If your pap smear test comes back as abnormal, or positive, it means there is an unusual cell appearing in your cervix. This result does not mean you have cervical cancer. Most often, these test results are the sign there have been cell changes caused by HPV (human papillomavirus). HPV is the most common STI (sexually transmitted infection) and in some cases, is linked to cervical cancer. The changes showing in your cervical cells can be moderate to severe.
What is a Pap Smear?
Pap smear or pap test is part of a pelvic exam. Pap is short for Papanicolaou, which comes from the doctor’s name, who studied changes in cervical cells. A pap smear is generally performed on a woman when she reaches the age of 21 unless there are unique health risks involved, such as HIV. The pap smear is the only method available to check the cells on your cervix to locate changes that can lead to cancer. If you are at risk for sexually transmitted infections (STI), your doctor at All Women's Care would also check for gonorrhea or chlamydia at the same time a pap smear is done.
How is a Pap Smear Performed?
Your physician at All Women's Care will insert a speculum into your vagina, so they are able to examine your cervix. Using a small plastic wand with a brush attached, they will then gently scrape a sample of cells from your cervix for testing. The pap smear should not be done during your menstrual cycle, as this can affect the results of the test. You should also not douche or use any other products to clean your vagina before having the smear.
Most women experience a small amount of cramping when their cervix is brushed, but this sensation should last only a minute or less. The cell samples will be placed in a glass bottle or on a glass slide and sent to the lab. A trained technician will examine the cells under a microscope to check if there are any abnormalities and report the findings to your doctor.
Results of a Pap Smear
Most times, the results of a pap smear return as normal; however, it is not uncommon for the results to come back as abnormal. The specialists in the lab will label abnormal cells according to how different they are from normal cells. Knowing the type of abnormality will help your doctor at All Women's Care decide on your treatment. Minor cell changes can disappear without the need for treatment, moderate to severe cell changes are more likely to be an indication of precancerous and could turn into cervical cancer.
These are some of the terms used to define the results of a pap smear:
A normal test result indicates that your cervix is healthy. Your doctor will then schedule your next pap smear at All Women's Care.
An unsatisfactory test result indicates a technician in the lab could not read the sample of cells taken during your pap smear. Your doctor will need to reschedule a pap smear with you to get another sample.
- Benign changes
This test result indicates your pap smear was basically normal, but there is an infection present that has caused inflammation of your cervical cells. You may need another pelvic exam to find the cause of the infection and receive treatment.
- Abnormal or ASCUS
ASCUS stands for atypical squamous cells of undetermined significance’ and means your test results are abnormal. An abnormal result indicates there are some cells in your cervix that are not ‘normal’ and need to be checked for possible HPV.
ASCUS happens when your cells are not typical. Your doctor at All Women's Care will perform a test with a special liquid to check for HPV. If none is detected, there is no reason for concern.
These are some guidelines used in young women under the age of 24:
- Low-Grade Squamous Intraepithelial Lesion (LSIL)
A test result of LSIL present indicates you have been infected with HPV (human papillomavirus), and will need to have a pap smear repeated within the next twelve months. This result could also require you to have a colposcopy.
If the repeat smear after twelve months is again abnormal, another follow up is requested in twelve more months. The doctor may ask that you have a colposcopy and, depending on the results return to pap smear schedule of every three years, or return in twelve months.
A colposcopy is a procedure to examine your vagina, cervix, and vulva closely for any signs of disease. The doctor uses a special instrument called a colposcope, which will provide them a magnified view of these areas. It is a nearly pain-free procedure, with some reporting only a small amount of pressure as the instrument is inserted.
Results showing ASC-H indicates your cervical cells are not typical and may be related to HPV. This result considered the cells to be ‘atypical,’ and ‘H’ means there is the possibility of ‘high-grade’ changes in your cervix. If you get an ASC-H result on your pap smear, the doctor will require you to have a colposcopy.
- Atypical Glandular Cells (AGC)
Results indicating AGC means there are changes in your glandular cells of the cervix. These cells create mucus and grow inside your uterus and in the opening of your cervix. These results will also require a colposcopy.
- High-Grade Intraepithelial Lesion (HSIL)
Test results indicating HSIL means the cells in your cervix are showing a change. The changes are more severe than a low-grade change. You most likely do not have cancer at this point, but if you do not receive treatment, you are at risk for developing cervical cancer. Having a colposcopy and treatment can prevent cancer from developing.
It is rare in women under the age of 24, but if the results come back from the pap smear showing cancer cells, you will have to be seen by a gynecologist who specializes in cancer. Treatment should be sought immediately and may require surgery. The earlier you catch and treat this form of cancer, the higher your success rate will be of remaining healthy.
