Pap Tests: What Women Should Do
Here is a quick review of what I would recommend:
All young girls and women should begin an every other year Pap test, starting at age 21.
Any inconclusive or mildly abnormal Pap test result should lead automatically to an HPV test. Women who have a mildly abnormal Pap test and also test positive for high-risk HPV need more testing, such as a colposcopy and closer follow up. Women who don’t have high-risk strains of the virus and, therefore, test negative with an HPV test can simply have their Pap test repeated in 6-12 months.
Starting at age 30, women who have had three consecutively normal Pap tests can have a Pap test every three years . If they have a normal Pap test and no high-risk strains of HPV, they can safely have a repeat check for cervical cancer every three years. It takes about three years from the time a woman is exposed to HPV to develop serious cell changes that can be detected with the Pap test. That doesn’t get women off the hook for the all-important regular checkup, including a pelvic exam, however.
Women who have had a hysterectomy and their cervix removed for benign conditions, such as fibroids or heavy bleeding, can stop having Pap tests altogether.
Women who have had a hysterectomy for cancer should continue with regular Pap testing. The vulvar, vaginal and, rarely, anal tissues can also develop precancerous cell changes and even cancer from high risk strains of HPV.
As always, I welcome your thoughts and suggestions.
Do I Need A Pap Test After 50
The short and simple answer for most women is yes. For those over 50 who have just entered menopause, It is recommended that you receive a pap test once every three years. However, this is mostly if you have had normal pap smear results three years in a row and you have no history of a pre-cancerous pap smear result.
What If Im Having Unusual Symptoms
If youre having unusual symptoms, like irregular or heavy periods, vaginal discharge, or pelvic pain, please make an appointment at our offices outside of your regular exam.
If any unusual symptoms are related to a health problem, like a sexually transmitted disease, uterine fibroids, or a urinary tract infection, early treatment can help you avoid complications that could affect your long-term fertility and health.
Your reproductive and pelvic organ health is essential to your overall wellbeing and quality of life. with our womens health specialists.
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Painful Pap Smear Exam
jojoseven39004 over a year ago
Guest over a year ago
cas over a year ago
jenny over a year ago
valmart over a year ago
I just had a papsmear last week, and it was horribly painful. The pain is not when the speculum enters the vaginal entrance. The speculum inserts fine, and there is no dryness in the entrance. It’s when the OB starts touching the cervix area. I guess that’s where they take piece from. Well, when she gets ready to pinch a piece off, it was excruciatingly painful, and she stopped the procedure and pulled out the speculum. I became so tense and I was crying. I was very upset and concerned and scared, and said to just hurry up and do it to get it overwith. When she did it, I was in very much pain, and was crying so hard. When she finished, I was crying like a little girl saying “I don’t want to do this again, ever. Do I have to do this again?” She said that, if I have had good results in the past, I can wait every two or three years. But, I don’t want to do this again. It was unbearable! Then, after I walked out of the room, an assistant came over and gave me a big hug. The pain subsided right away. I am surprised I had no bleeding. How could that not be?
I am 56, passed menopause, and have not had sexual relations for 15 years. I don’t think that has anything to do with it. When I have been kissing a man, my body lubricates fine so dryness is not an issue, unless, as I said before the cervix can be dry while the vagina is well lubricated.
Why Are They Done
Pap smears are used to determine whether you have abnormal cervical cells.
If you do have abnormal cells, your provider may conduct further tests to determine whether the cells are cancerous.
If needed, your provider will recommend a procedure to destroy the abnormal cells and reduce your risk of cervical cancer.
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How Do I Prepare For A Pap Or Hpv Test
You do not have to do anything special to prepare for a Pap or HPV test. Also, you should not before a Pap or HPV test. Most doctors do not recommend douching for any reason. You also should not put anything in or around your vagina to clean it, other than soap and water on the outside of your vagina.
Screening Guidelines: When And How Often To Get Screened For Cervical Cancer
The details of the recommendations vary, but all are based on research findings, including:
- HPV-caused changes in cervical cells happen slowly and often go away on their own, especially in younger women
- more effective screening tests
- the harms of overtesting and overtreatment for cervical changes that would have gone away on their own
Age 2129 years:USPSTF recommends that women get their first Pap test at age 21 and have Pap testing every 3 years. Even if a woman is already sexually active, Pap tests are not recommended until the age of 21.
Age 3065 years:USPSTF recommends that women in this age group be screened for cervical cancer using one of these methods:
- HPV test every 5 years
- HPV/Pap cotest every 5 years
- Pap test every 3 years
ACS has recently published updated cervical cancer screening guidelines that recommend women start screening at age 25 with an HPV test and have HPV testing every 5 years through age 65. However, testing with an HPV/Pap cotest every 5 years or a Pap test every 3 years is still acceptable. To read about the reasons for the changes, see ACSs Updated Cervical Cancer Screening Guidelines Explained.
