A Pap smear is a very important test for all women. It allows for the detection of any bacteria or changes in the vaginal flora, making it possible to treat various diseases that could become harmful to a woman’s reproductive health. The Pap smear was developed by gynecologist George Papanicolaou in the 1940s. Since then, this annual routine has helped save lives and prevent cervical cancer and other diseases1. A simpler procedure than colposcopy (which involves removing a small piece of the cervix for analysis), the Pap smear involves collecting vaginal secretions from women who are sexually active, even if they have not had sex for some time.
The Pap smear checks for the presence of abnormal cells or unusual bacterial growth. The vaginal flora consists of many different bacteria, but an unusual change could create an unhealthy environment. The Pap smear also checks for sexually transmitted diseases, including and primarily HPV, which can be a major cause of cervical cancer2, syphilis, gonorrhea, chancroid, and even signs of chlamydia.
How is the Pap smear done?
The Pap smear should be performed when the woman has been abstinent from sexual activity for at least 3 days. It is also not recommended to douche in the days leading up to the exam, and it should be scheduled for about a week before or just after menstruation. Vaginal creams and ointments can interfere with the results and should be avoided at all costs—they are contraindicated. At the lab or doctor’s office, the woman must remove the lower part of her clothing and lie on the examination table for the Pap smear collection.
A speculum is inserted to allow the vaginal secretions to be accessed easily. Using a suitable spatula, the professional carefully collects cervical secretions. After collection, if necessary, the doctor will also assess the color and appearance of the inner vagina and vulva. It is important to note that the presence of warts in the area is a warning sign for HPV (human papillomavirus). Women who have never had sexual intercourse can also have cervical cells collected. The difference is that a smaller speculum is used to avoid injury or discomfort.
Can pregnant women have a Pap smear?
Yes! In fact, it is recommended during pregnancy3. The difference for pregnant women compared to non-pregnant women lies in the extra care taken during the Pap smear. The test shouldn’t be performed just anywhere, due to the higher risks during pregnancy. It is best that it be done in a setting where an obstetrician can collect the cells for analysis. Typically, the sample is collected by technicians or nursing assistants. Some doctors perform this in their own labs, but for pregnant women, an obstetrician is the best choice.
Pap smear test results
After microscopic analysis, the results are divided into five classifications, from 1 to 5—1 being excellent and 5 indicating a more serious problem. They are usually interpreted as follows:
Type I: Normal result, no significant changes Type II: Some inflammation, common in sexually active women and easily treatable. Type III: Presence of cell changes; the doctor must assess the type and provide appropriate treatment. Type IV: Possible cervical cancer. Referral for further testing for a precise diagnosis, and if confirmed, specific radiotherapy or chemotherapy as needed. Type V: Invasive cancer. In this case, the doctor may recommend removal of the cervix or even a hysterectomy. Treatment is also necessary to halt the growth of malignant cells.
Treatment depends on the test result, but in cases such as type II and III, vaginal creams and oral medications are commonly prescribed. In other cases, treatment is decided on an individual basis, depending on the disease diagnosed. The Pap smear should be performed on women of any age and, as mentioned before, even on women who are virgins. Remember, the test should be done annually, and if anything suspicious is found, it should be repeated every six months.
Also see: What is a Nabothian cyst? – Causes and Treatment
Photo: PKMousie
