pap smear – Just Jenn

You’ve probably seen commercials for the HPV vaccine. Hopefully, you’ve gotten the series of three shots to help prevent certain types of human papillomavirus that could lead to cancer. But if you do get HPV, you may have the common LEEP procedure completed with your doctor to remove unhealthy cervical cells.

What is HPV?

HPV is the most common sexually transmitted infection, and if you are sexually active, you will most likely get HPV at some point in your life. GASP! That sounds bad, right? It’s not bad in most cases. HPV is so common because it’s spread through skin-to-skin contact, and most of the time it doesn’t show symptoms. Most strains of HPV are no big deal and go away on their own, but some strains are harmful because they can turn into cancer.

Think of it like the common cold. Most people will get many colds throughout their lifetime. That’s not shameful or “dirty” or scary. No big deal. It will go away on its own, but in some cases, that cold could turn into something more serious like pneumonia or a sinus infection. That’s when you need to seek medical attention.

Types 16 and 18 of the human papillomavirus can lead to cervical cancer. If you have a vagina and are age 21 or over, or sexually active, you should be getting regular Pap smears to test for unhealthy cells on your cervix. If your doctor detects abnormal cervical cells, they will likely do an HPV test to see if that is the cause. Although HPV can cause unhealthy cells, HPV tests and Pap smears usually aren’t done together unless there is an abnormality.

How does HPV relate to cancer?

You might be wondering, what even is my cervix? Where is it? Your cervix is a small area of tissue that connects your vagina to your uterus. Your vagina is the internal part of your genitalia and your uterus is also known as your womb. The cervix is kind of like a little cap at the top of the vagina. This is what prevents tampons or other things from getting lost in your body forever. The cervix is an important part of your body, so that’s why checking for healthy cells is so essential.

If you have unhealthy cells on your cervix and have a positive HPV test, you’ll likely undergo something called LEEP. You and your doctor will of course discuss the best course of action to treat your unhealthy cells, but LEEP is a very common procedure to remove unhealthy cervical cells.

LEEP, or Loop Electrosurgical Excision Procedure, is done by your gynecologist in their office and removes unhealthy cells from your cervix. LEEP uses a wire heated by electrical current to scrape away the unhealthy cells. Sounds high-tech, right?! You don’t need to do anything to prepare for the LEEP procedure, although it is usually done when you’re not on your period, so if you have LEEP done, schedule it so it doesn’t happen while you’re menstruating. LEEP might hurt a little, so you could also take some Tylenol or Advil prior to the procedure.

What can I expect from the LEEP procedure?

When you arrive at your doctor’s office, you’ll go into an exam room and undress from the waist down, similar to your Pap smear visit to the gynecologist. You’ll wear a gown and put your legs in stirrups so your doctor can see into your cervix. Your doctor will insert a speculum into your vagina to hold the vaginal walls open to have a clear view of your cervix. A speculum is made of metal or plastic and it honestly looks like a little beak that props open your vagina. Speculums are also used during Pap smears, so if you’ve had a Pap before, it’s the same thing. Once the vagina is open and the cervix is in view, your doctor might spray your cervix with a vinegar solution. This isn’t done with every LEEP procedure, but this solution turns the unhealthy tissue white, making it easier for your doctor to locate and remove it. After the solution is put into your cervix, you will be numbed. Your doctor will inject a numbing medicine into your cervix, then begin with the LEEP wire.

While holding very still, your doctor will put the wire through the speculum and into your cervix. Some doctors will also use a magnifying tool in your cervix to help see the unhealthy tissue clearer. The wire will take off the unhealthy tissue, your doctor will collect it, and send it to a lab for more testing. Because the wire uses electrical currents, it seals your blood vessels as it removes the unhealthy tissue, so you won’t bleed a lot during the procedure. The whole procedure takes about ten minutes and isn’t too painful. Since numbing medicine is used, most people only experience slight discomfort during the procedure.

What happens after the LEEP procedure?

It takes about three or four weeks for your cervix to heal after the procedure, so don’t have vaginal sex, use tampons, or douche during this time. You should never douche ever, so don’t even worry about that one! Additionally, you’ll probably have some cramping for a day or so after the procedure, and you will probably bleed a little and have some watery discharge. The discharge can last for the whole healing process, and it might smell a little. This is normal! It’s also recommended to take it easy in general during the three to four weeks following the procedure. Don’t do any super intense physical activity. You need to allow your body some rest so it can heal.

Are there any possible risks?

LEEP is a safe procedure, however, some serious complications could happen, although they are rare. Some people have pelvic infections, heavy bleeding, intense cramps or belly pain, fever, discharge that smells very bad, or bleeding that’s heavier than ever the heaviest day of your period. Additionally, LEEP may increase the risk of preterm birth in pregnancy. If you are currently pregnant and find abnormal cells, your doctor will wait until the pregnancy is over to do the procedure.

