Your Gynecologic Exam and Pap Test
A gynecologic (GUY-neh-keh-LOJ-ik) exam gives you and your doctor information about the health of your reproductive organs. Some people call this a gyne (GUY-nee) exam. A gynecologist (GUY-neh-CALL-uh-jist) is a doctor who specializes in the care of women’s reproductive organs. Certified nurse practitioners, nurse midwives, and other doctors may also do gyne exams.
When should you have a gyne exam?
Some doctors say you should begin having yearly exams between ages 16 and 18 or as soon as you have become sexually active.
However, call your doctor right away if you have any of the following:
- A discharge from your vagina that itches, burns, or smells bad
- Any vaginal bleeding that isn’t normal (even just spotting)
- Bleeding between periods or after intercourse
- Intercourse that is painful
- Unusually painful cramps with your period
- A need for birth control
- Bleeding after menopause
- Anything that is unusual and/or painful
- If you think you are pregnant
Before your visit
Schedule your appointment to occur after your menstrual period is over. Do not douche or use tampons, vaginal creams, or suppositories for at least 24 hours before your exam.
Your gyne exam
When you go for your first gyne exam, you will be asked about your medical, family, and reproductive history. You also will be asked:
- The date and length of your last period
- What type of birth control you use
- If you have ever been pregnant
- If you smoke, drink alcohol, or take any drugs or medicines
You will be asked to put on a gown for the exam. A gyne exam may include the following:
- Urine specimen
- Blood pressure
- Blood sample from a needle prick of your finger
- Height and weight
- Breast exam
- Heart and lungs exam
- Exam of your lower belly
- Rectal exam
- Colon-rectal cancer screening
- Pelvic exam
- Pap test
These tests and exams will depend on your doctor, your age, and your personal and family medical history.
The pelvic exam
You will be asked to lie on a table with special holders for your feet (stirrups). Your doctor will put on sterile gloves for the exam. He or she will check the outside of the vagina visually and by hand. Your doctor will insert an instrument called a speculum (SPEK-yuhlum) into your vagina. It allows your doctor to see the inside of your vagina and your cervix. The speculum also lets the doctor remove some cells for a test called a Pap test. A Pap test helps detect abnormal cells that can grow into cervical cancer.
Then, your doctor will do an internal exam. This exam checks the size and shape of your uterus, fallopian tubes, and ovaries. Because your doctor cannot see these organs, he or she also will examine you for any abnormal growths by pressing on your belly. Your doctor also may do a rectal exam. Let your doctor know if any of this is uncomfortable for you.
This exam takes a few minutes. When it is done, your doctor will tell you what he or she has found. Your doctor will tell you how to get the results of your Pap test or other lab tests. Ask your doctor any questions you may have and when you should make your next appointment.
The Pap test and results
The Pap test is a simple test used to help find cervical cancer as early as possible. It is the best method for finding changes on the cervix that can lead to cancer. The Pap test also can detect infection and other health problems of the uterus and vagina.
The Pap test takes only a few seconds and is painless. Some cells are gently scraped from your cervix with a wooden spatula, cotton swab, or plastic brush. You cannot feel the scraping because the cervix has no nerve endings. The cells are then placed on a glass slide, or they may be placed in a fluid. A person who is trained to read Pap smears (cytologist) then checks the cells to see if they are normal.
Your doctor will get a report of your Pap smear. The results may be:
- Normal — no abnormal cells
- Inflammatory — slightly abnormal cells that may be due to an infection. Your doctor may call you to discuss follow-up treatment.
- Dysplasia (diss-PLAY-sha)— abnormal cells that may mean pre-cancerous changes. If treated early, dysplasia is curable.
- ASCUS — slightly abnormal cells from the cervix. It may be caused by a mild infection or be the result of a pre-cancerous condition. This result is very common. Your doctor will recommend either a repeat Pap test in 4 to 6 months or a closer evaluation of your cervix.
- Cancer — cells have spread into deeper parts of the cervix.
Is the Pap test accurate?
Like any lab test, false results are possible because of:
- Too few cells
- Too many cells
- Cells not taken from inside and from the surface of the cervix
- An infection that “covers up” abnormal cells
- Douching or vaginal medicines that have “washed away” abnormal cells
If abnormal cells are discovered, your doctor will recommend more tests.
Since the Pap test was developed, the number of women with cervical cancer has gone down. No test is 100 percent accurate. However, there is much less chance of missing a serious problem if you have a regular Pap test.
A Pap test and gyne exam every year, like monthly breast self-exams, are important ways to protect your health.