What it Means to Have an Abnormal Pap Smear
Millions of women have a pap smear each year as a means of screening for cervical cancer. It is a simple procedure and part of a woman’s routine visit to a gynecologist. Your doctor swabs some cells from your cervix and sends them to the lab to determine if they are normal or abnormal.
A majority of pap smears come back normal, and you can sigh with relief, and schedule your next exam a few years down the road. There is only two to five percent of the women who have a pap smear that has results come back abnormal. If you happen to fall into that group, you may be a bit nervous. This information will help you understand what it means to get an ‘abnormal’ test result on your pap smear.
Causes of an Abnormal Pap Smear
Abnormal cells on your pap smear results are not an indication of cancer. There are numerous reasons your results came back as abnormal. The most common is HPV (human papillomavirus).
While HPV is the leading cause of abnormal pap smears, it does not mean you have cervical cancer. According to a study at the Henry Ford Health System in Detroit, almost ninety percent of the time this is the cause for the abnormal pap smear, it clears on its own without causing cancer. A lot of the time, women who have this condition have no symptoms or experience only mild symptoms.
When HPV does lead to precancerous or cancerous changes in your cervical cells, those cells will be categorized as mild, moderate, or severe. From this point, your doctor at All Women's Care will discuss your options.
Other causes can explain why you have had an abnormal pap smear. There are other sexually transmitted infections (STI) that can be blamed, as well as gonorrhea and chlamydia. Yeast infections and bacterial vaginosis will also cause changes in your cervical cells. All of these conditions are treatable.
- Yeast Infection
Yeast is a fungus and lives typically in a vagina in small numbers. When you develop a yeast infection, it indicates too many yeast cells are growing. Yeast infection is common among women, and they can become quite bothersome, but are not serious.
These infections develop when something happens to change the balance of the yeast. Antibiotics are sometimes the cause of the imbalance, as well as high estrogen levels caused by hormone therapy or pregnancy. Health issues such as HIV or diabetes are other causes of a yeast infection.
When you develop a yeast infection, you can experience soreness or itching in the vagina, and in some cases, it causes burning or pain during urination and sex. You may also notice a thick, clumpy discharge that looks somewhat like cottage cheese. It is easy to misdiagnosis this condition yourself. You should see your doctor at All Women's Care if you suspect you have a yeast infection.
- Bacterial Vaginosis
Bacterial vaginosis is a mild form of infection in the vagina. There is normally a lot of good bacteria and bad bacteria in a woman’s vagina. The good will control the growth of the bad. When you develop bacterial vaginosis, the balance has become upset. This condition is treatable, but when present, it can cause an abnormal pap smear result. If the condition is untreated, it can lead to more serious problems. You should see your doctor at All Women's Care to seek treatment if you think you have this infection.
Symptoms of bacterial vaginosis include a smelly discharge, which may look yellow or white. You could also experience a ‘fishy’ smell after sexual intercourse. Most women do not notice symptoms with this infection.
As a woman ages and enters menopause, it can produce changes in the cervical cells as well. When the body stops producing as much estrogen, the cells will begin to look funny and can even mimic precancerous conditions.
What To Do If Pap Smear is Abnormal
Having a pap smear is to find out if something is going on in your cervix, but it doesn’t tell you what is happening if the test is abnormal. Your doctor at All Women's Care will want to schedule a follow up to find out what the results mean. The majority of women do not need special testing or treatment; the follow-up pap smear is common practice.
It is acceptable to wait and perform a second pap smear, as minor cell changes usually do not become more severe during a short period of time. Watchful waiting is common when a pap smear comes back abnormal, especially if it is your first one.
Your doctor may request a second pap smear as a way of ruling out errors in the test and see if there are signs of HPV DNA. This second test will tell the doctor if you have HPV and that it is the reason your pap smear test came back abnormal. This second test can even alert the doctor if you have one of the specific strains of HPV (16 or 18), which causes cervical cancer.
The next step may be to order a colposcopy; however, not every abnormal pap smear means a colposcopy is needed. In younger women, especially, this test is seldom used as their risk of cervical cancer is very low. In cases of younger women (under the age of 25), a second pap smear is generally requested with six months of the abnormal one to determine if the results will still be abnormal.
Every year there are approximately 13,000 women who receive a diagnosis of cervical cancer, and around 4,000 of them die from this cancer. Most of these cases are preventable if patients schedule and have a pap test or do the appropriate follow-ups.
What to Expect if You Need a Colposcopy after Abnormal Pap Smear
If your pap smear results come back as ‘abnormal’ as listed above, there are certain times this result may require you to have a colposcopy. When you have a colposcopy, you will be asked to undress from the waist down. Typically, there is a consent form for you to sign before your physician begins.
