Every year, women all over the country go to their gynecologist for their annual pap smear test — which is part of their well-woman exam. The routine is familiar. You arrive at your scheduled appointment, you’re given several minutes alone to undress and put on a paper robe, and you lay down on an examination table while an OB-GYN examines your cervix, uterus, and performs a breast exam. In most cases, the procedure only takes a few minutes, and you never hear back again from the doctor’s office until it’s time to schedule your next appointment. But, what happens when a few days later, you receive a call that your pap smear results were abnormal? What does it mean? And, what do you have to do moving forward?
What’s the purpose of a pap smear?
A pap smear is a procedure designed to test the cells in the cervix for cancer. The reason why the test is recommended annually is because early detection significantly increases the chances of a cure. It is done at the same time as a routine pelvic exam. It involves opening the vagina with a speculum so that your OB-GYN can have a better view of the cervix. Your doctor will then use an extended cotton swab and run it along the walls of your vagina to collect cells for testing at a lab.
Something that makes pap smears extremely useful is that in addition to detecting cancer, it can also detect precancerous ones — meaning that you can detect abnormalities before they become cancerous. Since time can be essential for getting effective treatment, your likelihood of remission would be greater.
Does a pap smear hurt?
No, a pap smear doesn’t hurt. If you haven’t had sexual intercourse, it may feel somewhat unusual to have the speculum inserted into your vagina. However, the OB-GYN applies lubrication to it prior to doing so. The instrument may feel cold, and you may feel slightly uncomfortable when getting the procedure done for the first time, but you won’t feel any pain.
What happens during a pap smear?
A Pap smear examines the cells of the cervix to test for cervical cancers in women. The process of examining these cells may cause discomfort. Here’s what to expect once you enter the exam room!
- First, your physician will ask you to get comfortable and step out of the room while you remove your clothing and change into a highly fashionable paper robe.
- Then, you will be asked to lie on a table with your feet in a stirrup which allows the physician to take a closer look.
- If you think you’ll get away with having your knees touch while your feet are in the stirrups, think again – time to spread your legs!
- Your doctor will then lubricate a tool called a speculum which can be plastic or metal and insert it into your vagina (Don’t be alarmed, this is the tool that gently widens your vaginal walls once it’s in).
- Now that your doctor has your cervix in clear sight it’s time to swab!
- Your doctor will then insert what looks like an oversized one-ended q-tip into your vagina to get a sample of cells from your cervix.
- This step is what most women fear the most because it may stimulate a pain that is similar to menstrual cramping, don’t worry though it should stop right after the q-tip is taken out.
- Your sample is then placed into a tube and prepared for lab tests!
The entire procedure should last between 10 and 20 minutes with the most uncomfortable part only taking a minute or so! These sample cervix cells will detect changes in your cells that suggest cancer may develop in the future.
What does it mean to get an abnormal pap smear test?
Your Pap smear results will either be negative or positive. A positive Pap smear means there is unusual activity in your cervix. These cell abnormalities can signal the future development of cancer, but not always.
When pap results conclude that there’s an abnormality in your cells, it means that something within the cells is out of the ordinary. While the reason for the testing is to detect cancer cells, an abnormal pap result doesn’t necessarily mean you have cancer — in fact, most women who have an abnormal pap result do not have cancer. There are certain factors that could result in getting abnormal pap results. The most common ones include:
- Human papillomavirus (HPV)
- Having an impaired immune system
- The natural aging process
- Precancerous cells
- Cervical cancer
An abnormal result is not conclusive. The abnormality could be mild, moderate, severe, precancerous, or cancerous. If you get one, you will be called back into your doctor’s office for additional testing — called a colposcopy. During this additional testing, you will once again lay down on an examination table. Your OB-GYN will apply a solution to your vagina and cervix that’s designed to make it easier to detect abnormalities. The doctor will then use a microscope to look at your visible reproductive organs in detail.
It is possible for everything to look normal during the colposcopy, since some low-grade cervical cell changes often go away on their own. If something looks unusual, your doctor will take a sample of tissue to perform a biopsy. Prior to doing so, she will apply local anesthesia to minimize or eliminate your discomfort. However, you may still experience a pinching sensation. You can also experience cramping and spotting afterward.
Your OB-GYN will send the tissue sample to a lab for additional testing. Once they return, it may all have been a false alarm, or you may be told to watch and wait what happens — in such a case, you’ll likely have another pap smear scheduled in about six months. If the results indicate precancerous or cancerous activity, your doctor will sit down with you to design a treatment plan.
Types of Abnormal Pap Smears Results
If you received a positive result from your Pap smear, it doesn’t mean you have cancer or that you will get cancer. There are many reasons why your results may be positive.
Types of abnormal cervical cells include the following:
- Atypical Squamous Cells of Undetermined Significance, or ASCUS. Squamous cells flat, thin, and found on the surface of a healthy cervix. With ASCUS, the Pap test shows squamous cells that are slightly abnormal, but no substantial evidence of precancerous potential is present.
- Squamous intraepithelial lesion. Cells of this kind may be precancerous. Low-grade changes usually mean that a precancerous lesion is likely years away from becoming cancerous. High-grade changes indicate a higher probability that the lesion will soon turn cancerous
- Atypical glandular cells. These cells produce mucus around the cervix and uterus. Atypical ones may indicate a precancerous condition.
- Squamous cell cancer or adenocarcinoma cells. The discovery of cells of this kind provides almost certain evidence that cancer is developing.
What happens after an abnormal pap smear?
Depending on what your lab work reveals about the abnormality of your cervical cells your doctor may perform a colposcopy to examine the tissues of the cervix, vulva, and vagina. Your doctor may also take a tissue sample (biopsy) from any areas that appear to be abnormal. The tissue samples will be sent off to a laboratory for analysis and diagnosis; then your doctor will lay out your course of treatment.
Call OB-GYN Women’s Centre of Lakewood Ranch for More Information
At OB-GYN Women’s Centre of Lakewood Ranch, we provide a variety of services for every woman. No matter your age or medical history, we’ll help you feel comfortable and answer all of your reproductive health-related questions.
Call us today to schedule an appointment.