passed between sexual partners during sexual activity, but there are several strains of HPV, not all of which are linked with cervical cancer. Approximately 70% of of cervical cancer that is caused by HPV is the result of HPV-16 or HPV-18. Most infections do not lead to cancer, but should still be treated.
Who Performs a Pap Test?
A Pap test is usually performed by a gynecologist, who may also be an OB-GYN. This is a physician who is trained to test for, diagnose, and treat diseases that affect the woman’s reproductive organs. However, general physicians, such as primary care doctors, can and do perform Pap tests, as do some nurse practitioners (NPs) and physician assistants (PAs). If a Pap test comes back from the laboratory as abnormal, you’ll be referred to a gynecologist or oncologist.
Who Needs a Pap Test and How Often?
Although you should speak with your physician about when it is appropriate for you to begin getting a Pap test, most women begin to have this test done when they turn 21 and until they turn 65. However, you may want to begin getting it done as soon as you are sexually active to test for HPV, which can be a risk factor for cervical cancer, especially if it is a particular strain of HPV as mentioned above.
When you begin getting your Pap test done, you will have it conducted every three years unless you have an abnormal test. Once you turn 30 years old, you will want to get a Pap test done every five years as long as your tests continue to be normal. If you have a hysterectomy under benign (non-cancerous) circumstances at any time before you turn 65 years old, you no longer need to get a Pap test done at all.
Regardless of age, your physician may recommend that you have more frequent Pap tests if you have certain risk factors that may include a cervical cancer diagnosis, an abnormal Pap test, an HIV infection, a weakened immune system due to chemotherapy or other treatments and medications, a history of smoking, or exposure to diethylstilbestrol (DES) prior to birth. If you believe you have a high risk of cervical cancer, discuss the benefits of more frequent Pap tests with your physician.
Preparing for a Pap Test
You want to ensure that your Pap smear gives you the most accurate results possible and that you don’t have to return for another one if they return to your physician as inconclusive. Avoid having sexual intercourse for a minimum of two days prior to your appointment, and for the same time period, refrain from using tampons, vaginal medications, douches, birth control foams, and vaginal creams or powders to make sure abnormal cells are not washed away.
Your Pap Test Appointment
When you arrive at your appointment to have your Pap test, your physician or their assistant will ask you a series of questions related to your reproductive system. These questions may include the following:
- Are you pregnant?
- Are you currently taking any medications? If so, what are they?
- Are you using birth control? If so, what are you using?
- Are you a smoker?
- When did your last menstrual cycle begin and end?
- Are you experiencing any itching, redness, or sores in your vaginal area?
- Have you undergone any other procedures on your reproductive system?
- Have you ever had an abnormal Pap test?
Your physician will then have you change into a hospital gown and to lie down on the examination table. Your heels will be placed into metal stirrups at the end of the examination table. Once you’re in position, your doctor will insert a speculum, which will be lubricated, into your vagina to spread the vaginal walls. Using a cotton swab, your physician will carefully scrape cells from your cervix and place the swab in a sealed container for the laboratory.
A visual inspection of your cervix will also take place, and your physician may perform a pelvic exam at the same time. During this examination, the doctor will examine your vaginal area externally as well as your internal reproductive organs, including the cervix, ovaries, uterus, and fallopian tubes. To examine these organs, your doctor will place two gloved fingers inside your vagina while pressing on your lower abdomen with the other hand. They are checking for cysts and other abnormalities.
After Your Pap Test
You can resume your regular activities immediately following your test, but if it comes back abnormal, you may be asked to schedule an appointment for a repeat test. Even though Pap tests are excellent for cancer screening, they can still sometimes give inaccurate results. Repeating the test will let your physician know if further testing is necessary. Regular screening according to the recommended schedule is important to guard against false negatives, when results are normal when abnormal cells are present.
When Results Will Be Available
It can take up to three weeks to get the results of your Pap test, although most of the time, it doesn’t take that long. If the laboratory is backed up, you might end up waiting three weeks, but it’s rare. In the event that you have not received the results of your Pap test after three weeks, call your physician’s office and request the results. In most cases, if you haven’t received timely results, it’s because they’re normal.
Unsatisfactory Vs. Abnormal Results
Your physician may have you repeat your Pap test if the results come back either unsatisfactory or abnormal. Abnormal results have already been discussed and a repeat test is sometimes necessary to confirm the presence of precancerous cells. Unsatisfactory results, however, mean that the test could not be accurately conducted due to insufficient cells, the presence of mucus or blood, or an administrative error. There’s no cause for alarm in an unsatisfactory case, but a repeat test is still necessary.
Pap Tests During Pregnancy
It is entirely safe to get a Pap test done if you are under 24 weeks pregnant, and in fact, one will likely be done early in your pregnancy to ensure that any abnormalities can be immediately addressed. Once you reach 24 weeks pregnant and until you are at least three months postnatal, you shouldn’t have a Pap test. This is because after you give birth, you may receive unreliable Pap test results because of the presence of inflammatory cells.
What Is a Colposcopy?
As previously mentioned, if your Pap smear test comes back abnormal, your physician may recommend you undergo a procedure called a colposcopy. During this procedure, your physician will use a lighted instrument with a magnifier to look more closely at any abnormal areas on your cervix. From these abnormal areas, your physician will conduct a biopsy (remove some tissue) to be tested for cancer cells. The cells that are removed will be sent to a laboratory to be tested.
Biopsy results for cervical cancer tests can take up to two weeks to receive, but your physician should be able to let you know if they saw any abnormal areas on your cervix during the colposcopy. However, if the colposcopy doesn’t reveal the reason why your Pap test was abnormal, your physician may suggest you undergo a cold knife cone biopsy, which requires general anesthesia but is able to extract a larger section of the cervix for more accurate results.
Reducing the Risk of Cervical Cancer
Getting regular Pap tests along with an HPV test after age 30 according to the recommended schedule is the best way to reduce your risk of cervical cancer. You can also get the HPV vaccine to prevent most cancer-causing strains of HPV if you are between the ages of nine and 45. Finally, there are several steps you can take in your personal life to lower your risk of cervical cancer:
- Use a condom when having sexual intercourse
- Get tested for sexually transmitted diseases
- Stay monogamous
- Limit the number of sex partners you have
- Refrain from douching
There is no single action you can take to completely eliminate your risk of getting cervical cancer, but if you follow all of the above recommendations together, your risk will be significantly reduced. However, even if you use all of these suggestions, you should still get regular Pap tests to monitor your reproductive health.
Now that you know all about the Pap smear test and the reasons why it’s important, it’s time to schedule your well-woman exam and have a Pap test done. Contact Aurora OB-GYN in San Antonio, TX today and we’ll get you an appointment that works with your cycle.