What does a Pap test actually screen for. How does the Pap smear process work. When should women start getting regular Pap tests. What are the limitations of Pap smear screening. How often should Pap smears be performed.

The Science Behind Pap Smear Testing

A Pap smear, formally known as the Papanicolaou test, is a crucial screening tool for detecting abnormalities in cervical cells. But how exactly does this test work?

During a Pap test, a healthcare provider collects a sample of cells from the cervix – the lower part of the uterus that connects to the vagina. These cells are then preserved in a special liquid and examined under a microscope for any signs of abnormality.

What Can Abnormal Pap Results Indicate?

Abnormal Pap test results can point to several conditions:

• Mild inflammation
• Human papillomavirus (HPV) infection
• Precancerous changes
• Cervical cancer

Dr. Melissa A. Simon, an obstetrician and gynecologist at Northwestern Medicine, explains: “The Pap test can detect changes in cells that could be concerning for possible cervical cancer or precancerous changes.”

Understanding Pap Test Results

Pap test results are typically classified into categories based on the degree of cell abnormality:

1. Atypical squamous cells of undetermined significance (ASCUS)
2. Low-grade squamous intraepithelial lesions (LSIL)
3. High-grade squamous intraepithelial lesions (HSIL)

ASCUS results indicate slightly abnormal cells but don’t necessarily mean precancer is present. LSIL suggests mild abnormalities, often caused by HPV infection, which may resolve on their own. HSIL points to more serious changes that require further investigation.

The Link Between HPV and Abnormal Pap Results

Human Papillomavirus (HPV) is a key player in cervical health. But why is HPV so closely associated with abnormal Pap smears?

HPV is a sexually transmitted infection that can enter cervical cells and alter their structure and behavior. Certain high-risk types of HPV are strongly linked to an increased risk of several cancers, including:

• Cervical cancer
• Vulvar cancer
• Vaginal cancer
• Penile cancer
• Anal cancer
• Oral and throat cancers

The good news is that HPV can be prevented through vaccination. The HPV vaccine targets the virus types most commonly associated with cancer and genital warts, offering significant protection against these health risks.

Follow-Up Procedures for Abnormal Results

If a Pap test comes back abnormal, what happens next? Depending on the severity of the abnormality, your healthcare provider may recommend:

1. Colposcopy: A procedure using a special camera to examine the cervix more closely
2. Biopsy: Taking a small sample of cervical tissue for further analysis
3. LEEP (Loop Electrosurgical Excision Procedure): Removing a portion of cervical tissue for diagnosis or treatment

These follow-up procedures help determine the extent of cellular changes and guide appropriate treatment decisions.

Limitations of Pap Smear Testing

While Pap smears are invaluable for detecting cervical abnormalities, they have limitations. What can’t a Pap test detect?

Pap tests are not designed to detect ovarian cancer. The ovaries are located far from the cervix, making it extremely unlikely for ovarian cancer cells to be picked up during a Pap smear. For ovarian cancer to be detected, cells would need to travel through the fallopian tubes, uterus, and reach the cervical area – a highly improbable scenario.

Additionally, Pap tests have limited ability to detect sexually transmitted infections (STIs) other than HPV. If you’re concerned about STIs, it’s important to request specific screening tests from your healthcare provider.

Recommended Screening Guidelines for Pap Tests

When should women start getting Pap smears, and how often should they be performed? Different medical organizations have slightly varying recommendations:

• The U.S. Preventive Services Task Force (USPSTF) and the American College of Obstetricians and Gynecologists (ACOG) recommend starting at age 21
• The American Cancer Society suggests beginning screening at age 25

Dr. Simon notes that there are many nuances to these guidelines, and the appropriate screening schedule can vary based on individual risk factors.

Frequency of Pap Tests

How often should Pap smears be performed? Current guidelines suggest:

• Pap test every 3 years
• Primary HPV testing every 5 years
• Co-testing (combined HPV and Pap test) every 5 years if primary HPV testing is unavailable

For women over 65, screening may be discontinued if they have a history of adequate prior screening with normal results and are not at high risk for cervical cancer.

