Wellness

There are three main parts to a yearly Wellness Exam (otherwise known as an annual exam). These consist of a breast exam, pelvic exam, and pap test. Read below for more information about each of these.

What is a Pap test?

The Pap test, also called a Pap smear, checks for changes in the cells of your cervix. The cervix is the lower part of the uterus (womb) that opens into the vagina (birth canal). The Pap test can tell if you have an infection, abnormal (unhealthy) cervical cells, or cervical cancer.

Why do I need a Pap test?

A Pap test can save your life. It can find the earliest signs of cervical cancer. If caught early, the chance of curing cervical cancer is very high. Pap tests also can find infections and abnormal cervical cells that can turn into cancer cells. Treatment can prevent most cases of cervical cancer from developing.

Getting regular Pap tests is the best thing you can do to prevent cervical cancer. In fact, regular Pap tests have led to a major decline in the number of cervical cancer cases and deaths.

You should have a Pap test every year no matter how old you are if:

  • You have a weakened immune system because of organ transplant, chemotherapy, or steroid use
  • Your mother was exposed to diethylstilbestrol (DES) while pregnant
  • You are HIV-positive

Do all women need Pap tests?

It is important for all women to have Pap tests, along with pelvic exams, as part of their routine health care. You need a Pap test if you are:

  • 21 years or older
  • under 21 years old and have been sexually active for three years or more

There is no age limit for the Pap test. Even women who have gone through menopause (when a woman's periods stop) need regular Pap tests. Women ages 65 to 70 can talk to their doctor about stopping after at least 3 normal Pap tests and no abnormal results in the last 10 years.

I had a hysterectomy. Do I still need Pap tests?

It depends on the type of hysterectomy (surgery to remove the uterus) you had and your health history. Women who have had a hysterectomy should talk with their doctor about whether they need routine Pap tests.

Usually during a hysterectomy, the cervix is removed with the uterus. This is called a total hysterectomy. Women who have had a total hysterectomy for reasons other than cancer may not need regular Pap tests. Women who have had a total hysterectomy because of abnormal cells or cancer should be tested yearly for vaginal cancer until they have three normal test results. Women who have had only their uterus removed but still have a cervix need regular Pap tests. Even women who have had hysterectomies should see their doctors yearly for pelvic exams.

How do I prepare for a Pap test?

Many things can cause wrong test results by washing away or hiding abnormal cells of the cervix. So, doctors suggest that for 2 days before the test you avoid:

  • Douching
  • Using tampons
  • Using vaginal creams, suppositories, and medicines
  • Using vaginal deodorant sprays or powders
  • Having sex

Should I get a Pap test when I have my period?

No. Doctors suggest you schedule a Pap test when you do not have your period.

How is a Pap test done?

Your doctor can do a Pap test during a pelvic exam. It is a simple and quick test. While you lie on an exam table, the doctor puts an instrument called a speculum into your vagina, opening it to see the cervix. The doctor will then use a special stick or brush to take a few cells from inside and around the cervix. The cells are placed on a glass slide and sent to a lab for examination. While usually painless, a Pap test is uncomfortable for some women.

When will I get the results of my Pap test?

Usually it takes 3 weeks to get Pap test results. Most of the time, test results are normal. If the test shows that something might be wrong, your doctor will contact you to schedule more tests. There are many reasons for abnormal Pap test results. It usually does not mean you have cancer.

What is a pelvic exam?

During this exam, the doctor looks for redness, swelling, discharge, or sores on the outside and inside of the vagina. A Pap test tests for cell changes on the cervix. The doctor or nurse practitioner will also put two fingers inside the vagina and press on the abdomen with the other hand to check for cysts or growths on the ovaries and uterus. STD tests may also be done.

What do abnormal Pap test results mean?

It is scary to hear that your Pap test results are "abnormal." But abnormal Pap test results usually do not mean you have cancer. Most often there is a small problem with the cervix.

Some abnormal cells will turn into cancer. But most of the time, these unhealthy cells will go away on their own. By treating these unhealthy cells, almost all cases of cervical cancer can be prevented. If you have abnormal results, to talk with your doctor about what they mean.

My Pap test was "abnormal," what happens now?

There are many reasons for "abnormal" Pap test results. If results of the Pap test are unclear or show a small change in the cells of the cervix, your doctor will probably repeat the Pap test.

If the test finds more serious changes in the cells of the cervix, the doctor will suggest more powerful tests. Results of these tests will help your doctor decide on the best treatment. These include

  • Colposcopy: The doctor uses a tool called a colposcope to see the cells of the vagina and cervix in detail.
  • Endocervical curettage: The doctor takes a sample of cells from the endocervical canal with a small spoon-shaped tool called a curette.
  • Biopsy: The doctor removes a small sample of cervical tissue. The sample is sent to a lab to be studied under a microscope.

How can I reduce my chances of getting cervical cancer?

Aside from getting Pap tests, the best way to avoid cervical cancer is by steering clear of the human papillomavirus (HPV). HPV is a major cause of cervical cancer. HPV infection is also one of the most common sexually transmitted infections (STI). So, a woman boosts her chances of getting cervical cancer if she:

  • Starts having sex before age 18
  • Has many sex partners
  • Has sex partners who have other sex partners
  • Has or has had an STI (Sexually Transmitted Infection)