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What Is The Doctor Looking For
Almost all cases of cervical cancer are caused by HPV, varieties of the human papillomavirus.
Often, for women aged 30 and above, Pap testing is done at the same time as HPV testing.
A cytologist will examine the cells to determine if there are any precancerous or cancerous cells.
Your doctor should receive the results within a few days and hell then be able to interpret them for you.
- Negative/Normal: This shows that the cervix is healthy and all cells are the size and shape they should be.
- Positive/Abnormal: An abnormal result points to cells that are not of the expected shape or size.
If the results indicate any kind of abnormal finding, this does not automatically mean you have cancer.
In this case, youll require follow-up tests in order to establish firmly what the problem is.
How Much Does The Test Cost
The cost of a Pap smear depends on where the test is taken and if you have insurance coverage. Costs of testing may include the office visit, the fee for the healthcare professional to conduct the Pap smear, and the actual laboratory analysis.
If your doctor recommends a Pap smear, these costs are typically covered by insurance, but, depending on your plan, you may be responsible for copays or a deductible. Your doctor and insurance plan can provide more specific information about your costs for a Pap smear. Local and federal health departments may offer financial assistance programs for Pap smears for people who dont have insurance.
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Risk Of Postmenopausal Health Problems Increases With Age
Taking care of your health is important at every stage of life. Even women past their childbearing years should see their gynecologist or primary care doctor for annual wellness visits. Growing older raises the risk for gynecologic cancer, and the drop in a womans estrogen after menopause increases her risk for certain health conditions. These include:
Have Gone Through Menopause
Women should still get Pap smears after menopause up until the age of 65. Continuing Pap smears after age 65 will depend on whether a person has risk factors for cervical cancer.
A healthcare provider typically performs a Pap smear during a routine care visit. During the visit, a doctor will ask the person several health questions and perform an examination.
During the Pap smear, the person will typically lie on their back with their legs separated. A healthcare provider will then insert a speculum into the vagina to keep the vagina walls open.
With the speculum in place, the healthcare provider will take a sample of cervical cells using a brush or spatula. They will place the sample inside a container filled with a transport medium, which is a fluid that will preserve the sample.
The healthcare provider will then remove the speculum. During the procedure, the person may feel slight discomfort, pain, or pressure. A person can reduce the discomfort by urinating before the test.
The examination does not require any recovery time, and the person can leave immediately following the Pap smear.
13 weeks to come back, depending on the lab.
A person will usually get their results in a letter or through an online portal. A doctor can go over the results with the person to explain what they mean and discuss the next course of action, if necessary.
The results can be as follows:
- abnormal discharge
- pain during sexual intercourse or urination
- lesions or warts
- abdominal pain
At What Age Can You Stop Having Pelvic Exams
Yearly visits to your gynecologist should be a regular part of your health regimen. As a woman, you require several screenings on a regular basis, including pelvic exams. A pelvic exam covers everything from your uterus to your bladder to your vagina. Pelvic exams are especially important if youve had previous issues or a health pattern noticeable in your family history. Along with your regular dental and health exams with your dentist and general practitioner, you should also connect with your gynecologist for pelvic exams. However, as you get older, you may not require a pelvic exam the way you do when youre in your child-bearing years.
So, at what age can you stop having pelvic exams? For women under 30 years of age, annual screenings are vital for health. Past the age of 30, women can generally reduce their gynecological visits to every three years. However, this is dependent on your particular circumstances and should be determined with your doctor. Pelvic exams are an essential part of your health regimen even post-menopause, as they are a preventative measure that keeps you informed of your bodys health. The risk for cancer increases as you age. Therefore its vital you connect with your doctor to determine the frequency of your visits.
Exceptions To The Guidelines
- have a weakened immune system
- were exposed before birth to a medicine called diethylstilbestrol, which was prescribed to some pregnant women through the mid 1970s
- had a recent abnormal cervical screening test or biopsy result
- have had cervical cancer
Women whove had an operation to remove both their uterus and cervix for reasons not related to cancer or abnormal cervical cells do not need to be screened for cervical cancer. However, if your hysterectomy was related to cervical cancer or precancer, talk with your health care provider to learn what follow-up care you need. Women whove had an operation to remove their uterus but not their cervix should continue routine cervical cancer screening.
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I Get False Irregular Results Often When Can I Stop Having Follow
Dr. Jessie: Some women do get false irregular results after menopause. If this happens many times, you and your doctor may want to discuss how and when to do follow-up. Depending on the findings and your risk factors, the colposcopies may be able to be performed less often than yearly.
