Tag Archives: hpv

What is a Pap Smear, Anyway?


Posted on July 24, 2012 by

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A lot of women understand a pap smear as something they have to do to get their birth control, and may not know much about it beyond that. I know that when I decided to get on birth control at 18, I had to go get a full well-woman exam, and all I knew was that it was awkward and the speculum was uncomfortable. It was years before I actually knew what the purpose of the exam was, beyond getting a prescription for birth control. Because a pap involves a pelvic exam, I’ve noticed some women assume that if they had a pelvic exam, a pap was done. Not true! Let’s discuss what actually goes on in a pap smear, and when and why you should do it.

Your well-woman visit consists of your breast exam, a bimanual exam (performed by the doctor with both hands, to check the size, shape, consistency, and location of the cervix and uterus), and a pap smear. The pap smear is the part that involves a speculum.

The Speculum: Everyone's Favorite (not).

The practitioner takes a small brush and collects cells from your cervix, and at the lab a cytologist examines the cells to make sure they look normal.

Normal cells mean you don’t have cancer. Abnormal cells require further testing to require if you have precancerous changes (dysplasia), or possibly cancer. Cervical cancer often has no symptoms until it’s advanced, and symptoms may include irregular bleeding, which can be caused by other things and, therefore, be overlooked. Because of this, it’s important to get your pap smear regularly even if you feel fine.

The important thing to remember about a pap smear is that it’s a cancer screening, not an infection screening. Don’t assume that because you had a pelvic exam, you had a pap! Some infection screenings require a sample of vaginal discharge, and usually this means a practitioner will require a speculum exam.

A pap smear won’t tell you if you have a sexually transmitted infection (although abnormal results may indicate the presence of high-risk HPV, a second test must be done at the lab to confirm), or a common vaginal infection such as yeast, bacterial vaginosis, or trichomonis. If you have symptoms of infection, be sure to talk to your healthcare provider.

Here’s some questions you might want to ask yourself and your health care provider:

Do I need a pap smear if:

  • I have irregular bleeding or bleeding after sex?

If you are due for one or if all infections have been ruled out, probably. Ask your healthcare provider!

  • I have discharge, odor, or pain during sex?

You definitely need an infection screening, which will involve the provider inserting a speculum and taking a sample of discharge for testing. They most likely will not do a pap at this time.

  • I want to get tested for STIs?

A pap doesn’t directly test you for HPV or other STIs. You can get screened for most infections through urine and blood tests.

For routine pap screenings, current testing guidelines state:”It depends on your age and health history. Talk with your doctor about what is best for you.”

Most women can follow these guidelines:

  • Starting at age 21, have a Pap test every 2 years.
  • If you are 30 years old and older and have had 3 normal Pap tests for 3 years in a row, talk to your doctor about spacing out Pap tests to every 3 years.
  • If you are over 65 years old, ask your doctor if you can stop having Pap tests.

Ask your doctor about more frequent testing if:

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

If you are younger than 21 and require birth control, ask your healthcare provider what you need to do to get a prescription without a pap smear.

Trans* Health: Trans Men Need Paps Too


Posted on June 7, 2012 by

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Today’s guest post is from “Erin” who is a graduating student of Women’s and Gender Studies at a local university. She specializes in sexuality as it relates to gender and her main focus is reproductive rights history.

Here at Planned Parenthood we are concerned with the health of men and women. But say you do not identify as either one of the binary genders, or you do not identify with the gender assigned to you at birth. If that is the case, you may identify as Trans*.

Trans* is a general word for someone not living as the gender that was assigned to them at birth. This could include transgender or transsexual individuals. For the purpose of being all on the same page, I will define trans man as a female-to-male transgender person, and a trans woman as a male-to-female transgender person. It can be easy to get confused, especially if you are not familiar with people of non-gender conforming persuasions. The best thing you can do is respect how each person identifies.

As far as sexual health is concerned, trans men need to remember to get pap smears too. For whatever gender you identify as, if you have a cervix you can be at risk for cervical cancer and need to get screened. Check out this article from earlier this year that details “four ways we can prevent cervical cancer among trans men and genderqueer/gender nonconforming people.” Some barriers for trans men include: health insurance coverage that denies routine preventative care, like pap smear screenings, to trans folks; health care providers being culturally insensitive to the trans community, or just plain discriminating; and maybe not being aware of how to properly take care of cervical health.

For optimal cervical health:

• Get vaccinated for HPV, one of the main contributors to cervical cancer. More about HPV here. More about the HPV vaccine here.

• Go annually for routine pap smears after the age of 21 or 3 years after being sexually active (this goes even if you have been vaccinated for HPV). More about pap smears here.

• Use protection! Wear condoms, female condoms, gloves, and/or dental dams to help protect against STI’s that may cause cervical cancer. More about safer sex here.

As a reproductive rights scholar, I have taken a special interest in Trans* rights. This is for many reasons, but above all, when we talk about what people can and cannot do with their genitals, I believe this is encompassed within reproductive rights. The article Trans Rights Are Reproductive Rights is fantastic.

Another very cool resource for trans health is the Trans Youth Sexual Health Booklet. This is a fairly detailed pamphlet made by and for trans youth about sexuality and sexual health.

Cervical Cancer is Preventable


Posted on January 20, 2012 by

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We’ll be back with our regular Fun Friday this afternoon, but this morning, we’re featuring an op-ed from Dr. Sujatha Prabhakaran, MD, MPH, FACOG, our Senior Vice President of Medical Affairs/Medical Director, to mark Cervical Cancer Awareness Month.

January is Cervical Cancer Awareness Month, and it’s important to know that cervical cancer is preventable.

It is one of the few cancers that has two proven strategies to prevent – not just treat – the disease. In 2011, more than 12,000 women were diagnosed with cervical cancer and over 4,000 women died from it.

Almost all of these cases could have been prevented if these women had had access to either cervical cancer screening via Pap smears or to the HPV vaccination – or both.

One thing may not know is that Pap smears don’t usually detect cervical cancer. What they detect are precancerous cells, cells that aren’t cancer yet but show changes that suggest they could become cancerous. Once we detect precancerous cells, we are able to provide treatments to either destroy or remove these cells and prevent them from ever becoming a cancer.

Women who have regular Pap smears (every 2-3 years is now recommended for most women) have a much lower risk of developing cervical cancer because, if they have an abnormality, it is often detected in the precancerous stage.

Another way to prevent cervical cancer or prevent precancerous cells from ever developing is the HPV vaccination. Most cervical cancers are caused by the HPV virus. Seventy percent of cervical cancer cases are caused by two particular types, 16 and 18, which are included in the vaccine. By getting the HPV vaccine before they are exposed to those viruses, women can significantly reduce the risk of developing cervical cancer.

Access to these types of preventive care is vital for the health of women.

While uninsured or under-insured women do have access to Pap tests and HPV vaccinations at safety net providers like county health departments and Planned Parenthood, this access will improve as women’s preventive health services will now be covered 100 percent under the Affordable Care Act.

I’m certain this will be a welcome change for women all over the country.