The Pap test, also called a preventive test, is a gynecological test indicated for women from the beginning of sexual activity and which aims to detect changes and diseases in the cervix, such as inflammation, HPV and cancer.
This examination is quick, performed in the gynecologist's office and does not hurt, however the woman may feel a little discomfort or pressure inside the vagina while the doctor scrapes the cells of the uterus.
How Papanicolau is done
The Pap test is simple, quick and performed at the gynecologist's office. However, for it to be done, it is important for the woman to follow some guidelines, such as taking the exam outside the menstrual period, not having vaginal showers and using intravaginal creams 48 hours before the exam and not having sex 48 hours before the exam.
At the time of the examination, the woman is in a gynecological position and a medical device for viewing the cervix is inserted into the vaginal canal. The doctor then uses a spatula or brush to collect a small sample of cells that will be sent for analysis in the laboratory. In addition, two slides are made from the material collected during the examination that is sent to the microbiology laboratory to identify the presence of microorganisms.
The exam does not hurt, however, you may feel discomfort or a feeling of pressure inside the uterus during the exam, however the sensation passes right after the removal of the spatula and the medical device.
See more about how the Pap test is done.
When to do
The Pap test is indicated for women from the beginning of sexual activity until the age of 65, however it is prioritized for women between 25 and 65 years old. This test must be performed annually, but if the result is negative for 2 years in a row, the test can be performed every 3 years. This recommendation exists due to the slow evolution of cervical cancer, allowing precancerous and cancerous lesions to be identified early and treatment can be started afterwards.
In the case of women from the age of 64 who have never had a Pap smear, the recommendation is that two examinations be carried out with an interval of 1 to 3 years between examinations. In the case of women with lesions indicative of cervical cancer, the Pap smear is performed every six months. Cervical cancer is caused by the Human Papillomavirus, HPV, which must be identified and treated to prevent it from remaining in the body and leading to the development of cancer. Find out how to identify HPV infection and how treatment is done.
Pap smear in pregnancy
Pap smears can be done during pregnancy up to the fourth month at the most, preferably performed at the first prenatal visit, if the woman has not done so recently. In addition, the test is safe for the baby as it does not reach the inside of the uterus or the fetus.
What is it for
The Pap smear is done to identify changes in the uterus, which may include:
- Vaginal infections such as trichomoniasis, candidiasis or bacterial vaginosis caused by Gardnerella vaginalis ; Sexually transmitted diseases such as chlamydia, gonorrhea, syphilis or HPV; Cervical cancer; Assessing the health of the cervix and the presence of Naboth cysts, which are small nodules that can be formed due to the accumulation of fluid released by glands present in the cervix.
Pap smears can also be done by virgin women after the age of 21, using special material and only according to the doctor's guidance, in order to assess the cervix and identify possible changes.
Understanding the results
The results of the Pap smear are released by the laboratory according to the characteristics of the cells observed under the microscope, which can be:
- Class I: the cervix is normal and healthy; Class II: presence of benign changes in cells, which are usually caused by vaginal inflammation; Class III: includes NIC 1, 2 or 3 or LSIL, which means that there are changes in the cells of the cervix and the doctor may prescribe further tests to look for the cause of the problem, which may be HPV; Class IV; NIC 3 or HSIL, which indicate a probable onset of cervical cancer; Class V: presence of cervical cancer. Unsatisfactory sample: the material collected was not adequate and the examination cannot be performed.
According to the result, the gynecologist will tell you if more tests are needed and what is the appropriate treatment. In cases of HPV infection or changes in cells, the test must be redone after 6 months, and if cancer is suspected, a colposcopy should be performed, which is a more detailed gynecological examination in which the doctor evaluates the vulva, the vagina and the cervix. Understand what colposcopy is and how it is done.
