The Pap Smear and Pelvic Exam

The Pap Smear and Pelvic Exam

Routine gynecologic examinations are recommended for all women starting at age 21, sooner if the woman is sexually active and certainly if there are any problems with menstrual cycles. Pelvic exams include inspection of the outside of the vagina (vulva), the inside of the vagina, the cervix (the opening to the uterus), and palpation of the uterus (womb), the fallopian tubes and ovaries and possibly the rectum.

What is a Pap smear?

The Pap smear is part of the examination and is a scraping of the cervix and screens for cancer of the cervix. It does not screen other gynecologic cancers (uterus or ovary). The Pap smear is often thought to be the same thing as the pelvic exam, but a pelvic exam can be performed without obtaining a Pap smear.

How often should I get a Pap smear?

Pap smear screening starts at age 21. The frequency of pelvic exams and Pap smears may vary but is every 1-3 years depending on the age of the woman, her risk factors and how many normal Pap smears the woman has had in the past. More recently, tests for the HPV (Human Papilloma Virus) virus have been recommended in women over age 30 to compliment the Pap smear. The HPV virus is a known cause of cervical cancer and is very common among women. It takes a long time for cervical cancer to develop after the HPV virus is present and thus if both the Pap smear and the HPV testing is negative, the woman usually does not need another Pap smear for 5 years. This, however, does not mean that the woman should not get a pelvic exam since the exam is for other things and often a woman needs to be seen yearly if on prescription contraception (birth control pills or shots) or hormones.

Pap smears are not recommended after a woman has had a hysterectomy (unless she had cancerous or precancerous cells on the cervix before the surgery) or after age 65.