The Importance of Regular Screening and Communication

Regular cervical cancer screening is crucial for early detection and treatment. Dr. Simon emphasizes the importance of open communication with healthcare providers: “If you have vaginal discharge, abnormal bleeding or are feeling pain, schedule a visit with your healthcare clinician to discuss these symptoms. It’s important that if you are ever in any doubt of what you are feeling or experiencing, and are questioning if you need screening or a test, always reach out to your care team so you can have that conversation.”

Personalized Screening Recommendations

While general guidelines exist, it’s essential to discuss individual risk factors and screening recommendations with your healthcare provider. Factors such as personal medical history, family history, and lifestyle can influence the appropriate screening schedule for each woman.

The Role of HPV Testing in Cervical Cancer Screening

HPV testing has become an integral part of cervical cancer screening strategies. But how does HPV testing complement or differ from traditional Pap smears?

HPV tests specifically look for the presence of high-risk HPV types in cervical cells. Unlike Pap smears, which detect cellular changes, HPV tests identify the presence of the virus itself. This approach can be particularly effective because persistent high-risk HPV infection is the primary cause of cervical cancer.

Benefits of HPV Testing

HPV testing offers several advantages in cervical cancer screening:

• Higher sensitivity for detecting high-grade cervical lesions
• Longer intervals between screenings (5 years vs. 3 years for Pap smears alone)
• Potential for self-sampling, increasing access to screening

Some healthcare systems now use HPV testing as the primary screening method, with Pap smears reserved for follow-up on positive HPV results. This approach, known as primary HPV screening, is becoming increasingly common in many countries.

Emerging Technologies in Cervical Cancer Screening

While Pap smears and HPV tests remain the cornerstone of cervical cancer screening, researchers are continuously exploring new technologies to improve detection and accessibility. What innovations are on the horizon for cervical cancer screening?

AI-Assisted Cytology

Artificial intelligence (AI) is being developed to assist in the analysis of Pap smear samples. These AI systems can potentially:

• Improve accuracy of cell abnormality detection
• Reduce human error in sample analysis
• Increase efficiency in processing large numbers of samples

While still in development, AI-assisted cytology could significantly enhance the reliability and speed of cervical cancer screening in the future.

Biomarker Testing

Researchers are investigating various biomarkers that could indicate the presence of cervical cancer or high-risk precancerous lesions. These biomarkers include:

• Specific proteins expressed by abnormal cells
• DNA methylation patterns associated with cancer development
• microRNA profiles indicative of cervical abnormalities

Biomarker testing could potentially offer more precise and individualized risk assessment for cervical cancer, allowing for more targeted screening and follow-up strategies.

The Global Impact of Cervical Cancer Screening

Cervical cancer screening has had a profound impact on women’s health worldwide. How has the implementation of screening programs affected cervical cancer rates globally?

In countries with well-established screening programs, cervical cancer incidence and mortality rates have significantly decreased over the past few decades. For example, in the United States, cervical cancer rates have declined by more than 50% since the 1970s, largely due to widespread Pap smear screening.

Challenges in Global Screening Implementation

Despite the success of screening programs in many developed countries, significant challenges remain in implementing effective screening globally. These challenges include:

• Limited healthcare infrastructure in low-resource settings
• Cultural barriers to screening acceptance
• Lack of awareness about the importance of regular screening
• Financial constraints in providing widespread screening services

Efforts are ongoing to address these challenges and expand access to cervical cancer screening worldwide. Strategies include developing low-cost screening methods, implementing community-based education programs, and integrating cervical cancer screening with other health services.

The Role of HPV Vaccination in Prevention

While screening remains crucial for early detection, HPV vaccination has emerged as a powerful tool for primary prevention of cervical cancer. The widespread adoption of HPV vaccination, particularly among adolescents before sexual debut, has the potential to dramatically reduce cervical cancer rates in the coming decades.

The combination of HPV vaccination and regular screening offers the most comprehensive approach to cervical cancer prevention currently available. As vaccination rates increase and screening technologies continue to improve, the global burden of cervical cancer is expected to decrease significantly.

What Does a Pap Test Detect?

Updated November 2022

Its real name: Papanicolaou test. There’s a good chance you know it as a Pap smear, or more appropriately, a Pap test. Discover the science behind this test ­— including what it doesn’t detect.

