Pap Series: Part 1 - What is a Pap?

How and Why a Pap is performed

Transcript

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Let's talk about PAPPs big. Let's talk about you and me. Let's talk about all the good things and bad things about Pap smears. Hello and welcome to four vaginas. Only the podcast about everything. Female. I'm your host, Dr Celestine, bringing you important information about understanding your health and body in the way you wish your doctor would actually explain it. Hey, guys, welcome to episode number two on four Vaginas Only in this episode we're going to discuss the pepper nickel out test more commonly referred to as the Pap smear. Okay, so this test is referred to many different ways. Uh, the formal name, the paper, nickel out, test the pap, smear the pap test. I kind of go between calling it a pap or a Pap smear. But whichever way you refer to it doesn't matter as long as we're all on the same page. Now, this test, I personally think, is the bread and butter of office gynecology. Before I get into why it's done, I'll explain to you how it's performed. Many of you have had this test done, but I find that a lot of people I see don't fully understand why it's done or what's being done at their OBE joins office. So first of all, your physician will grab what's called a speculum. This speculum can be made of metal or plastic, but it's basically too long. Pieces attached in the back by a lever sort of looks like a duck bill. To me. This speculum is then inserted into the vaginal canal or vaginal tunnel as we previously spoke about it in our anatomy episode in episode number one of four vaginas only. And then, like I explained in Episode one, the vagina ends at the closed cervix. Thesis cervix is what we're trying to get to Using the speculum is that we can perform the path. I want to clarify here that every time a speculum is used does not mean that you are getting a pap smear performed. It is used in general to examine the vagina and the cervix for a multitude of different reasons. But today we're talking about the pap. So once you use the speculum, go through the vagina and open it up. You see the cervix at the end of the vagina. Once the cervix is visualized, your doctor will use a little tool to brush off a few cells on the cervix and send it to a lab for analysis. Then they take a speculum out, and that's it. That's the end of your pap. The whole thing is pretty quick and painless, and the best thing you can do to make it even quicker is to try to stay relaxed. I can't stress this enough. If you clench down, you're basically squeezing the speculum in the vagina. Ouch! Right, Um, and it's gonna take longer, and it's gonna be a lot more uncomfortable for you. All right, so now that everyone is on the same page on how the PAP is done, we can talk more about why it's done. Four morning. I'm only going to scratch the surface of this topic and talk about what I believe everyone should know as basic general knowledge on their body and health, so that you could be an active participant in your health care. There's a lot more to it, but each individual is obviously different. That's why we're called individuals, and you can go down different pathways based on the results on and even the treatment side of your Pap smear. So any specific questions. Please refer to Europa Julian for answers on your exact situation. Okay, so a pap is performed as a screening test for cervical cancer. It's not her diagnosis, screening and diagnosis are different, so a pap is a screening test. Yes, I also know that I said the big C word cancer, right? And obviously that freaks people out. But let me explain the PAP screens for pre cancerous changes as well as cancer of the cervix. The overwhelming majority of the time. It will detect either nothing or a pre cancerous change, meaning that you do not have cancer. I repeat, you do not have cancer. Thes pre cancerous changes, meaning before cancer on the cervix are either high grade or low grade changes. Guess how high grade changes closer to outright cervical cancer than a low grade change, But it's still usually takes many, many years to become cervical cancer. But we'll get to that. These high or low grade changes that the PAP can detect are caused by a virus called the human papilloma virus or more more commonly known as HPV. This virus could be tested for on a pap, along with testing for the cervical pre cancerous changes. Now HPV is a sexually transmitted disease. It's one that you can get even if you wear a condom. Um, it can be transmitted even on the fingers, so you know that something definitely to be aware of this is why it makes sense that about 80% of people in the country have all had it at one time or another. So why doesn't everyone, you know have cervical cancer? This is what I'm trying to tell you not to freak out about the C word in this case, at least not yet on Lee, a small factor of those infected with HPV develop cervical cancer. That's because most HPV infections are transient, meaning that they go away. We're talking 80 to 90% of those people that have HPV haven't go away on its own, similar to how the body clears a cold and that high percentage of people that clear the virus even refers to those that have high grade changes. But if the infection persists for one, maybe two years, there's a higher risk of significant disease, and more things need to be done. Most people who get cervical cancer are those that were never screened with a pap or were inadequately screened. Most of the time, this means that they did not follow up as their doctor recommended that thought to say that those who follow the path rules and follow up strictly never get cervical cancer. But it is more rare. So let's talk about how frequently you need to have a pap performed in general. The guideline is that young woman is to start getting Pap smears at the age of 21. Keep in mind that an initial visit to Europa Joy in should be before that age for other things such as routine checkups, pelvic exams, breast exams, whatnot. Women between the ages of 2129 will get a routine Pap smear every three years. Women between the ages of 30 and 65 will have testing done every 3 to 5 years, depending on the way your physician chooses to perform the test. It'll be every five years if your physician doesn't HPV test along with the General Pap smear and every three years, if they just do the PAP by itself. After the age of 65 if a woman has not had any history of high grade changes to her cervix or cervical cancer. And she has also had three negative Pap smears in a row or two negative Paps mirrors that also had HPV testing done with them. You can stop having the test performed. I know that's a little complicated, but if you refer to my website f ve Onley dot com, it has some pictures and flow charts there to help supplement this episode so that you can have a more solid understanding of the general guidelines. These guidelines are for those that continue to have negative or normal Pap smears. Now, if you have abnormal paps mirrors and the high grade or low grade changes that we previously discussed, the timing and frequency of your Pap smears and additional follow up tests are gonna be very different to this Now. That's an individual and personal discussion that you need to have with your o. B. Joanne physician that knows your history. And that is the basic gist of how Pap smears are performed and why they're performed. Keep in mind that these are the screening guidelines. As of today, they have changed in the past and they're probably going to change again in the future. But as of today, this is the most up to date Pap screening guidelines for routine Pap smears. All right, guys, Thank you for listening. Thio Episode two of four vaginas on Lee The Pap smear Siri's as usual. Please don't forget to subscribe and rate this podcast. And I'm also on the lookout for your comments. In addition, you can go to f ve only dot com to get a little bit more information about Pap smears along with some pictures to help you follow along with this episode. And there's also a little bit on that website for you to get to know me and my day to day life style. Thanks again, guys. You are very much appreciated. See you in the next episode.