What is a Pap smear? Does it hurt?

What is a Pap smear?

A Pap smear is a procedure performed by a health professional that consists of taking a sample of superficial cells or a specific liquid by rubbing lightly with a small brush, a spatula or a special cotton swab. This sample is then placed on a glass slide to be examined under a microscope to detect any abnormalities.

Different types of smears?

There are different types of smears:

• Cytological smears are used to observe the morphology of the cells

• Microbiological smears are used to detect the presence of markers, bacteria or viruses

Gynaecological smears are quite common and there are several types:

• The cervico-uterine smear: it consists in taking cells from the cervix in order to observe their aspect to detect a possible cancer or precancerous lesions.

• Vaginal swab: consists of taking cells from the vagina to study the microbial flora and look for the presence of infections.

There are also blood, urine and anal smears.

What are the interests of smears ?

Here, we focus on the cervico-uterine smear which is essential to avoid an advanced stage of cervical cancer due to the human papilloma virus. Indeed, this cancer is a silent disease that sometimes does not cause any symptoms for many years and that develops slowly in the body. However, it is the second most common cause of cancer in women worldwide. It is therefore important to carry out a screening through the smear test.

At what age should you have your first smear test and how often afterwards?

First of all, as far as the vaginal swab is concerned, it should be done if symptoms such as abnormal vaginal discharge, itching or discomfort occur.

Secondly, according to the National Cancer Institute, for cervical cancer screening, it is recommended to do it from the age of 25 (however, there is a risk from the first sexual intercourse), then the following year, and then every 3 years until the age of 65.

Nevertheless, the presence of certain abnormal results or exposure to infections will require a more frequent smear.

How to prepare for a Pap smear?

It is advisable to avoid having sex 48 hours before a gynecological appointment. Moreover, the smear cannot be done during menstruation or in case of bleeding, so it is advised to make an appointment in the middle of the cycle. It cannot be done if you have a local infection, or after the use of ovules or local cream. It is therefore necessary to wait about 4 weeks after the treatment of an infection to perform a smear. You should also not perform intimate hygiene before a smear.

All these recommendations are very important because they allow the health professional to perform a smear in good conditions. Indeed, 30 to 60% of false negatives are due to a bad sampling which leads to poor quality results.

Who can perform the examination?

A Pap smear is a medical procedure that must be prescribed by a health professional. It should be noted that the sample must be taken with your consent and that you have the right to accept or refuse it.

For cervical smears or vaginal swabs, they can be done by a gynecologist as a "routine check-up" or in case of specific symptoms. But they can also be performed by your doctor, a midwife or a biologist from a medical analysis laboratory.

How is the examination performed?

Smear tests are a fairly quick examination: the practitioner places you in the gynecological position and then inserts a speculum into your vagina to spread the vaginal walls so that a cotton swab, a small spatula or a small brush can be inserted to collect cells. Then, as explained before, the samples are placed on a glass slide with a dye and sent to the laboratory for analysis.

Smears are usually preceded or followed by an interview.

This examination is usually painless, although some pain may be felt depending on the patient.

In addition, a small amount of bleeding may occur following a smear test, mainly because of the "scraping" done. You can therefore wear menstrual panties to avoid any inconvenience after the examination.

The results are obtained after about 3 weeks and are communicated to the patient. If an abnormality is detected, the doctor may prescribe additional tests.