The Science Behind the Test

A Pap test is when a clinician takes a sample of cells from your cervix (the lower part of the uterus neck located at the top of the vagina). Then, they put the cells into small jar with a special liquid to preserve the sample so it can be tested for abnormalities under a microscope.

There are many reasons why you may have abnormal findings, such as:

• Mild inflammation
• Human papillomavirus (HPV)
• Cancer or precancer

Cervical cancer, if caught early, is highly treatable.

— Melissa A. Simon, MD

“The Pap test can detect changes in cells that could be concerning for possible cervical cancer or precancerous changes,” says Melissa A. Simon, MD, an obstetrician and gynecologist at Northwestern Medicine. 

Abnormal test results will indicate a number of atypical squamous cells, which will then be classified as low-grade or high-grade squamous intraepithelial lesions (LSIL and HSIL, respectively). LSIL indicates that the changes are mildly abnormal and usually caused by HPV infection, and they may go away on their own. HSIL suggests more serious changes.

“Cells that are determined to be atypical of undetermined significance basically reveal slightly abnormal cells, and it does not clearly mean precancer is there. Usually, these test results indicate to follow up in a year,” says Dr. Simon.

Abnormal Pap test results are typically caused by HPV. HPV is a sexually transmitted infection (STI) that enters cells and changes them. HPV can be prevented by getting the vaccine, which targets the HPV types that most commonly cause certain types of cancer and genital warts. Certain high-risk types of HPV are associated with an increased risk for the following types of cancer:

• Cervical
• Vulva
• Vagina
• Penis
• Anus
• Mouth and throat cancer

Depending on your Pap test results, your physician will determine the appropriate next steps. This can include another test, known as a colposcopy, which uses a special camera to look at your cervix. During this procedure, a biopsy of cells on your cervix may be taken for further analysis. Your physician may also opt for a loop electrosurgical excision procedure, known as LEEP, if there are more concerning findings or repeated abnormal Pap test results. A LEEP removes part of your cervix tissue for diagnosis and/or treatment.

What It Can’t Determine

Although Pap tests can help detect precancerous cells on the cervix, there are other types of gynecologic cancers that Pap tests cannot detect. 

Because your ovaries are far away from your cervix, it is extremely unlikely that a Pap test will  detect ovarian cancer. For that to happen, the cancer cells would have to travel away from your ovaries, through your fallopian tubes and uterus, and into the area surrounding your cervix.

The Pap test is also limited in detecting other types of STIs. If you are concerned you may have a STI, you should ask your clinician to screen for specific STIs.

Pap Tests Are Part of Routine Screening

The U.S. Preventive Services Task Force (USPSTF) and the American College of Obstetricians and Gynecologists (ACOG) both suggest starting screening at age 21. However, the American Cancer Society suggests that cervical cancer screening begin at age 25.

Dr. Simon explains that there are many nuances and complexities of when to start screening and how frequently screening should be done. Cervical cancer can also take a long time to develop, which could explain the varying guidelines.

Screening with a Pap test every three years during this time period is acceptable. However, other types of screening include primary HPV testing every five years. If primary HPV testing is not available, screening may be performed with co-testing that combines an HPV test with a Pap test every five years.

“If you have vaginal discharge, abnormal bleeding or are feeling pain, schedule a visit with your healthcare clinician to discuss these symptoms,” says Dr. Simon. “It’s important that if you are ever in any doubt of what you are feeling or experiencing, and are questioning if you need screening or a test, always reach out to your care team so you can have that conversation.”

The USPSTF, ACOG and American Cancer Society agree that people older than 65 do not need to be screened if adequate prior screening has been completed with normal results and if there is no history or high risk of cervical cancer. Dr. Simon recommends talking to your primary care clinician about your individual risks and recommendations for screening.

Bottom Line

The Pap test is a screening tool that can help detect abnormal cells on your cervix. This early detection can be important in stopping precancerous cells from progressing to cervical cancer.  

“Cervical cancer, if caught early, is highly treatable. And that’s why engaging in routine screening is very important,” says Dr. Simon. “Between the HPV vaccine and routine testing, this type of cancer really should be nonexistent. ”

What Should I Know About Cervical Cancer Screening?