On the other hand, it is always possible that there are actually abnormal cells there, so this needs to be a very careful discussion. In some cases, when the abnormal Pap is thought to be related to atrophy or thinning of the tissues after menopause, a woman can use vaginal estrogen for a couple of weeks prior to her annual exam and Pap, which can normalize the Pap.
When Will I Get My Pap And Hpv Test Results
Usually, it takes 1 to 3 weeks to get Pap and HPV test results. Most of the time, test results are normal.
If you do not get the results of your Pap and HPV tests 3 weeks after the test, call your doctors office to get the results. If the doctor or nurse tells you to schedule another appointment to follow up on abnormal results, be sure to go to the appointment.
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Some Older Women Are Not Getting Recommended Cervical Cancer Screenings
Some women who are 65 years old or older should be screened for cervical cancer.
One type of cancer that only women can get is cancer of the cervix, or cervical cancer. Most cervical cancer is caused by human papillomavirus . The only sure way to find out if you have cervical cancer is to get a screening test . If you are a woman who has not had her cervix removed by surgery , keep getting tested until you are at least 65 years old.
However, a recent study found that some women do not continue to get screened for cervical cancer as they get closer to 65 years old. Unfortunately, you can still get cervical cancer when you are older than 65 years. The only way to know it is safe to stop being tested after age 65 is if you have had several tests in a row that didnt find cancer within the previous 10 years, including at least one in the previous five years.
- For the Pap test alone, you should have three normal tests in a row.
- For the Pap-HPV co-test, you should have two normal tests in a row.
- Screening after age 65 may be appropriate for some women at high risk, including women with a history of cervical lesions or cancer, women whose mothers took a hormone called diethylstilbestrol while pregnant, or women who have a weakened immune system. Women at high risk should talk with their doctors about how often to get screened and until what age.
Can We Stay Clear Of Gaining Weight
Yes, given you take the bull by the horns! Preferably, from the age of 40, the lady that intends to protect against the common weight gain of menopause has all passion to require herself to excellent hygiene of life.This indicates working out and closely checking her diet plan. How Often For Pap Smear After Menopause
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A Little Background On Pap Tests
Until the Pap test was widely adopted in the United States in the late 1940s, cervical cancer was the number one cause of cancer death in women. After the widespread use of the Pap test, however, cervical cancer cases dropped by 70 percent. This is a huge success story.
Soon after the discovery of HPV as the cause of cervical cancer, a DNA test to look for the high-risk strains of HPV was developed. This simple test is done using the same scraping of cells used for the Pap test. Although most women are exposed to HPV at some point in their lives — which is why we suggest that all women undergo cervical cancer screening — most women will fight off the virus within a year or two, and the virus either disappears altogether or remains dormant. Only about 5 percent of women will not fight off the virus, and these women will continue to test positive with the HPV test and may eventually develop precancerous cell changes — and even cancer — if these cell changes aren’t treated.
Do I Still Need A Pap Smear Now That I Am Menopausal
Even if you are menopausal or postmenopausal, you should continue to have Pap or HPV tests. Women who have had a total hysterectomy for a noncancerous condition and have not had a previous history of precancerous Pap tests may be able to stop Pap screening depending on their medical history and risk of contracting human papilloma virus . Screening may also be discontinued at ages 65 or 70 if women have had at least three normal Pap tests in a row and no abnormal Pap tests in the previous 10 years.
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What If My Appointment Is During My Period
You may be able to move forward with your Pap if youre experiencing spotting or otherwise light bleeding.
But, in most cases, your provider will ask you to reschedule your appointment for a time when you arent menstruating.
Getting a Pap smear during your period can affect the accuracy of your results.
The presence of blood can make it difficult for your provider to collect a clear sample of cervical cells. This may lead to an inaccurate abnormal result or otherwise obscure any underlying concerns.
A Pap smear can be performed by a doctor or nurse.
Your provider may start by asking you a few questions about your medical history.
If its your first Pap smear, they may also explain the procedure. This is a great opportunity to ask any questions you may have.
Afterward, theyll leave the room so that you can remove all clothing from waist down and change into a gown.
Youll lie down on an examination table and rest your feet in stirrups on either side of the table.
Your provider will likely ask you to scoot until your bottom is at the end of the table and your knees are bent. This helps them access your cervix.
Next, your provider will slowly insert an instrument called a speculum into your vagina.
A speculum is a plastic or metal tool with a hinge on one end. The hinge allows the speculum to open, subsequently opening your vaginal canal for easier inspection.
You may feel some discomfort when your provider inserts and opens the speculum.