Pap Smears
The best defense against cervical cancer is early detection. That is why yearly routine exams (or more frequently if problems arise) are recommended. Below are some frequently asked questions you may have.
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.
What is a PAP Test?
Why do I need a Pap test?
A Pap test can save your life. It can find the earliest signs of cervical cancer - a common cancer in women. 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. About 13,000 women in America will find out they have cervical cancer this year. And in 2007, 4000 women died from cervical cancer in the United States.
Do all women need Pap tests?
It is important for most women to have pap tests, along with pelvic exams, as part of their routine health care.
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you need a Pap test if you are 21 years or older
There is no age limit for the Pap test. Even women who have gone through menopause (when a woman's periods stop) may need regular Pap tests.
Hot Flashes. Some women report that eating or drinking hot or spicy foods, alcohol, or caffeine, feeling stressed, or being in a hot place can bring on hot flashes. Try to avoid any triggers that bring on your hot flashes. Dress in layers and keep a fan in your home or workplace. Regular exercise might also ease hot flashes, but sometimes exercise can cause a hot flash. If hot flashes continue and HT is not an option, ask your doctor about taking an antidepressant or epilepsy medicine. There is proof that these can relieve hot flashes for some women.
Vaginal Dryness. A water-based, over-the-counter vaginal lubricant (like KY® Jelly) can be helpful if sex is painful. A vaginal moisturizer (also over-the-counter) can provide lubrication and help keep needed moisture in vaginal tissues. Really bad vaginal dryness may need HT. If vaginal dryness is the only reason for considering HT, an estrogen product for the vagina is the best choice. Vaginal estrogen products (creams, tablet, ring) treat only the vagina.
Problems Sleeping. One of the best ways to get a good night's sleep is to get at least 30 minutes of physical activity on most days of the week. Bu It depends on your age and health history. Talk with your doctor about what is best for you. The American Congress of Obstetricians and Gynecologists recommends the following if your pap smears have always been normal:
If you are between 21 and 30 years old, you should get a Pap test every 2 years.
If you are age 30 or older and have had three normal Pap tests for three years in a row, talk to your doctor about spacing out Pap tests to every two or three years.
If you are 70 and have had at least three normal Pap tests and no abnormal Pap tests in the last 10 years, ask your doctor if you can stop having Pap tests.
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 or chemotherapy
Your mother was exposed to diethylstilbestrol (DES) while pregnant
You are HIV-positive
Women who are living with HIV, the virus that causes AIDS, are at a higher risk of cervical cancer and other cervical diseases. The U.S. Centers for Disease Control and Prevention recommends that all HIV positive women get an initial Pap test, and get re-tested 6 months later. If both Pap tests are normal, then these women can get yearly Pap tests in the future.
t, don’t exercise close to bedtime. Also avoid large meals, smoking, and working right before bedtime. Caffeine and alcohol should be avoided after noon. Drinking something warm before bedtime, such as herbal tea (no caffeine) or warm milk, might help you to feel sleepy. Keep your bedroom dark, quiet, and cool, and use your bedroom only for sleeping and sex. Avoid napping during the day and try to go to bed and get up at the same times every day. If you wake during the night and can't get back to sleep, get up and read until you’re sleepy. Don't just lie there. If hot flashes are the cause of sleep problems, treating the hot flashes will usually improve sleep.
Mood swings. Some women report mood swings or "feeling blue" as they reach menopause. Women who had mood swings (PMS) before their periods or post-partum depression after giving birth may have more mood swings around menopause. These are women who are sensitive to hormone changes. Often the mood swings will go away with time. If a woman is using HT for hot flashes or another menopause symptom, sometimes her mood swings will get better, too. Also, getting enough sleep and staying physically active will help you to feel your best. Mood swings are not the same as depression.
Memory problems. As people age, their memory is not as good as it once was. Some women say they have "fuzzy thinking" as they reach menopause. This may be caused by changing hormones and can improve over time. Getting enough sleep and keeping physically active can help. If memory problems are really bad, talk to your doctor right away. This is not caused by menopause.
The only women who do not need regular Pap tests are:
Women over age 65 who have had a number of normal Pap tests and have been told by their doctors that they don't need to be tested anymore.
Women who do not have a cervix and are at low risk for cervical cancer. These women should speak to their doctor before stopping regular 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. See http://www.cancer.gov/cancertopics/pap-tests-older-women. 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.
Aside from getting Pap tests, the best way to avoid cervical cancer is by steering clear of the human papilloma virus (HPV). HPV is a major cause of cervical cancer. HPV infection is also one of the most common sexually transmitted diseases (STD). 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 a sexually transmitted disease (STD)
Human papilloma viruses are a group of more than 100 different viruses.
About 40 types of HPV are spread during sex.
Some types of HPVs can cause cervical cancer when not treated.
HPV infection is one of the most common sexually transmitted diseases.
About 75 percent of sexually active people will get HPV sometime in their life.
Most women with untreated HPV do NOT get cervical cancer.
Some HPVs cause genital warts, but these HPVs do not cause cervical cancer.
Since HPV rarely causes symptoms, most people don't know they have the infection.
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. She 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.
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.
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.
The FDA recently approved the LUMA Cervical Imaging System. The doctor uses this device right after a colposcopy. This system can help doctors see areas on the cervix that are likely to contain precancerous cells. The doctor uses this device right after a colposcopy. This system shines a light on the cervix and looks at how different areas of the cervix respond to this light. It gives a score to tiny areas of the cervix. It then makes a color map that helps the doctor decide where to further test the tissue with a biopsy. The colors and patterns on the map help the doctor tell between healthy tissue and tissue that might be diseased.
Pap tests are not always 100 percent correct. False positive and false negative results can happen. This can be upsetting and confusing. A false positive Pap test is when a woman is told she has abnormal cervical cells, but the cells are really normal. If your doctor says your Pap results were a false positive, there is no problem.
A false negative Pap test is when a woman is told her cells are normal, but in fact, there is a problem with the cervical cells that was missed. False negatives delay the discovery and treatment of unhealthy cells of the cervix. But, having regular Pap tests boosts your chances of finding any problems. If abnormal cells are missed at one time, they will probably be found on your next Pap test.