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“If I didn’t go to that appointment, I might not be around for my kids,” says Cindy. Her cervical cancer screening test found precancerous cells. She shares her story in this video.

The HPV test and the Pap test can help prevent cervical cancer or find it early.

• The HPV test looks for the virus (human papillomavirus) that can cause cell changes on the cervix.
• The Pap test (or Pap smear) looks for precancers, cell changes on the cervix that might become cervical cancer if they are not treated appropriately.

Both tests can be done in a doctor’s office or clinic. During the Pap test, the doctor will use a plastic or metal instrument, called a speculum, to look inside your vagina. This helps the doctor examine the vagina and the cervix, and collect a few cells and mucus from the cervix and the area around it. The cells are sent to a laboratory.

• If you are getting a Pap test, the cells will be checked to see if they look normal.
• If you are getting an HPV test, the cells will be tested for HPV.

What is cervical precancer? When there are cervical cells that look abnormal but are not yet cancerous, it is called cervical precancer. These abnormal cells may be the first sign of cancer that develops years later. Cervical precancer usually doesn’t cause pain or other symptoms. It is found with a pelvic exam or a Pap test.

If you have a low income or do not have health insurance, you may be able to get a free or low-cost screening test through the National Breast and Cervical Cancer Early Detection Program.

Find out if you qualify

When to Get Screened

If You Are 21 to 29 Years Old

You should start getting Pap tests at age 21. If your Pap test result is normal, your doctor may tell you that you can wait three years until your next Pap test.

If You Are 30 to 65 Years Old

Talk to your doctor about which testing option is right for you—

• An HPV test only. This is called primary HPV testing. If your result is normal, your doctor may tell you that you can wait five years until your next screening test.
• An HPV test along with the Pap test. This is called co-testing. If both of your results are normal, your doctor may tell you that you can wait five years until your next screening test.
• A Pap test only. If your result is normal, your doctor may tell you that you can wait three years until your next Pap test.

If You Are Older Than 65

Your doctor may tell you that you don’t need to be screened anymore if—

• You have had normal screening test results for several years, and
• You have not had a cervical precancer in the past, or
• You have had your cervix removed as part of a total hysterectomy for non-cancerous conditions, like fibroids.

No special preparation is needed before you have an HPV test.

If you are getting a Pap test, you can take steps to make sure the test results are accurate. Avoid intercourse, douching, and using vaginal medicines or spermicidal foam for 2 days before the test. If you had sex before the test, go to the appointment as planned and let the doctor know.

If you have your period, don’t worry. Both tests can still be done at this time.

Test Results

It can take as long as three weeks to receive your test results. If your test shows that something might not be normal, your doctor will contact you and figure out how best to follow up. There are many reasons why test results might not be normal. It usually does not mean you have cancer.

If your test results show cells that are not normal and may become cancer, your doctor will let you know if you need to be treated. In most cases, treatment prevents cervical cancer from developing. It is important to follow up with your doctor right away to learn more about your test results and receive any treatment that may be needed.

If your test results are normal, your chance of getting cervical cancer in the next few years is very low. Your doctor may tell you that you can wait several years for your next cervical cancer screening test. But you should still go to the doctor regularly for a checkup.

Smear analysis for flora in women and men, hurry up to take it at competitive prices in Moscow.

Lazarenko A. A.

Many thanks to the doctors Belikova O.S., Simonova E.B., Zhukov E.V. for patience and conscientious attitude towards the patient.

Oct 10 2018

Robert Greenberg

Ekaterina Borisova is an incredible specialist and a great person. For three years I suffered from various diseases of the gastrointestinal tract (erosion, inflammation, irritable bowel syndrome, etc.), and, frankly, I already gave up on myself. Couldn’t eat, couldn’t sleep, and other moments. Not a single doctor understood what was happening to me, why I felt so bad and where the legs of my problems grow from. But I was lucky, I went to the right doctor. First, they listened to me carefully (and this is generally a rarity, to be honest), then they conducted many tests and diagnostics (absolutely justified, and not for show), and every source of my ailments was found and eliminated. It took me about 5 months to feel better, and that’s more to blame for the pandemic and personal moments because of which I interrupted the treatment. I want to note that Ekaterina Borisovna even suggests which manufacturer (country) to buy medicines from, so that they work better. He also remembers your diagnosis and name, which is also nice. Thank you, my deepest respect and sincere appreciation for your competence, ability to cheer and personal interest in the result.

