Pap Smears — What’s the Deal?

Whether you’ve had a Pap smear before, or it’s your first time, here’s the 411.

People with vaginas have been going to gynecologists, getting exams and Pap smears since the 1930’s. But what is a Pap smear and why do we need them? Who needs them? And how often?

So, what exactly is a Pap smear?

Many women* have the false impression that every time their doctor performs a pelvic exam (the exam where they take a look, and often a feel, of your cervix, uterus, and ovaries) they are also doing a Pap smear. This is a common misconception. A Pap smear (named after the person who invented it — Georgios Nikolaou Papanikolaou) is a very specific test, used to take some cells from the center of the cervix (also known as the “os,” or the opening), and examine them under the microscope to look for cervical cancer or pre-cancer. That is the full extent of the test.

There are other things that can be seen on a Pap smear, but its main purpose is to look for cervical cancer. (It gives no information about your uterus, fallopian tubes, or ovaries, each of which may have their very own cancers, but cannot be screened for with a Pap smear). The Pap smear may also reveal if there is yeast, bacteria, or a viral infection present, but again, those are not the main purpose of the Pap smear.

Who is most likely to get cervical cancer?

Cervical cancer is almost always a disease of women who are, or who have been, sexually active. We now know that most cervical cancers and precancers come from a virus called the Human Papillomavirus, or HPV. HPV has many different types and strains, some of which are more likely to cause cervical cancer. HPV is a sexually transmittable virus that about 70% of the sexually active adult population (male and female) carry in their system. Various strains of this virus cause almost all cervical cancer and precancerous conditions. So, yes, if your grandma had cervical cancer, it was essentially caused by an STI.

How often does one need to get a Pap smear?

Current guidelines on doing Pap smears state that women should start getting them at age 21, and continue every three years until age 29. At age 30, it is recommended to test for the HPV virus and have a Pap smear (which is referred to as a Co-Test, since these are two separate tests, one for the abnormal cervical cells, and one for the presence of the HPV). Believe it or not, the reason it is not recommended to test women under the age of 30 for HPV, is that it is almost assumed that sexually active women under 30 will be positive for the presence of the virus, but somehow will be able to clear the virus from their body after a period of time (which often, but not always, happens in a 3–5 year period after it has been acquired). From age 30–65, it is recommended to do a Co-Test every 3–5 years if they continue to both come out negative. Guidelines, surveillance and treatments change if the Pap smear and/or the HPV test come out abnormal. After age 65, most women who have a history of normal Paps and negative HPV do not need to have them done any more.

You should always talk to your doctor or healthcare provider about what your individual situation is, what your risk factors are (Is your immune system compromised? Have you had abnormal Pap smears in the past? Do you have a new partner? Do you use condoms for sexual encounters?) so you will know just how often you need a Pap smear, and if you need HPV testing. Do not assume that every time you have an exam you have had a Pap smear, because it may not be the case at all.

How can one prepare for a Pap smear?

First, if you’ve never had one, make sure to ask your healthcare practitioner to show you the “device,” or speculum, before they start the exam. You will be able to see that it is not sharp, painful, or scary — nor does it ‘clamp’ on to you in any way (many people call it “the clamp” for some reason).
Dont’s: Do not have sex, use lube or any vaginal creams or gels the night before or the day of the exam (they may interfere with the Pap smear).

When you are actually having the exam done, try to relax all of your muscles in the pelvic area so it will be less uncomfortable. In most cases, it will be over in about a minute, and you will receive your results in a week to 10 days. Don’t forget to ask exactly how you will get your results — some practices call everyone, some send emails, or postcards. Do NOT ascribe to the adage “no news is good news.” You want to hear (or read) the words, “Your Pap smear was negative.” And, if you had the HPV test, you want to know those results, as well as next steps, depending on the results you receive.

Stay informed, talk to your doctor, and advocate for your health.

* In this context, “women” refers to people with vaginas, acknowledging, of course, that not all women have vaginas. For more information, check out the tabú bodies and gender basics!

Header image illustrated by Marcy Gooberman

Must be looooooove on the braaaaain 🧠. Or was that s£x? 👀🤭 Our brains are our largest s£x organs and sometimes they get a little sad, hyperactive, anxious, or overwhelmed. You won’t always be in the mood for s£x and that’s okay! Keep communication with your partner open and ongoing, check in with yourself and your mental health, and lean on the support of a trusted therapist or doctor if you need some extra guidance. 🫶🏽 Anything you would add?

I mean 😏

It is not wrong nor should it feel shameful to ✨seek pleasure.✨ I think those of us who grew up more religious were taught that you should always be in service of others and giving of yourself rather than concerned with our own needs or passions. While it is wonderful to be generous with giving (and can in fact be a source of pleasure), it should be equally encouraged to pursue your own pleasure — it whatever form it may take! It may feel self-indulgent, but why is that a bad thing? Pleasure boosts our mental health. It helps us cope with a difficult world, with anxiety, depression, and stress. It makes us feel good! It gives us something to look forward to. Pleasure helps us connect with others and with ourselves. Pleasure (as long as it is not at the expense of someone else’s safety or well-being) should be a priority, for our joy and for our health. It really is so important! Where do you find pleasure? I personally love a good massage… 💆🏽‍♀️

It’s time for a talk, friend. Let’s be clear, you nor your partner ever has to do *anything* you’re not comfortable with. That said, if it’s something you enjoy and that’s pleasurable to you, it’s okay to ask your partner for it! They can say no, but if they invalidate your pleasure, much less expect you to do something they won’t do?? The ball is then in your court to decide if this is the partner for you. You deserve someone who cares about and prioritizes your pleasure. Who is thrilled to be acquainted with your body, all of it! S-x can be vulnerable to talk about, but when you do…it’s so much better. 👅 included. Ask your partner what their hesitations are and have a *conversation.* Maybe they’re nervous, intimidated, or struggling with shame. Maybe they’re down to try other things you would enjoy and build up to it. The point is, it shouldn’t just be automatically dismissed. You can decide what’s right for you and what makes you feel aroused, validated, and appreciated. Whatever you do, don’t internalize their rejection. Your body is beautiful, desirable, and definitely worthy of pleasure. 😋🥰

A UK study published in the International Urogynecology Journal found that only 46% of participants correctly identified that a female has 3 holes in the external genitalia. 😬 Not great. We’re taught so desperately little about our bodies and so discouraged from exploring them that we don’t even know what we’ve got going on down there! Understanding your own anatomy (and getting educated on your partner’s anatomy) can boost pleasure 1000x!! So take a mirror, use your hands, and get comfy exploring! 🪞🕵🏽‍♀️ And if you really want to get informed (and inspired 😉), head to our website for our basics on pleasure and anatomy. What do you think? Could YOU correctly label a diagram of what lies beneath?

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