| Pelvic & PAP |
| Recommendation for Screening | |
|---|---|
| Age: How often: | 21+ Annual |
| Gender: | Female |
| Note: Women less than 21-years-old who are sexually active should have a baseline pelvic examination and plan for ongoing care. |
This screening includes a pelvic examination and may include a Pap test (often called the Pap smear), two distinct but often combined procedures. In a pelvic examination, your healthcare provider will do a careful examination of your pelvic area. During the Pap test, some cells from your cervix will be gathered and sent to the laboratory for analysis. This same specimen or another similar one can also be used to do the HPV DNA test in some cases.
The pelvic examination is done to look for any abnormalities in the structures of the pelvic area and evidence of sexually transmitted diseases, which can be further investigated if found. Testing for asymptomatic sexually transmitted disease can also be performed at this time (for example, chlamydia and gonorrhea can both be present without symptoms). Screening for chlamydia is done routinely through age 25 at the annual visit. You and your provider may also want to address other important health issues such as birth control, breast health, diet, and nutrition at the annual visit. There is some difference of opinion on how often to do a pelvic examination. Annual evaluation is a reasonable choice in which additional health concerns may be addressed. Check with your doctor.
The Pap smear is done primarily to screen for precancerous changes or cancer of the cervix or vagina. On rare occasions, cancer of the ovaries or uterus could be detected with the Pap smear. A specimen may also be sent for the HPV DNA test; this test looks for evidence of infection with any of the 13 different strains of the HPV virus that may lead in certain individuals to cancer of the cervix. It may been done in women over 30 in conjunction with the Pap smear or in any woman with an abnormal Pap smear.
The Pap smear should be done every 2 years for women starting at age 21. For low risk women, at age 30 and above, testing can be done every 3 years if the prior 3 consecutive Pap smears were normal. Certain women at higher risk (see risk factors below) should be screened annually. Pap screening may be stopped at age 65-70 (recommendations vary) if 3 consecutive Pap smears were normal and there were no abnormal results in the previous 10 years.
The pelvic exam includes a visual examination of the vulva, a speculum examination of the vagina and cervix, and a manual examination during which the doctor or nurse inserts one or two gloved fingers into the vagina and uses the other hand on the outer lower abdomen to examine the internal organs. A rectal examination is usually done also. The Pap smear is done by scraping the cervix during the speculum exam and transferring the cells to a slide or a liquid and sending them to a special laboratory.
It is usually recommended not to schedule your examination during your period. Many doctors feel that the best time to have this examination is 5-20 days after the first day of your last period. You will probably be instructed to abstain from sex for 2 days prior to the exam and to avoid douching, tampons, vaginal creams, vaginal suppositories, vaginal medications, vaginal deodorants, and vaginal powders.