Jul 17 2020

Irina Z.

I express my deep gratitude to Ekaterina Borisovna Simonova for her professionalism and mercy towards patients. I have been going to this doctor for several years for advice. All her conclusions and appointments are correct and confirmed by other doctors, for a consultation with which she very promptly not only sent me, but also helped to ensure that consultations and relevant examinations took place without delay. And this is very important in the appointment of competent treatment. Ekaterina Borisovna – Doctor and Man with a capital letter. I’m glad I’m in good hands. Thank you from the bottom of my heart, Ekaterina Borisovna! I wish you and your loved ones good health. I advise everyone to contact such a competent, experienced and humane therapist. Best regards, Irina Z.

Mar 18 2021

Marina

Ekaterina Borisovna, Professional with a capital letter. Very caring, knowledgeable and compassionate doctor. Her work and professionalism deserve only the highest praise.

Aug 6 2020

Getmanova G.P.

She was treated by the therapist Ponomareva Larisa Vladimirovna for ARVI. The doctor is very attentive, responsible, qualified, and a very pleasant person. The treatment quickly got me back on my feet. I am glad that IMMA has specialists of this level. Thank you very much Larisa Vladimirovna.

Dec 28 2022

Elvira

My family and I have been served in Imma for almost 10 years, and I would like to especially mention Ekaterina Borisovna Simonova. Doctor with a capital letter. I think that this is a big plus for a clinic that has such employees. It is very difficult to find such doctors. I trust her with the most sacred things – my whole family. I always recommend to my friends. I have never met such help and support before meeting with her anywhere. Separately, I want to say about her professionalism – she always writes out very adequate methods of treatment, and she not only relieves symptoms, but looks for the very problem from which symptoms arise and successfully treats. Thank you very much, Ekaterina Borisovna, for the health of our entire family! I recommend it to everyone from personal experience!

23 Sept. 2020

Fayzrakhmanov A.A.

The best pediatrician in Moscow – Lapteva Svetlana Pavlovna!

Oct 28 2016

Tatyana

I want to express my deep gratitude to Lapteva Svetlana Pavlovna. This is one of the best pediatricians not only in this clinic, but also in Moscow. I try to enroll my children only to her. This is a 100% specialist in his field, doing his job not only professionally, but also with soul. Always responsible, attentive, competent and loving her work. I trust her opinion and listen to her advice. Thank you very much for your work!!!!

Dec 8 2018

Merkulova Irina

Our beloved doctor Svetlana Pavlovna! Thank you for being with us for more than 10 years since the birth of your first child (Erik) and the second youngest (Nikita)!

Feb 12 2020

Zabegaeva I.G.

I want to express my gratitude to the doctor Simonova Ekaterina Borisovna for her sensitivity, responsiveness to patients, as well as for competent treatment over the course of several years.

11 Apr. 2018

Tatyana M.

I would like to thank Ekaterina Borisovna Simonova from the IMMA Maryino clinic for her sensitive attitude and high professionalism!!! How lucky for me and my son that we got to SUCH A DOCTOR !!!!! Polite, explains everything, after which there are no questions left. THANK YOU that you treat your work 5++++++!

25 Apr. 2017

Elena

I would like to express my gratitude to the pediatrician Grechanaya Evgenia. This is how real pediatricians should be: kind, sensitive, attentive. Thanks to the doctor’s recommendations, the child slept through the night calmly, and improvements in his condition became noticeable. Thank you very much!!!!

Oct 4 2021

Elena

I know that a gynecological examination is not always easy for girls. And I am glad that I have been seeing Marina Trofimovna for more than 5 years. I recommend her as a specialist, because she is a true professional in her field. In addition to the gynecological examination, she also performs an ultrasound on her own (which is very convenient). She is always very attentive and responsive, listens tactfully, prescribes competent treatment and will do everything possible, if only you were healthy. A doctor who inspires confidence is a rarity in our time. Therefore, if you still choose a specialist, feel free to make an appointment, you will not regret it.