If these possible side effects seem too severe or risky, talk to your doctor about other methods to remove unhealthy cells. LEEP isn’t the only method, although it is very common. Because HPV is so common and these unhealthy cells can turn into cancer, it is imperative that you get regular Pap smears! Encourage other people with vaginas in your life to go as well. Our vaginal and sexual health is super important, and although it might be uncomfortable or intimidating to think about, you need to stay on top of it.

I remember hearing about “That First Trip” to the gynecologist when I was younger. I wasn’t exactly sure what happened at the gynecologist, I just knew you had to take your pants off in front of some doctor, and this doctor had to stick things inside you to make sure you were healthy. I thought going to the gynecologist was guaranteed to be painful and uncomfortable, and my first trip to the gynecologist was something I was afraid of. When the time for my first visit came I was really nervous, but I was pleased to find all the mystique and scary rumors surrounding my visit were nothing like my actual positive experience.

What is a gynecologist?

A gynecologist is “a physician who specializes in treating diseases of the female reproductive organs and providing well-woman health care that focuses primarily on the reproductive organs.” Gynecologists provide patients with birth control, information about sexual health, menstruation, fertility, as well as treat conditions or vaginal health concerns, and provide Pap smears.

If someone hasn’t already made a visit to the gynecologist well into puberty, it is recommended that you start going for Pap smears either once you become sexually active or once you turn 21. A Pap smear is a test that gynecologists do to test for cervical cancer and overall cervical health.

What to expect at the gynecologist

After checking in, you’ll be led into an examination room and the nurse will ask you if you have any questions for the doctor. This is a good time to voice any questions or concerns about your sexual health. Asking about contraception, STD tests, pain during sex, or any other sexual health concerns are all things you should feel comfortable asking your gynecologist. For example, I’ve asked my gynecologist how and why some antibiotics make birth control pills less effective.

People often feel uncomfortable talking about sex, but giving you information on your sexual health is what the gynecologist is there for. Even if it seems scary, it is totally normal and important to voice any questions or concerns you have while you are at the office and the doctor can take a look at anything they need to. You won’t be judged – it is literally the gynecologist’s job to help you!

Asking lots of questions

You can also ask your gynecologist general questions about sexual health and birth control, even if they don’t apply to you. You can inquire about birth control methods you don’t use but have read about, or you could ask about managing emotional health along with sexual health in a relationship. I know that at Planned Parenthood, for example, they always ask questions about your emotional well-being within your sexual relationships, and I just love that.

Next, you’ll be asked to take your clothes off and wear a robe of some sort and wait until the doctor comes in. You’ll be left alone for a while, then the doctor will arrive. The doctor will likely ask if you have any questions or concerns you want to address, then they’ll start the exam. You’ll scoot your booty to the bottom of the examination table and place your feet in stirrups so your legs are spread nice and wide. The doctor will then place a speculum or a metal instrument into your vagina to hold the vaginal walls open so they can see your cervix. The gynecologist should have various sizes of speculums and will likely use the smallest one when it is your first visit. The doctor will then look at your cervix and take a small little brush to take a sample of your cells. The doctor may also put a finger or two into your vagina and feel around to make sure you have no unnecessary pain or pressure.

It’s not as scary as it seems

I know this all sounds really intense and vulnerable, but it truly is not as scary as it sounds. The most important thing is to try and keep your body relaxed. If you tense up your muscles while the doctor is doing their business, it might be more painful than if you stay relaxed. The actual Pap smear takes less than a minute, so you will only be uncomfortable for a short amount of time.

You can also ask your doctor to explain what they are doing for the exam before they do it. During my first visit, my gynecologist showed me the speculum before inserting it, told me he was using the smallest one and described how he was going to insert it before he did. This helped me feel prepared, relaxed, and overall more comfortable. This visit is about you and your health, so you should feel empowered to ask for what you need to be most comfortable.

How often to go to the gynecologist

While you’re at the visit, the gynecologist will likely also feel your breast tissue to make sure there are no abnormal lumps or anything like that. After that, you’ll have a final chance to ask any questions, then you’ll get dressed, schedule your next appointment, and be on your way.

Talk with your doctor about how often they think you need to get a Pap test, but for most people between the ages of 21 and 29, a test every three years is appropriate. For patients aged 30 to 64 a Pap test with an HPV test every 5 years is appropriate, and patients over 65 might not need Pap tests anymore. It is best to ask your doctor what they think is best for you and your body.

Although visiting the gynecologist isn’t always the most comfortable experience, I always feel good leaving my appointment knowing I’m in control of my sexual health. Knowing that my body is healthy and working correctly makes me feel good.

If you’re anticipating your first visit to the gynecologist, take a deep breath, relax, and know that people get Pap smears done all the time. It’s important for your health, and after the first visit, you definitely won’t be as nervous.

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