Understanding Pap Smears
A Pap smear is a routine screening test for cervical cancer. It detects precancerous changes and cell abnormalities on the cervix to catch potential problems early on. Guidelines recommend regular Pap testing every 3-5 years for women ages 21-65.
What a Pap Smear Involves
During a pelvic exam, a speculum is used to open the vagina allowing the doctor access to the cervix. Cells are collected by gently scraping the surface of the cervix and vagina to be sent to a lab for microscopic analysis.
The lab checks for abnormal precancerous cells or early signs of cervical cancer. HPV testing may also be performed on a Pap sample to check for high-risk strains of human papillomavirus.
Recommended Pap and HPV Test Guidelines
Current guidelines from the American Cancer Society for average-risk women are:
- Begin Pap tests at age 21
- Pap test every 3 years for women ages 21-29
- Pap test plus HPV test every 5 years ages 30-65
- May end screening over age 65 after adequate prior testing
Getting a Pap Smear While on Your Period
It is possible to have a Pap smear done while you are menstruating. But is getting a Pap test on your period a good idea? Heres what women should know.
Impact on Test Results
There are no medical concerns or restrictions that prevent a provider from collecting Pap smear cells while a woman is menstruating. Some blood or discharge will be present during sample collection. But the lab is still able to analyze the cervical cells with accurate test results.
More Discomfort
Most women report a Pap smear causes mild discomfort or brief pain during the pelvic exam. Being on your period can make the procedure feel slightly more uncomfortable. The cervix may be more sensitive and cramping may feel worse during a pelvic exam while menstruating.
Logistical Challenges
Excess blood can pose some practical challenges for the accuracy of sample collection and assessment. It may be more difficult for the provider to adequately see or fully scrape cells from the cervix there is heavy bleeding or clotting.
Some doctors prefer to reschedule a missed appointment until after a womans period ends to reduce sampling issues. However, rescheduling is up to physician and patient preference.
Reasons to Reschedule Your Pap
While not prohibited, there are some good reasons women may want to consider rescheduling a Pap smear planned during their period. Reasons to postpone include:
Extreme Pain
If you normally experience severe menstrual cramps or pain with pelvic exams that inhibits sample collection, waiting until your flow lightens up or ends can improve comfort.
Heavy Bleeding
Very heavy periods make it difficult to obtain cells and achieve accuracy. Blood can dilute samples or limit microscopy. Clots can also block the speculum or obliterate cervical cells.
Risk of Infection
An active tampon in place raises the small chance of introduce bacteria into the vagina leading to issues like Toxic Shock Syndrome. Removing it ups odds of excess bleeding or discomfort.
Preparing for a Pap During Your Period
If you plan to keep an appointment falling during your cycle, take steps to ease collection and improve accuracy such as:
Discuss Flow with Your Doctor
Talk to your gynecologist in advance about your flow. Together you can determine if its better to proceed or reschedule based on heaviness.
Avoid Scheduling on Heavy Days
Try to book exams on light flow days near the beginning or end of menstruation. Extreme bleeding can interfere with cells collection.
Empty Your Bladder First
Urinate immediately before the pelvic exam. A full bladder makes it harder to position the speculum to access the cervix.
Remove Tampons Beforehand
Take out any tampons a few hours prior to your visit to lower chances of toxic shock worries and avoid strings interfering.
Wear a Pad to Catch Flow
Opt for a pad over a tampon or menstrual cup to absorb flow during the exam for easier access and less mess.
What Impacts Pap Smear Results?
Certain factors unrelated to periods can affect Pap test findings. Being aware of these issues allows patients and doctors to account for them.
Hormonal Changes
Hormone fluctuations during adolescence, pregnancy, and menopause can lead to minor cell changes that appear abnormal but are actually harmless.
Inflammation or Irritation
Inflammation from infections, abrasions or even vigorous sex or douching near the time of the exam can mimic abnormal cell changes.
Birth Control Effects
Hormonal contraceptives can cause altered cell appearances. Certain IUDs may also impact results.
Previous Treatment
After procedures like cone biopsy to remove precancerous cells, the cervix heals through cell regrowth that may seem abnormal at first.
Understanding Abnormal Pap Results
Doctors look for cellular changes called squamous intraepithelial lesions (SILs) ranging from low to high grade. The higher the grade, the more serious the abnormalities that may potentially lead to cancer if left untreated.
Atypical Squamous Cells (ASC)
The squamous cells lining the cervix or vagina appear slightly abnormal but its uncertain whats causing it. Repeat testing is needed.
Low-Grade SIL (LSIL)
Mild cell abnormalities are present, often linked to an active HPV infection causing changes. These may resolve without treatment but ongoing monitoring is key.
High-Grade SIL (HSIL)
More serious precancerous changes affecting many cervical cell layers are classified as high-grade. Treatment is required to stop progression to cervical cancer.
Next Steps After Abnormal Pap Results
Dont panic with an initial abnormal Pap report. Your doctor determines recommended follow up based on the grade of changes seen.
Repeat Pap Test
Another Pap after 6-12 months helps determine if early cell changes resolved or need investigation. This watches for more serious changes.
HPV Testing
Identifying the presence of high-risk human papillomavirus causing cell changes guides treatment, especially for mild abnormalities.
Colposcopy Exam
Using a special magnifying instrument allows the doctor to closely inspect the cervix to judge severity before collecting cell samples (biopsy) if concerning areas are spotted.
Precancerous Cell Removal
For moderate to severe abnormalities that could lead to cancer, procedures like LEEP or cone biopsy remove the affected cervical cells.
Reducing Cancer Risk with Regular Screening
Following recommendations for Pap and HPV testing allows precancerous cell changes to be caught early and monitored or treated promptly. This prevents progression to cervical cancer in nearly all cases with adequate screening.
Women should not avoid getting a Pap smear because of menstruation worries. But those with heavy, painful periods may prefer to reschedule exams for better comfort and accuracy.
Discuss any concerns about abnormalities with your gynecologist to determine appropriate management. Understanding the typical follow up procedures for early cell changes can ease anxiety.
FAQs
Can you have a Pap smear while on your period?
Yes, it is possible to get a Pap smear done while you are menstruating. Doctors can still collect an accurate cell sample from the cervix even if some blood is present.
Does your period affect Pap smear results?
No, having your period does not affect the accuracy of Pap smear test results. The lab can still properly analyze the cells. However, heavy bleeding can make sample collection more challenging.
Is a Pap smear more uncomfortable during your period?
Women often report more discomfort and cramping with a Pap smear when done while menstruating. The cervix may be extra sensitive making the exam feel more unpleasant.
Should you reschedule a Pap if it falls during your period?
Most women can undergo Pap testing while having their period without issue. But those with extremely heavy flow or severe cramps may prefer to ask their doctor to reschedule until after their cycle ends.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.
Add Comment