Mar 26 2021

Irina

I am very grateful to Ekaterina Borisovna Simonova for competent treatment, professionalism, as well as great personal participation in my treatment, sympathy, and moral support. I come to Ekaterina Borisovna as a friend. Thanks for the help! More such professionals!

Aug 9 2022

Sudakova O.A.

An excellent, highly qualified doctor and a wonderful person. Thank you very much for the excellent treatment.

Dec 17 2018

Kuzmina Ksenia

I express my gratitude to doctors Simonova E.B. and Ryabinin V.V. on behalf of his grandmother Bazyut Lilia Sergeevna. She came with a serious problem – abdominal pain and a total weight loss of 17 kg. Doctors even from a respected institute could not help her for a year. However, thanks to the joint work of the doctors of the IMMA clinic, my grandmother recovered. In the truest sense of the word, she has already gained 7.5 kg, she eats well and does not suffer from pain. Many thanks for the high professionalism and attentive attitude!

Dec 18 2018

Malysheva A.T.

I would like to express my sincere gratitude to Ekaterina Borisovna Simonova. She is not only an attentive therapist, but also an excellent psychologist, she can bring you to feelings even when you want to howl like a wolf. Thank you for being such wonderful doctors.

Feb 18 2018

Sabanina Margarita

Last year I took my daughter to the clinic with a question about a strange inflammation on the skin that appeared after visiting a kindergarten. My daughter has autism, so going to the doctor is always a challenge, especially in unfamiliar surroundings. I am very glad that I got to Evgenia Vladimirovna. My child has never received SUCH a detailed, delicate and careful examination anywhere: neither by OMS, nor for money. The doctor herself is very kind, attentive, calm and most importantly, she was able to help. Now only to her.

30 Sept. 2021

Arcady

Ekaterina Borisovna is a doctor by vocation. Competently conducts treatment for such a difficult disease as UC. Great professional and just a really nice person. Knows how to work quickly and is always ready to help!

Jan 16 2021

Elena

Hello! I want to thank Marina Trofimovna for her attentive attitude and sensitive approach. Thank you!

Jan 7 2020

What do the smears mean? Encyclopedia of the IVF Clinic

Any visit by a woman to a gynecologist is always accompanied by taking swabs. What do they mean? The doctor obstetrician-gynecologist of the Department of Obstetrics and Gynecology of the Medical Academy of Postgraduate Education of St. Petersburg Marina Vladislavovna BONDARENKO tells.

Any visit by a woman to a gynecologist is always accompanied by a swab. What do they mean? The doctor obstetrician-gynecologist of the Department of Obstetrics and Gynecology of the Medical Academy of Postgraduate Education of St. Petersburg Marina Vladislavovna Bondarenko tells.

Flora smear

Flora smear is the most common test in gynecological practice. It is taken both at the first visit to the doctor and at subsequent visits. If a woman is healthy, then such a prophylactic smear is done with a frequency of about once every 3 months. In cases where it is necessary to confirm a particular disease or test the effectiveness of treatment, it makes sense to examine it at every visit to the doctor.

Before the procedure, you should not go to the toilet “in a small way” for 2-3 hours. Otherwise, you may wash away bacteria and epithelium, which are important for a correct diagnosis. For a day, you must refrain from intimate contacts. Also, do not use spermicidal creams or douche.

A prophylactic smear for flora in a healthy woman is taken approximately once every three months. When performed correctly, a smear on the flora can say a lot. First of all, determine the number of leukocytes. If there are a lot of white blood cells, then you may have inflammation. The type of microflora is also determined in this smear. It is directly related to the phase of the menstrual cycle. In the analysis, there may be different cells of the rod or cocci. If there is inflammation, then there will always be a lot of cells, since they are rejected faster. “Cluster cells” characteristic of sexually transmitted diseases (STDs) may appear. This also suggests that it is time to take care of your health. When gonococci or Trichomonas appear in the analyzes, then you definitely should not put off a visit to the doctor. Although it should be noted that only those gonococci that “sit” inside the cell are dangerous. But extracellular ones can be present in a smear in an absolutely healthy woman.

