Hands up who likes a papsmear? No? This is how to make it better!

Womens' Health Wednesdays are back.

The Doc kicks of 2011 with the “dreaded” Pap smear:

Cervical cancer is the most common cause of death due to cancer among South African women. But cervical cancer usually takes 10-20 years to develop and, if detected early, can be fully excised and eliminated.

Most cases of cervical cancer occur in women in their 40s & 50s, with less than 10% of cases occurring before the age  of 30 years.

The Pap smear test (named after Papanicolaou who introduced it) is a screening test used by gynaecologists to detect pre-malignant changes in the cervix.

The objective is early detection of abnormalities, so that these can be treated and/or eliminated before cancer develops.

Screening Guidelines

Women are advised to commence screening within a three years of becoming sexually active, because cervical cancer is caused by human papillomavirus (HPV) which is sexually transmitted.

 Guidelines on frequency of screening vary – but screening every 2  years in low risk woman is adequate.

 If a woman has an abnormal smear, she will be advised to return after 6 months and, depending on the result, may require further in-depth inspection of the cervix (with colposcopy).

Previously abnormal smears are then followed up annually for at least 3 years.

Women over the age of 30 who have had three consecutive “normal” Pap smears can then wait three years between smears. If a woman’s last three Pap smears are normal then she can stop screening at the age of 65.

The procedure:

In order to perform a Pap smear, the cervix (or mouth of the womb) needs to be visualized. After passing a speculum into the vagina, the doctor then uses a brush or spatula to take cells from the transformation zone of the cervix.

 These cells are then preserved and transported to a cytologist to be evaluated under a microscope. Cells are evaluated for various degrees of  abnormality, as well as evidence of infection. A grading system is used to report on the findings and according to these findings, the woman will either be advised to continue with routine screening or have a repeat smear in 6 months.

If the follow-up smear remains abnormal, then colposcopy may be indicated (colposcopy is a procedure where the cervix is “painted” & then inspected directly under a magnifying-glass to observe any abnormalities).

When you go for a Pap smear you should advise your doctor if you:

·         Are taking any medications or birth control pills

·         Have had an abnormal Pap smear

·         Might be pregnant

Within 24 hours of the test, avoid:

·         Douching

·         Having intercourse

·         Using tampons

Many women find the Pap smear extremely uncomfortable.

There are a few tips to make the experience more manageable:

·         Empty your bladder before you have a Pap

·         Ask the doctor to use an appropriately sized speculum that is warm

·         Ask the doctor to use ample lubricant and not to rush the procedure*

·         If you are sensitive, consider taking a simple analgesic or anti-inflammatory beforehand

·         Most women tell me they are so embarrassed that they try not to talk to the doc.  It is much better to screw your courage to the sticking post and say: “ I would like this to be as painless as possible. Please use sufficient lubrication  and don’t go to quickly”

·         Do not be shy about telling your doctor if it is hurting!

·         Even if it hurts, it has to be done to prevent cancer.  YOU are worth the brief pain. Don’t avoid it.

You should avoid scheduling a Pap smear when you are menstruating, as the blood from the uterus will affect the accuracy of the test.

The Pap smear result should be available within a few days to a week at most.

If there are abnormalities, your doctor may suggest doing an HPV test, to detect the presence of high-risk HPV infection. The absence of HPV infection is reassuring, while the presence of high-risk HPV infection may lead to further investigation (with colposcopy).

Take this quiz: http://www.womenshealthmag.com/files/cervical-cancer/index.html

Some pics: http://www.mayoclinic.com/health/medical/IM01823