Editor’s Note: Anyone with a cervix can get a Pap smear, but for this article we included sources that generally identified these people as women.
Going to the doctor for any kind of exam can feel daunting and uncomfortable, especially when it comes to your vagina. Not many people enjoy sitting on an exam table with their feet in stirrups while a doctor casts a light between your legs. But if you have a vagina, then you’ve probably heard that at some point you need to start getting regular pap smears. These tests are considered an important part of vaginal health, which is why it’s crucial to actually do them as needed.
Given that your vagina doesn’t come with an instruction manual, it’s understandable to have questions about what a pap smear is and what it is why you need one So POPSUGAR spoke to experts to better understand Pap tests, including why you need a Pap test regularly; what happens during a pap test; how to prepare for a pap test; when to start Pap tests; and what an abnormal Pap test means. Here’s everything you need to know.
OK, what is a pap smear?
A Pap smear, also known as a Pap test or cervical cytology, is a special test done to look for changes in the cells of the cervix that could lead to cancer American College of Obstetricians and Gynecologists (ACOG). A pap smear can detect precancerous cells and cervical cancer cells that National Cancer Institute (NCI) explained. It can also detect some infections and inflammation.
Why do you need a regular pap smear?
ACOG currently recommends that women between the ages of 21 and 29 have a Pap test every three years. Women ages 30 to 65 can have a Pap test and HPV test every five years, only one Pap test every three years, or only one HPV test every five years.
OK, but why? It typically takes three to seven years for major changes in cervical cells to become cancer, ACOG explains, and screening with a Pap smear can detect these changes before they become cancer. If you have what are known as “low grade changes,” you may be tested more often than every three years to see if your cells are returning to normal, according to ACOG. And if you have “high grade changes,” you can have treatment to have the cells removed.
Pap smears are effective in preventing cases and deaths from cervical cancer. ACOG notes that cervical cancer cases and deaths have fallen by half over the past 30 years, largely due to early detection of cervical cancer such as Pap smears.
When to start Pap smears
You should have Pap smears by the age of 21 United States Preventive Services Task Force (USPSTF). It is not recommended that you have a pap smear before this age as cervical cancer is extremely rare in this age group and research shows that screening for cervical cancer in people under the age of 21 does not reduce the rate of cervical cancer and leads to a can result in unnecessary treatment, ACOG says.
How to prepare for a Pap smear
Doctors say there’s not much you need to do to prepare for a Pap smear. “Don’t worry,” he says Christine Greves, MD, a board-certified OB/GYN at Winnie Palmer Hospital for Women and Babies. “Just make the appointment and come over.”
The one thing to keep in mind, says Dr. Greves, is that you must avoid showering beforehand (a practice not recommended anyway). Otherwise, just go to your doctor’s office as usual.
What happens during a Pap smear?
A Pap smear is a fairly quick process. Before your test, you will be asked to undress from the waist down, put on a dress, and drape a drape across your lower body. You will then put your feet in footrests to keep your legs apart, says Mary Jane Minkin, MD, a clinical professor of obstetrics and gynecology and reproductive sciences at Yale Medical School. “Keep the pelvic floor muscles as relaxed as possible.”
Your provider will then place a speculum. This is a “device that helps keep the vaginal walls out of the way so you can look around inside the vagina,” explains Dr. Minkin. “I usually warm up the speculum if it’s metal – the plastic speculums aren’t usually cool to start with.”
The speculum is inserted to the top of your vagina and opened up so your doctor can view your cervix. “We then take a small narrow brush and insert it into the opening of the cervix and swish it around,” says Dr. Minkin. This can cause a “strange stinging,” warns Dr. Greves, noting that it’s “temporary.” The speculum is then removed.
“For someone who’s sexually active, a Pap smear shouldn’t be very uncomfortable,” says Dr. Minkin. For someone who isn’t active, however, it might be a little awkward. So be sure to let your provider know if you’re not active.
Some people also complain of cramping after a pap smear or speculum discomfort during the exam. Be sure to tell the doctor about any pain or discomfort you experience during or after the Pap test.
Your doctor will also usually do what’s called a “bimanual exam,” in which they’ll place one or two fingers inside your vagina and the other hand on the lower part of your abdomen to feel your uterus and ovaries to make sure they’re doing this the case is OK, says Dr. Minkin.
The Pap smear will then be sent to a lab, and you should get your results back within a few days.
What is an abnormal Pap smear?
An abnormal pap smear means certain changes have been detected in your cervical cells, explains Dr. Greves. But “it’s pretty common” to have abnormal results on a Pap smear, she says. And she stresses that an abnormal result doesn’t mean you have cancer, as cervical changes often go back to normal on their own.
If you get an abnormal screening result, your doctor may recommend monitoring, further testing, or treatment to remove the abnormal cells. according to the National Cancer Institute. Be sure to contact your provider for the next steps.