You will lie down on the exam table with your feet placed in the holders or stirrups. A colposcopy specialist will then gently insert a speculum into your vagina the same way as when you had your pap smear. The speculum separates the vaginal walls so your cervix can be examined. With the use of a colposcope to magnify your cervix, the doctor will perform an exam of your cervix walls.
The colposcope only touches the outside of your vagina and not you. This tool is similar to a large magnifying glass, and with it, your doctor can look at the tiny cells on your cervix. The doctor will swab your vagina and cervix with a vinegar solution. This solution will temporarily cause unhealthy cells to change their color so the doctor can observe them easier. If unhealthy cells appear, the specialist will more than likely take a sample of them to perform a biopsy.
A sample of the unhealthy cells is taken with a tool similar to tweezers. The sample will be placed in a jar that has a preservative liquid inside. The jar is then sent to the lab, where they will check the sample for any signs of disease.
The procedure of colposcopy is not usually uncomfortable. It is described as a long pelvic exam to allow your doctor to examine your cervix. The biopsy, if necessary, can cause some discomfort, but this sensation would last less than a minute. Some women report they feel a slight pinching or experience mild cramps, while others report feeling nothing after a biopsy. If you are concerned about experiencing discomfort during your colposcopy, you can take an over-the-counter pain reliever before your procedure. Pain relievers, such as naproxen sodium or ibuprofen, should help with any pain. If you experience any discomfort during a pap smear, then you would benefit from taking these pain relievers before a colposcopy.
Once the procedure is over, the specialist will explain what they saw and if they have taken a sample for further examination. If they did remove a sample, the test results for this should be returned to your doctor within two to three weeks. What you might experience after a colposcopy:
- It is not uncommon for some slight bleeding to occur after a biopsy or perhaps some spotting
- If you notice any sign of blood after your procedure, you should use pads and not a tampon
- There may be some clumps or brownish material appearing in your panties or underwear after a biopsy. This discharge is common and not a reason for concern. The clumps will last up to five days and are from a solution used during your procedure to control bleeding
- There may even be a black-looking discharge after your biopsy. If your doctor used a solution known as ‘silver nitrate’ to control bleeding, it would result in a black-looking discharge. This discharge is also common and not a cause for alarm.
- For 48 hours after your procedure, you should not use tampons, douche, or have sexual intercourse.
Risks for Causing Abnormal Pap Smears?
Certain sexual behaviors put a woman at risk for an abnormal pap smear. One practice is having unprotected sex. Not using a condom puts a woman at risk for numerous health risks, and having an abnormal pap smear is one. Another risk is having more than one sex partner as this increases your risk for HPV, and HPV raises the risk of abnormal pap tests.
HPV can stay in a person’s body for many years without them even knowing it. So, even after a woman commits herself to one partner, she could still have an abnormal pap smear, as she could have contracted HPV in the past.
Other risks of receiving an abnormal test result include smoking or having an impaired immune system. These can both change the cells in the cervix. If you were exposed to the drug, DES, while your mother was carrying, you could also cause abnormal pap smear results, although this is rare.
- Impaired Immune System
The immune system is your body’s natural defense system, which fights infections. If your system is impaired, it is not working correctly and will not protect you from infections. There are some medications and health conditions which can impair or weaken your immune system:
- Radiation or chemotherapy treatments
- Drugs such as corticosteroids taken to suppress the immune system after an organ transplant
- Substance use disorders
- Certain diseases such as cancer, diabetes, AIDS/HIV
Between the years of 1948 and 1971, women were given a drug called diethylstilbestrol (DES) as a means to prevent a miscarriage. Daughters who have been born to an expecting mom who took this drug have an increased risk of developing:
- Abnormal cervical cells which will lead to abnormal pap smears
- Vaginal cancer
- Problems with the structure of their reproductive organs such their uterus being T-shaped which causes infertility
Are There Symptoms With Abnormal Cell Changes?
When cells change in the cervix, the change itself does not cause symptoms. If HPV has caused the change, there typically are not any symptoms related to this condition. If the cause for your abnormal pap smear results from a sexually transmitted infection, you could have symptoms related to the infection, which include:
- A discharge which is not typical as it has a different texture, odor, or color
- A painful itching or burning in your genital or pelvic area during urination or sex
- The appearance of rashes, blisters, lumps or warts around the genitals
Where Can I Learn More About Abnormal Pap Smears Near Me?
Call or visit one of our physicians at All Women's Care 213-250-9461 if you have received an abnormal pap smear on your last exam. We have been treating women in the local community with the highest standards and can provide you answers to all your questions regarding abnormal pap smear results. Using the most up to date procedures and protocols, we cover a wide range of women’s health issues and are ready to help you.