Clearing up misconceptions about the pap smear
THERE are a lot of misconceptions surrounding the Pap smear. Some women fear the “scraping”, the size of the speculum, the potential discomfort, or just the general anxiety associated with the procedure.
This is why many women dread visiting their Ob/Gyn. The procedure may be slightly uncomfortable, but with the right mindset and approach, a Pap smear can literally be painless and a walk in the park.
What is a Pap smear?
A Pap smear involves taking a sample of cells from the opening of the cervix. The doctor will slowly insert a device called a speculum into the vagina to keep the vaginal walls open and provide access to the cervix. A cotton swab or cervical brush is used to collect the cells, which are then “smeared” onto a slide or placed into a fluid (thin prep Pap). The sample is sent to the lab to be tested for precancerous cells secondary to the sexually transmitted Human Papilloma Virus (HPV).Once identified, precancerous cells can be treated, thus preventing cancer.
Is it painful?
A Pap smear may be uncomfortable, but mostly this is anxiety-related. It is rarely painful, but if it is, this could be caused by an underlying condition such as infection or endometriosis. If the patient is calm and relaxed and follows her doctor’s instructions, the entire procedure can be quick and painless.
Is there a difference between a pelvic examination and a Pap smear?
Yes, there is a difference! Most patients believe a Pap smear is actually the examination, but this is not so. A pelvic examination is done in most Ob/Gyn consultations and involves using a speculum (that metal instrument hated by patients) to examine the tissue of the vagina and the cervix for any abnormalities or discharge. This is followed by the physician examining the uterus, Fallopian tubes and ovaries placing one hand on the abdomen and two fingers of the other hand in the vagina. At the point of use of the speculum, depending on the purpose of the examination, a Pap Smear can be done.
Is there any other way to do a Pap Smear without using a speculum?
Unfortunately there is no other way to examine the cervix properly and conduct a Pap smear without the use of a speculum.
Why are there different sizes for the speculum?
“Doc, please use the smallest speculum” is a statement I hear daily. Speculums have various sizes and designs which have to be suited to the patient’s body size, medical complaint and age/sexual maturity. The smaller speculum usually is reserved for either the very young or for post-menopausal women. A medium-sized speculum is usually adequate for women in the reproductive age group.
When should I do my Pap smear?
A Pap smear should be done yearly from the age of 21 until 65. Women should schedule their Pap smears when they are not menstruating and should avoid sexual intercourse for at least 24 hours prior to the procedure.
Do Pap smears always cause bleeding after?
If there is an underlying infection on the cervix — cervicitis — or if there are precancerous cells present, after the Pap smear there may be a small amount of spotting. This usually resolves within two days.
How long does it take to be processed?
This is all dependent on the lab and its workload. The actual process of analysing and interpreting a Pap smear can be done in a matter of minutes and results made available. Most labs in Jamaica will give results within three to four weeks.
Can I have sex after?
Yes, a woman can have sex after doing a Pap smear unless advised otherwise by her doctor.
What about the HPV vaccine?
The HPV vaccine is recommended ideally for girls between the ages of 12-13 years — before sexual contact and exposure to HPV. Most studies have shown that there is still some benefit in giving the vaccine to women even after exposure to the virus.
Dr Daryl Daley is a consultant ObGyn at Gynae Associates, 23 Tangerine Place, Kingston 10, and Shops 46-50, Portmore Town Centre, Portmore. Call 929-5038/9, 939-2859, or email drdaryldaley@gmail.com.