You also need to remember that the diagnosis of gonorrhea can only be made after inoculation on special media. So I’ll have to take another smear. Before this, treatment cannot be started.

If filaments of mycelium are found in your flora smear, then this is a characteristic sign of candidiasis, in other words, “thrush”. However, for the final statement of that diagnosis, it is also not possible to do without sowing.

“Sterility” swab

At the gynecologist’s appointment, you can take a swab to check the degree of purity and hormonal levels. It determines the composition of the contents of the vagina, which is normally represented by a secret, various epithelial cells and coccal microflora. In order to properly conduct the study, you need to use a sterile Tampax-type swab, which is removed after 8 hours. It is most convenient to introduce it at night and remove it in the morning at a gynecologist’s appointment. The swab is sent to the laboratory in a sterile tube.

The degree of purity as a result of a smear is expressed in numbers:

1 and 2 are indicators of health, and 3 and 4 indicate the presence of colpitis – inflammation of the vagina.

There is also a smear for hormonal levels. It shows how during the menstrual cycle the female body is affected by sex hormones – estrogens and progesterone. According to its results, it is possible to establish how correctly and in what quantity they are produced.

A variant of this smear is the Threat swab. It is used during pregnancy to determine the risk of termination.

Pap smear or Pap test

Papanicolaou test or Pap test is needed to detect abnormalities in the cells of the cervix. In our country, it is also called a smear for atypical cells or cytology. All these are “names” of one analysis.

A Pap smear should not be done during menstruation or if there is inflammation, as the result may be false. During the day, as well as when taking a smear for flora, you should avoid intimacy, do not use candles or tampons.

In a cytological smear, the size, shape, number and location of cells are evaluated. In young girls, according to this analysis, it is possible to assess the correct production of estrogens. A smear is considered normal or negative when all cells are of normal size and shape and there are no abnormal cells. Atypical cells are “wrong” cells. They have the wrong shape, size, and they are often not located as they should.

In the first half of the cycle, the cells are located separately, in the second half, the cells seem to “bunch”. Therefore, such a smear is sometimes called “dirty”. To describe an abnormal smear, cytologists use special terms: dysplasia of 1, 2, 3 degrees, atypia. With grade 1 dysplasia, it is necessary to repeat the study after 3-6 months. Such a result can be with untreated chlamydia, gonorrhea or trichomoniasis. Therefore, it is necessary to repeat the procedure after a course of treatment.

In the case when dysplasia was found in the previous smear, or the woman or her partner suffered from herpes or genital warts, an additional examination should be done – colposcopy.

If grade 2 or 3 dysplasia is detected, then a biopsy is indispensable in this case. At the same time, a small piece of tissue is taken from the changed area. If atypical cells are detected, consultation with an oncologist is necessary.

An abnormal smear does not always mean that a woman has cervical cancer. In inflammation, cells can also look abnormal. But after treatment, the smear usually becomes normal.

According to the latest recommendations of the American Cancer Society, which Russian gynecologists also adhere to, a Pap test should be performed for all women from 20 years old once a year. If the result is negative twice, then the analysis can be repeated at least once every 3 years, up to 65 years. Women with a large number of sexual partners, infertility, menstrual irregularities, and genital herpes need more frequent examinations. As well as ladies taking hormonal contraceptives and obese.

The same category includes those who have ever found the papilloma virus. It is his role that is currently considered the main one in the development of cervical cancer. Remember also that if you decide to use an intrauterine device, then before setting it up, you must also take a swab for atypical cells.

Latent Infection Swab

These swabs are used to detect infections that are not detected by flora testing. These include chlamydia, ureaplasmosis, mycoplasmosis, genital herpes, appillomavirus and cytomegalovirus infections. In addition, this research method helps in the detection of candidiasis.

There are a fairly large number of different methods for diagnosing such infections. The most reliable is the PCR method – polymerase chain reaction, in which the infection is determined by its DNA.

PCR diagnostics are very informative, but in some cases there is a possibility of false results. Then it makes sense to supplement the examination with crops on special nutrient media. In order to minimize false results, it is better to have your own permanent gynecologist and be examined in the same laboratory.

At the MAMA Clinic, you can undergo a complete examination to find out the causes of infertility or clarify the diagnosis.