Pelvic Exam and Pap Smear

During a pelvic exam your doctor will look at your vagina (inside and outside), your cervix (opening of the uterus), and your uterus (womb). Your doctor will use a speculum (plastic instrument) to see inside your vagina. He/she may also do a pap smear, and tests for gonorrhea or chlamydia.

What happens during the pelvic exam?

• During the pelvic exam, drops of vaginal discharge may be looked at under a microscope to check for yeast, Trichomonas, bacterial vaginosis and irritation or infection of the cervix. An examination of the vagina may be done to check for genital warts, herpes, or syphilis.
• The second part of a pelvic examination is when the doctor puts two fingers inside the vagina and checks the uterus, fallopian tubes and ovaries for normal development, infection, tubal pregnancy or ovarian cysts.

• A pap smear is a gentle scraping of the loose cells at the opening of the cervix. The cells are put on a glass slide and are examined under a microscope for any changes or abnormalities.

• The purpose of a pap smear is to find early changes in the cells that may need treatment so that cancer never has an opportunity to develop.

• Most women should get a pap smear once a year. If you have had an abnormal pap, or if you have a history of genital warts, you may need to get repeat paps every 3 - 6 months until the cells return to normal.

• Normal:  Satisfactory, no signs of cancer
• Unsatisfactory:  Not a good specimen; the test will need to be repeated
• Inflammation:  Irritation of the cells, maybe from a vaginal infection or sexually transmitted disease (STD) such as Trichomonas
• Atypical:  Mildly abnormal cell changes
• Abnormal Changes:  Abnormal changes in the cells can suggest wart virus (HPV infection) or sometimes pre-cancer types of changes in the cells

• Another useful function of the pap smear test is to find possible wart changes on the cervix. If you have had genital warts, inside or outside of the vagina, you should get a pap smear every six months.
• You may be asked to return to the clinic for a repeat pap test if changes on the cervix are found. Many of the changes will have returned to normal and won't need treatment. You may be treated for a vaginal infection which might be causing the changes. If changes in the cells continue to show up after several pap tests, or if more serious changes in the cells are seen, you may be referred to another medical facility for a closer examination.
• Remember, the best time for a pap smear is before or after your menstrual cycle. For best results don't douche, use any medication in your vagina, or have sexual intercourse for 24 hours before your pap is done.

• Ask your doctor any questions you have regarding pap smears, or other parts of the pelvic exam. You will not be contacted if your pap smear result is normal.